论文部分内容阅读
目的:研究经皮雌二醇(E2)凝胶对手术绝经妇女围绝经症状和T淋巴细胞分泌辅助性T细胞1(Th1)和辅助性T细胞2(Th2)型细胞因子的影响。方法:研究对象为手术绝经组,使用经皮E2凝胶(17β-E2,0.75 mg/d)3个月,用药前、后分别取外周静脉血分离T淋巴细胞,检测T淋巴细胞分泌干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)水平和IFN-γ/IL-4比值,检测外周血E2和卵泡刺激素(FSH)水平,评估围绝经症状和生存质量。生育年龄组检测外周血E2和FSH水平及T淋巴细胞分泌IFN-γ、IL-4水平和IFN-γ/IL-4比值。手术绝经组用药前、后进行自身比较,另以生育年龄组作为参考对象。结果:手术绝经组用经皮雌激素治疗(ET)后,E2水平较用药前明显升高(P<0.05);FSH水平较用药前有下降趋势,但差异无统计学意义(P>0.05);围绝经症状和生存质量均得到显著改善(P<0.01)。手术绝经组用ET前T淋巴细胞分泌IFN-γ和IL-4的水平均明显低于生育年龄组(P<0.05和P<0.01),IFN-γ/IL-4水平明显高于生育年龄组(P<0.01),呈现出Th1优势。手术绝经组用ET后IFN-γ较用药前显著下降(P<0.01),IL-4较用药前显著上升(P<0.01),IFN-γ/IL-4的水平较用药前显著下降(P<0.01),与生育年龄组无明显差异,显示了Th1/Th2趋于平衡。结论:经皮雌激素治疗能显著改善手术绝经妇女的围绝经症状,同时能使手术绝经妇女的Th1/Th2趋于平衡。
OBJECTIVE: To study the effects of percutaneous estradiol (E2) gel on perimenopausal symptoms and the secretion of T helper 1 (Th1) and T helper 2 (Th2) cytokines by T lymphocytes in postmenopausal women undergoing surgery. Methods: The study group was treated with percutaneous E2 gel (17β-E2, 0.75 mg / d) for 3 months. Peripheral venous blood was used to separate T lymphocytes before and after treatment. T lymphocytes were assayed for the secretion of interferon γ, IL-4 and IFN-γ / IL-4 ratio were measured to detect peripheral blood E2 and follicle stimulating hormone (FSH) levels, to evaluate the menopausal symptoms and quality of life. The level of E2 and FSH in peripheral blood and the ratio of IFN-γ, IL-4 secreted by T lymphocytes and IFN-γ / IL-4 ratio in the reproductive age group were detected. Menopause group before and after treatment compared with their own, while the other childbearing age group as a reference object. Results: After transdermal estrogen treatment (ET), the level of E2 in surgical menopause group was significantly higher than that before medication (P <0.05); FSH level was lower than that before medication (P> 0.05) ; Menopausal symptoms and quality of life were significantly improved (P <0.01). The levels of IFN-γ and IL-4 secreted by pre-ET T lymphocytes in the surgical menopause group were significantly lower than those in the reproductive age group (P <0.05 and P <0.01), and the levels of IFN-γ / IL-4 were significantly higher than those in the reproductive age group (P <0.01), showing a Th1 advantage. The levels of IFN-γ in postmenopausal group were decreased significantly (P <0.01), the level of IL-4 was significantly increased (P <0.01) and the level of IFN-γ / IL-4 was significantly decreased <0.01), no significant difference with the reproductive age group, showing that Th1 / Th2 tends to balance. CONCLUSIONS: Percutaneous estrogen therapy can significantly improve perimenopausal symptoms in menopausal women undergoing surgery and at the same time balance Th1 / Th2 in postmenopausal women.