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多数研究支持动脉粥样硬化病变始于内皮损伤,且睾酮和双氢睾酮对内皮具有保护作用,雌激素可影响血脂变化,而对下肢动脉硬化病变的进展与安慰剂对比无差异。过去认为激素替代治疗对外周血管病有积极作用,但最近研究显示,性激素替代治疗有加重冠心病及诱发静脉血栓形成的危险。因此,对于激素替代治疗的具体使用已经达成共识:对于临床上需要采用激素替代治疗的患者,必须在临床医师指导下按照个体化方案进行。
Most studies support that atherosclerotic lesions start with endothelial injury and that testosterone and dihydrotestosterone have a protective effect on the endothelium. Estrogen may affect blood lipid changes, but there is no difference in the progression of arteriosclerosis in lower extremities compared with placebo. In the past that hormone replacement therapy has a positive effect on peripheral vascular disease, but recent studies have shown that sex hormone replacement therapy can increase the risk of coronary heart disease and induced venous thrombosis. Therefore, it has been reached a consensus on the specific use of hormone replacement therapy: For patients who need clinical hormone replacement therapy clinically, they must follow an individualized scheme under the guidance of a clinician.