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Vojnosanitetski pregled
2006, vol. 63, br. 4, str. 387-391
jezik rada: srpski
vrsta rada: originalan članak
objavljeno: 02/06/2007
doi: 10.2298/VSP0604387J
Efekat tibolona na faktore rizika za kardiovaskularne bolesti kod žena u postmenopauzi
Klinički centar Srbije, Klinika za ginekologiju i akušerstvo, Beograd

e-adresa: jeremicj@hotmail.com

Sažetak

Uvod/Cilj. Tibolon je preparat koji pripada grupi steroidnih supstancija. Efekti primene tibolona su posledica aktivnosti njegovih metabolita pri čemu njihova hormonska aktivnost zavisi od vrste tkiva u kome se stvaraju. Cilj rada je bio ispitivanje efekta primene tibolona na faktore rizika za nastanak kardiovaskularnih oboljenja kod žena u postmenopauzi. Metode. U prospektivnu studiju je uključeno 94 ispitanica koje su imale koncentraciju 17ß-estradiola < od 50 pg/ml i koje su bile u menopauzi bar jednu godinu. Od ukupnog broja, 63 ispitanice koje su prihvatile da primaju tibolon u dozi od 2,5mg na dan, činile su ispitivanu tibolon (T) grupu, dok je 31 ispitanica odbila da koristi supstitucionu terapiju i one su činile kontrolnu (K) grupu. Merene su koncentracije lipida (ukupni holesterol, LDL holesterol, HDL holesterol, trigliceridi), antitrombina III, fibrinogena i C-reaktivnog proteina (CRP) pre i posle terapije tibolonom koja je trajala šest meseci, a zatim je ispitivana statistička značajnost razlike u vrednostima posmatranih koncentracija. Ispitivane su i promene u vrednostima ispitivanih koncentracija u kontrolnoj grupi žena. Rezultati. Kod 31 ispitanice u postmenopauzi koje su činile kontrolnu grupu, nije došlo do značajnije promene vrednosti definisanih parametara u odnosu na njihove početne vrednosti, tokom posmatranog perioda. Kod ispitanica kod kojih je primenjen tibolon došlo je do značajnih promena u vrednostima posmatranih parametara (p < 0,001) tokom perioda od šest meseci, kao što je smanjenje vrednosti ukupnog holesterola za 17,8%, smanjenje vrednosti HDL holesterola za 27%, smanjenje vrednosti LDL holesterola za 4% (bez statističke značajnosti p > 0,05) uz smanjenje vrednosti triglicerida za 35%. Nije uočena statistička značajnost u promeni koncentracije antitrombina III, fibrinogena i CRP nakon primene tibolona. Zaključak. Primena tibolona dovodi do smanjenja vrednosti ukupnog holesterola, triglicerida, HDL holesterola, ne smanjujući značajno vrednost LDL holesterola. Takođe primena tibolona ne utiče značajno na promene koncentracije fibrinogena, antitrombina III i CRP. Broj serumskih parametara merenih u ovoj studiji je ograničen, zbog čega se može diskutovati samo o metabolizmu lipida, dok definitivni zaključak o riziku za nastanak kardiovaskularnih oboljenja tokom primene tibolona zahteva dalja klinička istraživanja.

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