【摘要】 目的 :验证微粉化 1 7β-雌二醇 ( E2 )阴道片剂治疗绝经后泌尿生殖道雌激素缺乏症状的疗效及安全性。方法 :61例主诉为泌尿生殖道雌激素缺乏症状的绝经后妇女 ,经阴道用微粉化 1 7-β E2 片剂 2 5μg,前 2周每日上药 1次 ,后改为每周 2次 ,疗程为 8周。分别于用药前、用药 2周及用药 8周评估症状及体征、阴道涂片成熟值 ( MV)及核致密指数( KPI)。阴道超声检查子宫内膜厚度 ,血 E2 、谷丙转氨酶 ( AL T)及血尿常规。结果 :经阴道给药后 ,阴道症状消失率为 84%～ 1 0 0 % ,泌尿道症状消失率为 62 %～ 95 % ;阴道健康评分、MV、KPI显著升高。阴道健康评分分别为用药前 7.3 0± 1 .60 ,用药 2周后 1 3 .90±1 .5 0 ,用药 8周后 1 4.1 0± 1 .3 5 ( P均 <0 .0 5 ) ;MV分别为 42 .3 0± 1 3 .0 0、5 3 .90± 4.1 0及5 1 .90± 4.70 ( P均 <0 .0 5 ) ;KP分别为 ( 0 .1 1± 0 .5 0 ) %、( 8.3 6± 9.2 1 ) %及 ( 5 .5 5±8.80 ) % ( P均 <0 .0 5 )。血 E2 水平显著上升 ,分别为 ( 1 3 .2 0± 6.2 0 )、( 2 8.80± 1 9.60 )及( 1 7.40± 1 0 .2 0 ) pg/ ml( P均 <0 .0 5 ) ,但仍处于绝经后水平 ,子宫内膜厚度无显著变化 ;AL T及血尿常规皆正常。结论 :微粉化 1 7β-E2 片剂能安全有效地治疗绝经后泌尿生殖道雌?更多还原

【Abstract】 Objective: To evaluate the efficacy and safety of micronized 17 β estradiol transvaginal suppository (Vagifem) in the treatment of postmenopausal urogenital estrogen deficiency symptoms (UEDS). Methods: sixty one postmenopausal women with UEDS were treated by Vagifem. The initial dose was 25 μg daily at night for 2 weeks followed by 25 μg twice per week for further 6 weeks. Their symptoms, vaginal health score(VHS), maturation value(MV) and karyopyknotic index (KPI)of vaginal cytology, serum estradiol levels,endometrium thickness, liver function and blood routine, urine routine were evaluated and compared before treatment and at 2 week, 8 week after treatment. Results: After treatment, vaginal symptoms disappeared in 84%~100% cases while urinary symptoms in 62%~95% cases. The VHS, MV, KPI elevated significantly. Serum E 2 levels increased from (13 2±6 2)pg/ml to (28.8±19.6) pg/ml(2 week)( P<0.05 ) and (17.4±10.2) pg/ml (8 week)( P<0.05 ), which is still within the postmenopausal range. Endometrium thickness did not change significantly. Liver function and blood routine, urine routine remained in the normal range. Conclusion: Vagifem is an effective and safe choice in the treatment of UEDS. It shows no any stimulative effect on the endometrium, therefore a combination with progestin is unnecessary.更多还原