激素治疗是否会加剧静脉血栓塞栓症的其他危险因素?
Laura Porterfield, John W Davis1, Susan C Weller1
1Department of Population Health Science, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX.
Menopause (New York, N.Y.)
|January 25, 2024
概括
在绝经后的女性中,激素治疗 (HT) 构成静脉血栓栓塞 (VTE) 的轻微风险,癌症和手术等其他因素更为重要. 然而,组合激素避孕药具有相当大的VTE风险.
科学领域:
- 生殖医学 生殖医学
- 血管医学 血管医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 绝经后的症状在高危女性中往往没有得到充分的治疗,因为人们担心荷尔蒙疗法 (HT) 会增加静脉血栓塞栓症 (VTE) 的风险.
- 对于HT对VTE风险与其他已确定的风险因素的比较影响仍然不清楚.
研究的目的:
- 评估激素治疗 (HT) 使用与绝经后妇女静脉血栓栓塞 (VTE) 风险之间的关联.
- 将与HT相关的VTE风险与其他已知的风险因素进行比较.
主要方法:
- 从2007年到2019年使用商业索赔数据库的病例控制研究.
- 包括50-64岁的女性,病例定义为急性VTE诊断和相关的医疗干预或30天内死亡.
- 根据指数日期和年龄,对对照 (10:1) 与病例进行匹配,检查前一年内的风险因素和并发症.
主要成果:
- 转移性癌症 (OR,13.66) 和住院/手术 (OR,8.51) 是最重要的静脉瘤风险因素.
- 激素治疗 (HT) 显示了静脉瘤风险的适度增加 (OR,任何暴露的1.51),与未对抗雌激素 (OR,1.13) 和结合更年期HT (OR,1.23) 的特定风险.
- 与没有最近的HT暴露相比,组合激素避孕药呈现出明显更高的VTE风险 (OR,5.22).
结论:
- 激素疗法 (HT) 的使用似乎在静脉血栓塞栓症 (VTE) 风险中起到很小的作用,并且不会显著加剧其他风险因素.
- 组合激素避孕药被确定为VTE的强烈危险因素.
- 研究结果表明,HT可能是高风险女性管理更年期后症状的可行选择,前提是要仔细考虑其他风险因素.
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