【摘要】 本文探讨了雌激素尼尔雌醇对老年高血压妇女微量蛋白尿的影响 ,经 6个月治疗 ,发现与对照组相比 ,雌激素可明显减少患者的微量蛋白尿。此实验只是一种初步探索 ,并不意味着可以作为一种药物应用于临床治疗 ,目前已有数类药物—如血管紧张素转换酶抑制剂及血管紧张素受体阻滞剂已证实对糖尿病及非糖尿病肾病的微量蛋白尿有效 ,可用于临床。至于雌激素单用因可增加子宫内膜癌危险 ,采用雌激素加孕激素替代疗法 (HRT) ,经美国大系列研究结果显示HRT不能降低冠心病事件 ,并有增加静脉血栓栓塞和乳腺癌的危险 ,老年妇女需慎用。摘要　　目的 :探讨老年原发性高血压妇女微量蛋白尿与细胞黏附分子的关系 ,以及尼尔雌醇 (nilestriol)对它们的影响。　　方法 :已接受降压治疗的 4 1例老年原发性高血压妇女随机分为两组 ,A组 ( 2 1例 )加服尼尔雌醇 ,B组 ( 2 0例 )加服安慰剂 ,疗程为 6个月。正常对照组 2 4例。观察治疗前后尿转铁蛋白 (TRF)、尿视黄醇结合蛋白 (RBP)、P 选择素(P selectin)、E 选择素 (E selectin)和可溶性细胞间黏附分子 1 (sICAM 1 )的变化 ,并对TRF、RBP与sICAM 1进行相关性分析。结果 :4 1例原发性高血压患者TRF、RBP、P 选择素、E 选择素和sICAM 1明显高于正常对照组 (P <0 0 5～ 0 0 1更多还原

【Abstract】 Objective:To investigate the effects of nilestriol on microalbuminuria and cell adhesion molecules in aging hypertensive women. Methods:Forty one aging hypertensive women under antihypertensive treatment were randomly divided into groups A and B. Group A(n=21) was given additional nilestriol while group B(n=20) placebo for six months. Twenty four healthy subjects were set as the control group. Levels of urinary transferrin (TRF),retinol binding protein (RBP),P selectin,E selectin and soluble intercellular adhesion molecules 1(sICAM 1)were measured before and after treatment. Results:TRF,RBP,P selectin,E selectin and sICAM 1 were significantly higher in aging hypertensive women than those in the control group(p<0 05～0 01).TRF and RBP were decreased in both groups after six months treatment, but more significantly in group A (p<0 01)than in group B(p<0 05) P selectin,E selectin and sICAM l were also decreased in group A(p<0 01),but no change was found in group B.P selectin was positively correlated with TRF(γ=0 54,p<0 001)and RBP(γ=0 367,p=0 016).E selectin was positively correlated with TRF(γ=0 359,p=0 018).There was no correlation between sICAM 1 and TRF,RBP. Conclusions:Nilestriol can significantly decrease microalbuminuria in aging hypertensive women. This may be related to the decreased expression of P selectin, E selectin and sICAM 1.更多还原