更年期激素治疗和长期死亡率:全国范围的基于登记的队列研究
Anders Pretzmann Mikkelsen1,2, Thomas Bergholt3,4, Øjvind Lidegaard4,5
1Department of Gynaecology and Obstetrics, Copenhagen University Hospital Herlev, 2730 Herlev, Denmark anders.mikkelsen@regionh.dk.
BMJ (Clinical research ed.)
|February 18, 2026
概括
在丹麦的一项大型队列研究中,更年期激素治疗 (MHT) 的使用与全因死亡风险的增加无关. 研究结果表明,MHT对于整体死亡率来说是安全的,即使长期使用.
科学领域:
- 生殖医学 生殖医学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 更年期激素治疗 (MHT) 被广泛用于管理更年期症状.
- 人们仍然担心MHT对长期死亡率的影响.
- 需要强有力的证据来澄清MHT与全因死亡率之间的关联.
研究的目的:
- 调查更年期荷尔蒙治疗使用与全因死亡率之间的关联.
- 评估与MHT使用有关的特定原因死亡风险.
- 评估MHT对接受双边卵巢切除术的女性死亡率的影响.
主要方法:
- 全国范围,基于登记册的队列研究在丹麦.
- 包括出生于1950-1977年的女性,从45岁开始跟踪到2023年7月.
- 使用考克斯回归来估计死亡率的调整危险比率,控制众多共变量.
主要成果:
- 使用MHT与整体死亡风险比率略有降低 (0.96;95% CI 0.93-0.98) 相关.
- 在使用MHT的不同持续时间内没有观察到增加的死亡风险,而一些持续时间显示风险降低.
- 在接受双侧卵巢切除术的女性中,MHT使用与27-34%较低的死亡风险有关.
结论:
- 这项研究没有发现证据表明更年期激素治疗增加了全因死亡的风险.
- 研究结果表明,MHT与死亡率的增加无关,即使长期使用.
- 在特定的子组中,MHT可能与死亡率的降低有关,例如卵巢切除术后的妇女.
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