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雌激素治疗对胆囊疾病的影响
Dominic J Cirillo1, Robert B Wallace, Rebecca J Rodabough
1Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, USA.
JAMA
|January 20, 2005
概括
绝经后使用雌激素治疗的妇女,包括结合性马类雌激素 (CEE) 和雌激素加孕激素 (E + P),面临明显增加的胆囊疾病风险,包括胆囊炎和胆病.
科学领域:
- 内分泌学 在内分泌学.
- 胃肠病学 胃肠病学
- 妇女健康 妇女健康
背景情况:
- 雌激素治疗通常与胆结石形成和胆囊炎有关.
- 现有的数据主要来自观察性研究,缺乏随机试验的严格性.
研究的目的:
- 研究雌激素治疗对健康绝经后妇女胆囊疾病结果的影响.
- 从随机对照试验中提供关于雌激素对胆道健康影响的证据.
主要方法:
- 两项大型,随机,双盲,安慰剂对照试验,涉及超过22,000名绝经后妇女.
- 参与者接受了结合性马类雌激素 (CEE) 或雌激素加孕激素 (E + P) 或安慰剂.
- 胆囊疾病的事件和程序被跟踪和分析使用Cox比例危险回归.
主要成果:
- 雌激素治疗显著增加了任何胆囊疾病或手术的风险 (HR为CEE的1.67,E + P的1.59).
- 胆囊炎 (CEE的HR为1.80,E + P的1.54) 和胆病 (CEE的HR为1.86,E + P的HR为1.68) 的风险更高.
- 雌激素使用者更有可能接受胆囊切除术.
结论:
- 使用雌激素治疗的绝经后妇女表现出胆道疾病的风险较高.
- 增加的发病率和相关成本需要在开出雌激素治疗时仔细考虑.
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