※ 引述《ckkboy (.....)》之銘言：
: p6寫說 estrogen搭配progestin可減低endometrial carcinoma的危險性
: 但是兩個一起使用會有其他很多的危險
: "The WHI results tell us that during 1 year, among 10,000 postmenopausal
: women with a uterus who are taking estrogen plus progestin, 8 more will
: have invasive breast cancer, 7 more will have a heart attack, 8 more will
: have a stroke, and 18 more will have blood clots, including 8 with blood
: clots in the lungs, than will a similar group of 10,000 women not taking
: these hormones.
: 原始論文
: Writing Group for the Women's Health Initiative Investigators.Risks and
: benefits of estrogen plus progestin in healthy postmenopausal women:
: principal results from the Women's Health Initiative randomized controlled
: trial. JAMA 288, 321-333 (2002)
謝謝冠博的補充 ^^
附上課本關於endometrial carcinoma部分的原文
Exogenous Estrogens(Harrison P.414)
"Unopposed estrogen therapy increases the risk of endometrial carcinoma
threefold to sixfold after 5 years of use and more than tenfold after
10 years, compared with the risk in womwn who had not used hormones.
The risk is drastically reduced or even eliminated when progestins are
added to the therapeutic regimen."
Oral Contraceptives(Harrison P.415)
"There is no increased risk, and oral contraceptives probably exert
a protective effect."
estrogen跟progestin兩者合併使用本來就可能有其他許多潛在危險性
比如冠博引的那篇paper提到關於乳癌 心血管疾病 血栓等等
這些可以參考共筆口服避孕藥的部分(原理接近 都是兩種激素合併使用)
但是有幾點是需要考慮的：
1.一般此類研究都是cohort study 不同的研究報告可能得到截然不同的結論
這跟實驗設計以及取樣方法有關
2.兩者合併使用時 兩者之間的比例 個別的劑量 都可能會影響研究結果
也就因為與各種疾病的相關性大小尚有爭議
所以我是認為去瞭解原理可能會比記那些結論更重要一點^^"
給大家參考囉~
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