cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2012-4-42-51cardiovascular-1864Research ArticleЛЕЧЕНИЕTREATMENTСовременная комбинированная гормональная терапия у женщин в ранней постменопаузеModern combined hormonal therapy in early postmenopause womenМычкаВ. Б.MychkaV. B.

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victoria-mychka@yandex.ruКирилловаМ. Ю.KirillovaM. Yu.

аспирант отдела

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victoria-mychka@yandex.ruКузнецоваИ. В.KuznetsovaI. V.

профессор кафедры акушерства и гинекологии

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victoria-mychka@yandex.ruВойченкоН. А.VoychenkoN. A.

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victoria-mychka@yandex.ruФедоровичА. А.FedorovichA. A.

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victoria-mychka@yandex.ruНИИ кардиологии им. А. Л.Мясникова ФГБУ «Российский кардиологический научно-производственный комплекс» Минздравсоцразвития России, МоскваРоссияA. L. Myasnikov Research Institute of Cardiology, Russian Cardiology Scientific and Clinical Complex, MoscowRussian FederationГБОУ ДМО «Российская медицинская академия последипломного образования», МоскваРоссияRussian Medical Academy of Post-diploma Education, MoscowRussian FederationГБОУ ВПО «Первый Московский государственный медицинский университет им. И. М.Сеченова» Минздравсоцразвития России, МоскваРоссияI. M. Sechenov First Moscow State Medical University, MoscowRussian FederationГБОУ ВПО «Московский государственный медико-стоматологический университет» Минздравсоцразвития России, МоскваРоссияMoscow State MedicoStomatological University, MoscowRussian Federation2012200820121144251Copyright © Мычка В.Б., Кириллова М.Ю., Кузнецова И.В., Войченко Н.А., Федорович А.А., Балахонова Т.В., Прохорова Ю.В., Вышиванюк В.А., 20122012Мычка В.Б., Кириллова М.Ю., Кузнецова И.В., Войченко Н.А., Федорович А.А., Балахонова Т.В., Прохорова Ю.В., Вышиванюк В.А.Mychka V.B., Kirillova M.Y., Kuznetsova I.V., Voychenko N.A., Fedorovich A.A., Balakhonova T.V., Prokhorova Y.V., Vyshivanyuk V.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1864

Цель. Изучить эффекты применения комбинации эстрадиола с дроспиреноном (ДРСП) для заместительной гормональной терапии (ЗГТ) на кардиометаболические риски и субклиническое поражение сосудов у женщин в ранней постменопаузе. Материал и методы. Обследованы 84 пациентки в ранней постменопаузе, которые были разделены на две группы: группа женщин, которым по показаниям при согласии после стандартного обследования гинекологом назначалась ЗГТ, содержащая 1 мг 17 β-эстрадиола и 2 мг ДРСП (Анжелик). Вторую группу составили женщины, не принимающие ЗГТ. Определялись метаболические параметры, висцеральное ожирение (ВО), суточный профиль АД, степень выраженности вегетативных расстройств, толщина комплекса интима-медиа (ТКИМ) общей сонной артерии (ОСА), артериальная жесткость и состояние микроциркуляции (МЦ) исходно и через 12 мес. наблюдения. Результаты. ЗГТ обладает вегетокорректирующими эффектами, положительно влияет на липидный обмен, ТКИМ ОСА, артериальную жесткость, уменьшает выраженность ВО, обладает слабо выраженным антигипертензивным эффектом, а также увеличивает дилататорный резерв МЦ русла у пациенток в постменопаузе. Заключение. Низкодозированная комбинированная, гормональная терапия, содержащая ДРСП, может рассматриваться у определенной группы женщин в ранней постменопаузе при дифференцированном подходе к назначению.

Aim. To study the effects of hormone replacement therapy (HRT) with a combination of estradiol and drospirenone on cardiometabolic risk levels and subclinical vascular pathology among women in early postmenopause. Material and methods. In total, 84 women in early postmenopause, who had given informed consent and underwent a standard examination, were divided into two groups: Group I (with gynaecologist-confirmed indications for HRT with Angeliq (1 mg 17 β-estradiol and 2 mg drospirenone)) and Group II (no HRT). All participants underwent the assessment of metabolic parameters, visceral obesity, intima-media thickness (IMT) of common carotid arteries (CCA), arterial stiffness, and microcirculation (MC) status at baseline and 12 months later. Results. HRT demonstrated beneficial effects on autonomic regulation, lipid metabolism, CCA IMT, and arterial stiffness. It was also associated with a reduction in visceral obesity, some antihypertensive effect, and an increase in the MC dilatation reserve in postmenopausal women. Conclusion. Low-dose combined hormone therapy with drospirenone and estradiol could be recommended to a specific clinical group of women in early postmenopause.

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The authors declare that there are no conflicts of interest present.