本文選題：絕經(jīng)激素治療 + 動脈粥樣硬化　； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:彩色超聲觀察絕經(jīng)激素治療(menopause hormone therapy,MHT)對女性頸動脈內(nèi)膜中層增厚及相關(guān)因素影響,了解MHT對頸動脈內(nèi)膜增厚及斑塊的影響作用。方法:選擇2011年12月至2014年12月就診我院婦科內(nèi)分泌門診,有子宮和至少一側(cè)卵巢,自然絕經(jīng)有絕經(jīng)后癥狀且從未接受過MHT的40-60歲女性,按個人意愿選擇不同治療方法,分為接受MHT(周期序貫或連續(xù)聯(lián)合)治療的68例為觀察組,未治療組87例為對照組。觀察兩組患者兩年治療前后的臨床資料并進行比較。測量患者體質(zhì)量(身高、體重)、血壓,檢測血脂四項和空腹血糖,選用彩色超聲觀察雙側(cè)頸動脈內(nèi)膜中層厚度及斑塊形成情況,并采用Crouse積分對斑塊進行定量分析。結(jié)果:(1)觀察組和對照組入組時平均年齡分別為(50.8±3.1、49.6±3.8)歲,兩組患者入組時臨床資料比較差異無統(tǒng)計學(xué)意義(p0.05),組間具有可比性。治療2年后,觀察組的頸動脈異常率為20.59%(14/68),Crouse積分為1.71±0.22,對照組分別為40.23%(35/87)、2.22±0.65,兩組比較差異有統(tǒng)計學(xué)意義(p0.05)。兩組間收縮壓(SBP)、總膽固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、空腹血糖(FPG)比較差異有統(tǒng)計學(xué)意義(p0.05),觀察組SBP、TC、LDL和FPG明顯低于對照組,HDL高于對照組,兩組間舒張壓(DBP)、體重指數(shù)(BMI)、總甘油三脂(TG)比較差異無統(tǒng)計學(xué)意義(p0.05)。(2)觀察組治療前后各觀察指標(biāo)比較差異均無統(tǒng)計學(xué)意義(p0.05);對照組隨訪2年后患者SBP、TC、LDL水平均大于入組時,且差異有統(tǒng)計學(xué)意義(p0.05)。結(jié)論:(1)兩年MHT治療組頸動脈異常增加量明顯少于未治療組,斑塊進展速率低于未治療組,MHT可能能延緩頸動脈內(nèi)膜中層增厚及斑塊形成速率,延緩動脈粥樣硬化形成;(2)觀察組治療兩年后血壓、血脂等較入組時有降低趨勢,但無統(tǒng)計學(xué)意義,可能與觀察年限較短有關(guān),對照組SBP、TC、LDL水平較兩年前升高,動脈粥樣硬化的危險因素增加,MHT可能能減緩動脈粥樣硬化危險因素進展。
[Abstract]:Objective: to observe the effect of menopausal hormone therapy on carotid intima-media thickening and its related factors, and to understand the effect of MHT on carotid intimal thickening and plaque. Methods: from December 2011 to December 2014, 40 to 60 years old women with uterus and at least one ovary, who had postmenopausal symptoms and had never received MHT, were selected to choose different treatment methods according to their personal wishes. The patients were divided into observation group (n = 68) and untreated group (n = 87). The clinical data before and after two years treatment were observed and compared between the two groups. Body mass (height, weight, blood pressure, blood lipid and fasting blood glucose) were measured. Color ultrasound was used to observe the intima-media thickness and plaque formation of bilateral carotid artery. The plaque was quantitatively analyzed by Crouse score. Results the mean age of the observation group and the control group were 50.8 鹵3.1 鹵49.6 鹵3.8 years old, respectively. There was no significant difference in clinical data between the two groups. After 2 years of treatment, the abnormal rate of carotid artery in the observation group was 20.5914 / 68% and the Crouse score was 1.71 鹵0.22, which was significantly higher than that in the control group (40.23% / 87% 2.22 鹵0.65). There was a significant difference between the two groups (p 0.05). The systolic blood pressure (SBP), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), fasting blood glucose (FBG) in the two groups were significantly higher than those in the control group (P 0.05). The levels of FPG and FPG in the observation group were significantly lower than those in the control group. There was no significant difference in DBP, BMI, TGG between the two groups before and after treatment. There was no significant difference between the two groups before and after treatment, and in the control group, the levels of SBPnTCfU LDL were higher than those in the control group after 2 years of follow-up, and there was no significant difference between the two groups before and after treatment, and the levels of SBPnTCfLDL in the control group were higher than those in the control group after 2 years follow-up. The difference was statistically significant (P 0.05). Conclusion the abnormal increase of carotid artery in the MHT treatment group was significantly lower than that in the untreated group for two years, and the plaque progression rate was lower than that in the untreated group, which might delay the carotid intima-media thickening and plaque formation rate. After two years of treatment, the blood pressure and blood lipid in the observation group were lower than those in the control group, but there was no statistical significance, which might be related to the shorter period of observation, and the level of TCU LDL in the control group was higher than that of the control group two years ago. Increased risk factors for atherosclerosis may slow down the progression of atherosclerosis risk factors by MHT.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R711.75

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