关于激素替代疗法的长期影响的随机试验证据
Valerie Beral1, Emily Banks, Gillian Reeves
1Cancer Research UK Epidemiology Unit, Gibson Building, Radcliffe Infirmary, Oxford OX2 6HE, UK.
Lancet (London, England)
|October 2, 2002
概括
绝经后妇女使用激素替代疗法 (HRT) 会增加患乳腺癌,中风和肺栓塞的风险,同时降低结直肠癌和骨骨折的风险. 总体而言,风险超过了好处,特别是在健康的妇女身上.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在瘤学瘤学.
- 心血管医学 心血管医学
背景情况:
- 在绝经后的女性中,激素替代疗法 (HRT) 的使用量有所增加.
- 开始进行随机试验,以评估HRT对癌症和心血管疾病的长期影响.
- 妇女健康倡议试验的提前结束需要对现有证据进行审查.
研究的目的:
- 审查随机试验中关于HRT对绝经后妇女的影响的证据.
- 分析HRT对主要健康结果的影响,包括癌症和心血管事件.
主要方法:
- 分析了四项涉及超过2万名女性的随机试验.
- 平均随访时间为4.9年.
- 对于各种健康终点,HRT使用者与非使用者的比较.
主要成果:
- 对于HRT使用者来说,乳腺癌,中风和肺栓塞的发生率显著增加.
- HRT使用者显著减少了结直肠癌和股骨部部骨折的发生率.
- 没有观察到子宫内膜癌或冠状动脉心脏病率的显著变化.
结论:
- 联合HRT在健康的绝经后妇女中造成重大疾病的净风险过多.
- 需要对单独使用雌激素的HRT进行未来的研究,而组合HRT的数据将有限.
- 观察性研究对于理解更罕见的HRT效应和特定激素影响至关重要.
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