【摘要】 目的:研究经皮雌二醇凝胶对手术绝经妇女的凝血功能、血脂、T淋巴细胞凋亡的影响。方法:选取手术绝经、自然绝经1～5年内以及生育年龄妇女各15例,采外周静脉血检测,并分离出T淋巴细胞,用流式细胞术检测细胞凋亡率。手术绝经组共有13例使用经皮雌二醇凝胶治疗3个月,用药前后采外周静脉血检测,并采用"改良Kup-perman评分法"和"绝经期生存质量量表"评估围绝经症状和生存质量。结果:手术绝经和自然绝经妇女的血清E2水平显著低于生育年龄组,FSH水平显著高于生育年龄组(P<0.01),T淋巴细胞凋亡率显著高于生育年龄组(P<0.05)。手术绝经组用经皮雌二醇凝胶治疗3个月后,血清E2水平从(8.38±9.49)pg/ml升至(27.23±24.11)pg/ml(P<0.05),改良Kupperman评分从(19.46±6.70)降至(14.46±4.46)、绝经期生存质量量表评分从(37.31±8.92)降至(23.77±9.69)(P均<0.01);活化部分凝血酶时间从用药前(24.85±1.77)s升至(28.31±3.43)s(P<0.05);甘油三酯水平从(2.56±0.90)mmol/L降至(1.78±0.96)mmol/L、低密度脂蛋白水平从(2.99±0.72)mmol/L降至(2.73±0.58)mmol/L(P均<0.05),T淋巴细胞凋亡率从用药前(14.89±2.28)%降至(13.96±2.38)%,但差异无统计学意义(P>0.05)。结论:经皮雌激素治疗(ET)显著升高了手术绝经妇女血清E2水平,显著改善了围绝经期症状和生存质量,并且凝血功能和脂代谢也有一定的改善。经皮ET有降低手术绝经妇女T淋巴细胞凋亡的趋势,提示低剂量ET可能有保护免疫功能的作用。更多还原

【Abstract】 Objective:To investigate the clinical effect of transdermal estradiol gel on surgically postmenopausal women.Methods:15 healthy women who have undergone total hysterectomy and bilateral salpingo-oopherectomy within 1 to 5 years were chosen as the experimental group;15 naturally menopausal women and 15 young women were chosen as control groups.Peripheral vein blood were collected and detected.T lymphocytes were separated and apoptosis rates were detected using Flow Cytometry.There were 13 women in the surgically menopausal group who finished 3 months of transdermal estrogen therapy(ET),whose menopausal complaints and life quality were evaluated by "Improved Kupperman index" and "menopause-specific quality of life questionnaire" before and after ET.Results:After ET,the serum E2 levels of surgically menopausal group was(27.23±24.11)pg/ml,higher than(8.38±9.49)pg/ml of before(P<0.05).The "Improved Kupperman index" and "menopause-specific quality of life questionnaire" were scored lower respectively(P<0.01).APTT was upleveled from(24.85±1.77)s to(28.31±3.43)s(P<0.05),TG and LDL levels decreased from(2.56±0.90)mmol/L to(1.78±0.96)mmol/L and(2.99±0.72)mmol/L to(2.73±0.58)mmol/L,respectively,compared to those of before significantly(P<0.05).The T lymphocyte apoptosis of surgically menopausal group were decreased after ET,but the difference was not significant.Conclusions:Transdermal ET significantly improve menopausal symptoms and life quality of surgically menopausal women.It also has positive effects on lipid metabolism and coagulation function.Transdermal ET can decrease the T lymphocyte apoptosis,although the difference is not significant,indicating that low dose of transdermal ET may have a protective effect on menopausal women’s immune function and aging.更多还原