药物使用和更年期激素治疗:美国艾滋病毒感染和没有艾滋病毒感染的妇女的治疗开始和中断,2008-2019年
Andrea K Knittel1, Brooke W Bullington2,3, Andrew Edmonds2
1Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
概括
在患有中度至重度血管运动症状 (VMS) 的女性中,更年期激素治疗 (MHT) 的启动率较低,特别是那些使用烟草或其他药物的女性. 不管药物使用史,MHT断裂是常见的.
科学领域:
- 生殖内分泌学和妇女健康.
- 临床药理学和物质使用研究.
- 公共卫生和更年期流行病学.
背景情况:
- 血管运动症状 (VMS) 对绝经前和绝经后妇女的生活质量产生重大影响.
- 更年期激素治疗 (MHT) 是一种有效的治疗VMS,但它的启动和坚持有所不同.
- 药物使用可能会影响妇女健康的医疗保健决策和治疗结果.
研究的目的:
- 为了比较绝经期和绝经后妇女与中度至重度的血管运动症状 (VMS) 的绝经期激素治疗 (MHT) 启动率.
- 检查物质使用 (当前和过去) 与MHT启动和中断之间的关联.
- 分析这些模式在一个多元化的美国妇女队列,包括那些有和没有艾滋病毒.
主要方法:
- 长度队列研究使用来自妇女机构间艾滋病毒研究 (10/2008-9/2019) 的数据.
- 基于目前或过去的物质使用,与中度至重度VMS的女性之间的MHT启动和中断进行比较.
- 使用波桑回归计算MHT使用的调整率比率 (RR),控制人口和健康变量.
主要成果:
- 这项研究包括1579名女性 (平均年龄50岁,73%的艾滋病毒感染者,68%的黑人) 患有中度至严重的VMS.
- MHT启动率为3.53/100人年;目前的烟草使用 (RR:0.67) 和曾经使用其他药物 (RR:0.61) 与较低的启动率有关.
- MHT断裂发生率很高 (100人/年52.58人),并且与物质使用无关.
结论:
- 在这种中度至重度VMS的女性队列中,MHT启动率很低,而MHT断裂率很高.
- 目前的烟草使用和过去使用其他药物与减少MHT启动有关.
- 关于MHT使用的临床指南应考虑患有VMS的绝经前和绝经后妇女的物质使用史.
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