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目的观察替勃龙治疗对绝经后妇女更年期症状及颈动脉和椎动脉I MT和RI的影响。方法有更年期症状的绝经后妇女138例,随机分为治疗组(替勃龙2.5 mg/d)和对照组。替勃龙治疗前及治疗2 a后询问病史,按改良Kupperman评分,并检测血TC、TG、HDL-C、LDL-C及颈动脉I MT,颈动脉、椎动脉的RI。结果 129例完成观察和治疗。替勃龙治疗2 a后血TC显著降低(P<0.05),LDL-C和Lp(a)极显著降低(P<0.01),HDL-C略有降低(P>0.05)。替勃龙治疗2 a CCA的I MT下降26.7%(P<0.01)。CCA的RI从0.72±0.06下降到0.68±0.06,ICA的RI从0.59±0.05至0.56±0.05,VA的RI从0.66±0.06下降到0.62±0.04(P<0.05)。ECA的RI下降不明显(P>0.05)。结论替勃龙可改善更年期症状,并降低胆固醇、LDL和Lp(a),颈动脉RI,颈动脉内I MT厚度,对动脉粥样硬化有预防作用。
Objective To observe the effects of tibolone on the menopausal symptoms and the I MT and RI of carotid artery and vertebral artery in postmenopausal women. Methods 138 postmenopausal women with menopausal symptoms were randomly divided into treatment group (2.5 mg / d) and control group. Tibolone treatment before treatment and 2 a after treatment history, according to improved Kupperman score, and detection of blood TC, TG, HDL-C, LDL-C and carotid I MT, carotid artery, vertebral RI. Results 129 cases completed the observation and treatment. After 2 weeks of tibolone treatment, blood TC decreased significantly (P <0.05), LDL-C and Lp (a) decreased significantly (P <0.01) and HDL-C decreased slightly (P> 0.05). I MT decreased by 26.7% (P <0.01) for CCA with tibolone for 2 years. The RI of CCA decreased from 0.72 ± 0.06 to 0.68 ± 0.06, the ICA RI decreased from 0.59 ± 0.05 to 0.56 ± 0.05, and the RI of VA decreased from 0.66 ± 0.06 to 0.62 ± 0.04 (P <0.05). The RI of ECA was not obvious (P> 0.05). Conclusion Tibolone can improve menopausal symptoms and reduce cholesterol, LDL and Lp (a), carotid artery RI, carotid artery I MT thickness, and prevent atherosclerosis.