谢梅青;谢小倩;
XIE Mei-qing;XIE Xiao-qian;Department of Obstetrics and Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University;

• 1:中山大学孙逸仙纪念医院妇产科

摘要(Abstract)：

绝经激素治疗(menopausal hormone therapy, MHT)是对卵巢功能衰退的女性进行外源性雌激素补充以解决与雌激素不足相关的健康问题,MHT对于缓解绝经症状、防治泌尿生殖道萎缩相关疾病和预防骨质疏松的获益是毋庸置疑的。近80年来,医学界对MHT获益与风险的认识经历了跌宕起伏、崎岖发展的过程。特别是21世纪初美国大型前瞻性随机对照研究"妇女健康倡议(Women's Health Initiative, WHI)"中期研究报告的发布,对全球MHT的应用产生了巨大震动,该项研究报告了老年女性使用MHT过程中心脑血管疾病事件及乳腺癌的发生风险升高,在2002年之后的18年里,医学界对MHT获益与风险的再评估从未停止过。目前,较为统一的认识是MHT的获益与风险与多种因素相关,包括启用MHT的年龄,绝经年限,性激素的种类、剂量、使用途径、用药时长,女性的基础健康状况,MHT管理是否规范等。本文参考过去10年内全球颁布的各项MHT指南、共识和发表的重要文献,对MHT的获益与风险进行论述。
Menopausal hormone therapy(MHT) is a supplemental treatment with exogenous estrogen for women with ovarian failure to solve health problems related to low sex hormone. It is no doubt that MHT is beneficial for relieving menopausal symptoms, treating genitourinary atrophy of menopause, and preventing osteoporosis. MHT has undergone nearly 80 years of development, and understanding of its benefits and risks has been changing over time. Particularly, the publication of the report of mid-term research of Women's Health Initiative that is a randomized controlled trial in 2002 largely influenced the application of MHT globally. It was reported that the use of conjugated equine estrogens(CEE) and medroxyprogesterone acetate(MPA) was associated with increased risks of cardiovascular disease and breast cancer in old women, which reencouraged the exploration of benefits and risks of MHT to menopausal women in the past 18 years. Today, it is widely accepted that the effects of MHT are related to several factors, including age at which MHT is started, age when menopause occurs, the type, dosage and route of MHT, duration of treatment, health status, and whether MHT is standardized and well-managed. This article discussed the benefits and risks of MHT based on various guidelines, consensus and articles on MHT published in the past ten years.

关键词(KeyWords)： 绝经激素治疗;获益;风险
menopausal hormone therapy;benefits;risks

Abstract:

Keywords:

基金项目(Foundation): 中华预防医学会科研资金支持项目“中国妇女盆底功能障碍防治专项”(201819126)~~

作者(Authors): 谢梅青;谢小倩;
XIE Mei-qing;XIE Xiao-qian;Department of Obstetrics and Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University;

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