雌激素加上孕激素和静脉血栓形成的风险
Mary Cushman1, Lewis H Kuller, Ross Prentice
1Department of Medicine, University of Vermont, Burlington 05446, USA. mary.cushman@uvm.edu
JAMA
|October 7, 2004
概括
绝经后使用雌激素加孕激素的激素治疗使静脉血栓形成的风险增加了一倍. 这种疗法还放大了与年龄,肥胖和V因子莱登突变相关的风险.
科学领域:
- 内分泌学 在内分泌学.
- 心血管健康 心血管健康
- 遗传学 是一个遗传学.
背景情况:
- 已知绝经后的激素治疗会增加静脉血栓形成的风险.
- 激素治疗与其他血栓形成风险因素的累积效应尚不清楚.
研究的目的:
- 介绍女性健康倡议雌激素加孕激素试验中静脉血栓发生率的最终数据.
- 在其他风险因素的背景下,研究激素治疗和静脉血栓症之间的关联.
主要方法:
- 这是一项双盲,随机对照试验,涉及50-79岁的16608名绝经后妇女.
- 随访5.6年,进行了一项嵌套病例对照研究,分析遗传变异.
- 参与者接受了结合性马类雌激素加上酸甲基或安慰剂.
主要成果:
- 静脉血栓发生在3.5/1000人/年与激素治疗相比1.7/1000人/年与安慰剂 (HR,2.06).
- 风险随着年龄显著增加 (HR 7.46对于70-79岁) 和BMI (HR 5.61对于肥胖女性).
- 因子V莱登突变显著放大了与激素治疗相关的血栓形成风险 (增加6.69倍).
结论:
- 雌激素加孕激素治疗大约会使静脉血栓形成的风险增加一倍.
- 激素治疗加剧了与老年,肥胖和V因子莱登突变相关的血栓形成风险.
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