那时和现在:我们从WHI中学到的东西
Irene Lambrinoudaki1, Eleni Armeni1,2, Nikoletta Milli1
1Second Department of Obstetrics and Gynaecology, University of Athens, Aretaieio Hospital, Athens, Greece.
The Journal of clinical endocrinology and metabolism
|December 11, 2025
概括
更年期激素治疗 (MHT) 提供骨折减少和潜在的心血管益处,当早期启动,但风险增加使用延迟. 个性化MHT决策考虑时间,配方和患者因素,以获得最佳结果.
科学领域:
- 内分泌学 在内分泌学.
- 妇科 妇科医生 妇科
- 预防医学 预防医学
背景情况:
- 妇女健康倡议 (WHI) 研究提供了关于更年期激素治疗 (MHT) 的关键数据.
- 了解MHT的长期风险和益处对于绝经后妇女的健康至关重要.
- 临床实践的不断发展需要对MHT复杂效应的最新见解.
研究的目的:
- 审查WHI关于更年期激素治疗 (MHT) 研究的关键发现.
- 提供对绝经后妇女MHT风险和益处的平衡评估.
- 突出目前临床决策的关键学习点.
主要方法:
- 我们对PubMed进行了全面的文献搜索.
- 关键词包括MHT,骨健康,心血管疾病,癌症和认知结果.
- 包括的研究包括临床试验,观察性研究和系统性审查.
主要成果:
- MHT (仅适用于CEE-MPA和CEE) 显著降低骨折风险,加上和维生素D.
- 心血管疾病的好处取决于时间:早期启动 (在60岁之前) 可能有保护作用,而晚期启动会增加风险.
- CEE-MPA增加了乳腺癌的风险;仅用雌激素治疗显示了非显著的降低. 这两种疗法都能减少结肠直肠癌.
- 早期MHT启动不会影响认知,但晚期启动会增加痴呆风险.
结论:
- WHI的发现强调了个性化和时间敏感的MHT处方.
- MHT的益处和风险受到配方,启动时间和患者特征的影响.
- 这些见解是当前和未来MHT临床指南的组成部分.
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