Gürkan KIRAN, Alanur GÜVEN, Önder ÇELİK, Hakan KIRAN, Hasan Çetin EKERBİÇER, Nurhan KÖKSAL

Menopoz sonrası hormon replasman tedavisinin solunum fonksiyonları üzerine olan etkileri

Menopoz sonrası dönemde kullanılan hormon replasman tedavisi (HRT)'nin; başta kalp damar sistemi, meme dokusu, kemik dokusu, endometrium, menopoza/ semptomlar ve cinsellik üzerine olan etkileri oldukça iyi bilinmektedir. Ancak HRTnin solunum fonksiyonları üzerine olan etkileri konusunda oldukça az sayıda çalışma mevcuttur. Biz bu çalışmamızda menopoz sonrası kullanılan HRTnin solunum fonksiyonlarına olan etkisini değerlendirdik. Bu amaçla çalışmaya alınan postmenopozal kadınlar iki gruba randomize edildi. Birinci gruptaki hastalara (n= 32) HRT tedavisi olarak 0.625 mg konjuge equine östrojen + 5 mg medroksiprogesteron asetat ve kontrol grubu olarak kabul edilen ikinci grup hastalara (n= 20) plasebo başlandı. Tüm olgulara tedavi başlamadan önce ve tedavinin üçüncü ayında aynı teknisyen tarafından solunum fonksiyon testleri (SFT) yapıldı. FVC, $FEV_1$, $FEV_1$/FVC, $FEF_{25-75}$ ve PEF parametreleri karşılaştırıldı. Her iki grup yaş, menopoz yılı ve vücut kitle indeksi (VKl) bakımından benzerdi (p> 0.05). FVC, $FEV_1$, $FEV_1$/FVC, $FEF_{25-75}$ ve PEF değerleri açısından, HRT ile plasebo grubu karşılaştırıldığında, başlangıç ve üçüncü ay değerleri arasında anlamlı fark bulunmadı (p> 0.05). HRT grubu içinde PEF'in başlangıç ve üçüncü ay değeri (4.42 ±2.6 ve 4.84 ±1.1) arasındaki fark istatistiksel olarak anlamlı bulundu (p= 0.023). Karşılaştırılan diğer SFT parametreleri arasında anlamlı fark gözlenmedi (p> 0.05). Sonuç olarak HRT kullanan postmenopozal kadınların SFT'lerinde bir obstrüksiyon parametresi olarak kullanılan PEF artışı gözlemlenmiştir. Menopozla birlikte solunum fonksiyonlarında olan değişiklikleri ve HRTnin solunum fonksiyonlarına olan etkilerini ortaya koyacak geniş kapsamlı ve prospektif çalışmalara ihtiyaç olduğunu düşünmekteyiz.

The effects of hormone replacement therapy on pulmonary functions in postmenopausal women

Although the effects of hormone replacement therapy (HRT) used after the menopause on the cardiovascular system, bone tissue, mammary gland, endometrium, menopausal symptoms and sexuality has been well known, there are uery few studies about the effects of HRT on the pulmonary functions. In this study, we evaluated the effects of HRT on the pulmonary functions. For this purpose the postmenopausal women were randomized into two groups, 0.625 mg conjugated equine estrogens + 5 mg medroxyprogesterone acetate as a HRT was given to the group I (n= 32), and placebo was given to the control group. Pulmonary function tests (PFT) were performed to the all cases by same technician before and three months after the treatment. FVC, $FEV_1$, $FEV_1$/FVC, $FEF_{25-75}$ and PEF parameters of the groups were compared. There were no statistically significant differences between the two groups considering the age, duration of the menopause and body mass index (BMI) (p> 0.05). There were no statistically significant differences between the groups considering FVC, $FEV_1$, $FEV_1$/FVC, and $FEF_{25-75}$ values of initial and the $3^{rd}$ months measurements (p> 0.05). But PEF levels of the HRT group were significantly different than the initial values three months after the treatment (4.42 ± 2.6 and 4.84 ± 1. 1) (p= 0.023). There were no statistically significant differences between the other compared parameters of PFT. As a result among the PFT parameters of the postmenopausal women taking HRT, PEF that was used as on obstruction parameter was found elevated. So, we concluded that more detailed and prospective studies were needed about the effects of HRT on PFT.

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