对于绝经后患者慢性疾病的初级预防,荷尔蒙疗法:美国预防服务工作组建议声明
, Carol M Mangione1, Michael J Barry2
1University of California, Los Angeles.
JAMA
|November 1, 2022
概括
在绝经后的患者中,预防慢性疾病的激素治疗没有净益处. 美国预防服务工作组建议不要为此目的使用雌激素或组合激素治疗.
科学领域:
- 生殖健康
- 预防医学
- 内分泌学
背景情况:
- 绝经意味着更年期的过渡期,
- 绝经后的人面临心血管疾病,癌症和骨质疏松症等疾病的高风险.
- 在绝经后的妇女中,经常考虑使用激素治疗来预防这些慢性疾病.
研究的目的:
- 评估全身激素治疗在绝经后预防慢性疾病的益处和危害.
- 更新2017年美国预防服务工作组 (USPSTF) 关于激素治疗的建议.
- 为了确定结果是否因年龄或激素治疗的时间而异.
主要方法:
- 一个系统的审查是由USPSTF委托.
- 该审查评估了全身激素治疗 (口服或通过皮肤) 作为慢性疾病的初级预防.
- 该审查考虑了无症状的绝经后患者进行激素治疗.
主要成果:
- 经过更年期,子宫完好后的雌激素和孕激素联合治疗没有显现任何净益处.
- 对于经过子宫切除的绝经后患者,仅用雌激素治疗也没有显现的净益.
- 这些发现具有中等的确定性.
结论:
- 在绝经后的个人中,USPSTF建议不要使用雌激素和孕激素组合来预防慢性疾病.
- 此外,USPSTF还建议不仅仅使用雌激素来预防经绝经后有过子宫切除病例的患者.
- 这些是"D"建议, 表明基于没有净收益的证据的强烈反对.
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