口服和透皮雌激素替代疗法与静脉血栓栓塞风险的差异关联
Pierre-Yves Scarabin1, Emmanuel Oger, Geneviève Plu-Bureau
1INSERM Cardiovascular Epidemiology Unit U258, Villejuif, France. scarabin@vjf.inserm.fr <scarabin@vjf.inserm.fr>
Lancet (London, England)
|August 21, 2003
概括
口服雌激素替代疗法 (ERT) 在绝经后妇女中显著增加静脉血栓栓塞 (VTE) 风险. 透皮ERT不会增加VTE风险,这表明它可能是一个更安全的替代方案.
科学领域:
- 生殖医学 生殖医学
- 心血管健康 心血管健康
- 药理学 药理学是指药理学的学科.
背景情况:
- 已知口服雌激素替代疗法 (ERT) 会增加绝经后妇女的血液凝结和静脉血栓栓塞 (VTE) 风险.
- 透皮ERT对血液静止的影响最小,但其血栓形成风险仍未得到充分研究.
研究的目的:
- 调查口服与透皮ERT给药途径对绝经后妇女静脉瘤风险的差异性影响.
主要方法:
- 在1999年至2002年期间,法国进行了一项多中心的,基于医院的病例控制研究.
- 招募了155名患有异常性静脉动脉栓塞 (肺栓塞或深静脉血栓塞) 的绝经后妇女和381名匹配的对照.
主要成果:
- 与非使用者相比,口服ERT使用者的VTE风险明显增加 (OR3.5;95%CI1.8-6.8).
- 与非使用者相比,穿皮ERT的使用者没有增加VTE风险 (OR 0.9;95% CI 0.5-1.6).
- 口服ERT使用者面临的VTE风险比通过皮肤ERT使用者高四倍 (OR 4.0;95% CI 1.9-8.3).
结论:
- 口服ERT与绝经后妇女的VTE风险增加有关.
- 透皮ERT似乎是关于血栓形成风险的更安全的替代方案.
相关概念视频
Heart Failure Drugs: β-Blockers
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Varicose Veins II: Diagnostic Studies and Interprofessional Care
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...


