폐경여성의 호르몬 치료가 사망률에 미치는 영향
Mortality Associated with Hormone Replacement Therapy in Postmenopausal Women
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초록
호르몬 치료의 궁극적인 결과로서 사망률의 감소에 관하여 현재까지 많은 논란이 있다. 대규모 전향적 코호트 연구에서는 교란 변수들을 보정한 이후에도 호르몬 치료를 시행한 경우가 시행하지 않은 경우에 비해 전체 사망률을 의미 있게 감소시켰다. WHI 연구결과의 두 번째 분석 (second analysis)에서는 호르몬 치료군에서 30%의 사망률 감소를 보고하였고, 과거의 관찰연구들도 이와 유사한 결과를 보여주었다. WHI 연구결과의 두 번째 분석을 포함한 메타분석에서는 젊은 폐경여성에서의 호르몬 치료는 사망률을 감소시키는 것으로 나타났다. 비록 득과 실에 대한 이해에 있어 엄청난 동요가 있어 왔지만 적어도 젊은 폐경여성에서의 호르몬 치료는 심혈관질환의 이환율 및 사망률을 줄이고 나아가 전체 사망률을 줄일 수 있을 것으로 생각된다.
Abstract
There was controversy about decrease in mortality as the eventual result of hormone replacement therapy (HRT). The reduction of mortality was known in large observational-cohort studies in women with HRT compared with non-HRT after correction of confounding factors. The second analysis of Women’s Health Initiative (WHI) results revealed that the 30% decrease in mortality was observed in HRT users. These findings resemble with the results of past observational studies. The meta-analysis including the second analysis of WHI results showed that HRT use in young menopausal women decrease the mortality. Although there was a chaos about the risk and benefit of HRT since the first announcement of WHI study in 2002, HRT in young menopausal women could decrease the morbidity and mortality related to coronary heart disease and stroke.
참고문헌 (15)
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