课件：更年期保健.ppt

* * * * * 女性荷尔蒙在30岁左右达到高峰，骨密度也在此时达到峰值，此时我们的骨骼是最健康的；30岁以后，女性荷尔蒙开始流失，骨质也开始逐渐丢失，每10年骨骼钙量丢失10% 。 由于女性荷尔蒙流失的速度大大快于男性，因此女性骨密度下降的速度也比男性快的多，到了绝经期，骨钙量只有40岁时的40%，绝大部分女性都会出现骨质疏松，容易骨折，影响生活质量。? 根据此规律，为延缓骨钙丢失和保护骨骼，除增加膳食钙摄入外，适量补充女性荷尔蒙也是有重要作用的 * * * 妇女绝经后, 动脉粥样硬化损伤加速进行, 心血管疾病的发病率较绝经前显著增加 Framingham 心脏研究: 2873名小于55岁的女性， 20年随访 1Kannel WB, Hjortland MC, McNamara PM, Gordon T. Menopause and risk of cardiovascular disease. The Framingham study. Ann Intern Med. 1976;85:447-452. 2Smeets-Goevaers CG, Lesusink GL, Papapoulos SE, et al. The prevalence of low bone mineral density in Dutch perimenopausal women: the Eindhoven Perimenopausal Osteoporosis Study. Osteoporos Int. 1998;8:404-409. * 女性荷尔蒙对心血管系统具有非常重要的益处 （按片中文字描述） * 动脉粥样硬化模拟进展图，如果早期开始HRT治疗，则可预防附壁血栓的形成，但如果55~65岁之后再开始应用HRT，其时附壁血栓已经形成，在应用后，由于血管壁的软化等作用，反而会造成栓子的脱落，导致患者在用药后1年内死亡率的增加 * 女性荷尔蒙对我们的智力也有影响 （按片中文字简要描述） 由此可见，女性荷尔蒙对我们的心理健康是多么重要 * * * This figure depicts the AD annual hazard for HT users, nonusers, and men. Women who used HT for 10 years or more had an AD risk similar to that of men. In contrast, HT nonusers had an annual hazard higher than that for women who used HT for 3 to 10 years, or for less than 3 years. The following slide looks at these findings in more detail. Hormone Replacement Therapy and Incidence of Alzheimer Disease in Older Women: The Cache County Study??Peter P. Zandi, PhD; Michelle C. Carlson, PhD; Brenda L. Plassman, PhD; Kathleen A. Welsh-Bohmer, PhD; Lawrence S. Mayer, MD; David C. Steffens, MD; John C. S. Breitner, MD; for the Cache County Memory Study Investigators . JAMA. 2002;288:2123-2129. Context??Previous studies have shown a sex-specific increased risk of Alzheimer disease (AD) in women older than 80 years. Basic neuroscience findings suggest that hormone replacement therapy (HRT) could reduce a womans risk of AD. Epidemiologic findings on AD and HRT are mixed. Objective??To examine the relationship between use of HRT and risk of AD among elderly women. Design, Setting, and Participants??Prospe