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用激素:女性绝经后睡眠呼吸障碍下降
http://www.100md.com 2001年7月26日 家庭医生医疗保健网
     路透社纽约健康消息 据《美国呼吸和急救医学杂志》近期报道,女性绝经期后采用激素替代疗法,发生睡眠呼吸障碍的危险性降较低。

    睡眠呼吸障碍又叫睡眠呼吸紊乱症,包括从打鼾到睡眠呼吸暂停的过程。睡眠呼吸暂停以睡眠时呼吸中断为特征,是在睡眠呼吸紊乱症中较严重的一种。在女性绝经前,睡眠呼吸障碍并不常见,但绝经后发生率升高。因为使用激素替代疗法是否可以减少绝经后妇女发生睡眠呼吸障碍尚有争议,研究人员进行了这项研究。

    为了确认女性睡眠呼吸紊乱症的发生率以分析其是否受激素替代疗法影响,研究人员调查了年龄介于20-100岁之间的1000位女性和700男性。总的来说,男性患睡眠呼吸暂停的可能性是女性的三倍多,睡眠呼吸暂停的发生率随着女性年龄的增加而增高,肥胖女性的发生率是一般女性的11.5倍。

    研究表明,绝经后女性睡眠呼吸障碍的发生率较绝经前为高。使用激素替代疗法可以彻底消除绝经前后发生率的差异。使用雌激素和孕激素激素联合治疗比单纯使用雌激素对女性的保护力更强。所有的资料表明,绝经是女性发生睡眠呼吸暂停的一个很重要的危险性因素。激素替代治疗看来可以降低其发生风险。
, http://www.100md.com
    专家们相信,激素替代疗法可以降低女性发生心脏病的危险。因为睡眠呼吸障碍可以引发高血压,激素替代疗法对呼吸障碍的治疗作用可能是它可以改善心脏健康的原因之一。然而,是否使用激素替代疗法目前仍有争议。因此,当一位妇女在决定是否使用激素替代疗法时,激素替代疗法对呼吸障碍的治疗作用只是应该考虑的因素之一。

    来源:《美国呼吸和急救医学杂志》

    Hormones May Help Breathing Problems During Sleep

    NEW YORK (Reuters Health) - Women who take hormone replacement therapy (HRT) after menopause face a lower risk of breathing problems during sleep--ranging from snoring to sleep apnea--compared with women not on hormones, a report suggests.
, 百拇医药
    Sleep-related breathing problems (called sleep-disordered breathing) seem to be uncommon among women before menopause, but whether using HRT after menopause reduces the likelihood of such problems is controversial, according to Dr. Edward Bixler, from Pennsylvania State University College of Medicine in Hershey, and his colleagues.

    To clarify sleep-disordered breathing rates among women and to see whether HRT affects those rates, the investigators examined 1,000 women and more than 700 men aged 20 to 100.
, http://www.100md.com
    Overall, men were more than three times more likely than women to have obstructive sleep apnea, a more severe form of sleep-disordered breathing. According to the report in the March issue of the American Journal of Respiratory and Critical Care Medicine, 1.2% of women and 3.9% of men had obstructive sleep apnea, a disorder marked by repeated interruptions in breathing during sleep.

    Obstructive sleep apnea rates were higher as women increased in age, the researchers note, and obese women faced 11.5 times the risk of having sleep apnea as women who were not obese.
, 百拇医药
    But while postmenopausal women had higher rates of sleep apnea than did premenopausal women, the use of HRT completely eliminated the difference in risk between these two groups.

    Hormone therapy containing both estrogen and progesterone provided better protection than HRT with only estrogen, the results indicate.

    ``These data combined indicate that menopause is a significant risk factor for sleep apnea in women and that hormone replacement appears to be associated with reduced risk,‘‘ Bixler and colleagues conclude.
, 百拇医药
    However, he told Reuters Health, ``the decision to employ HRT is a very controversial one. Thus, when a women is making the decision regarding HRT, this association is one additional piece (of information) that should be considered.‘‘

    HRT is believed to cut women‘s heart disease risk, which naturally rises after menopause. Since sleep-related breathing problems may trigger high blood pressure, the authors note, the effects of HRT on breathing problems may be one reason for its benefits to heart health.

    SOURCE: American Journal of Respiratory and Critical Care Medicine, http://www.100md.com


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