作者在本文中叙述雌激素替代治疗对预防因雌激素缺乏的远期影响,主要是介绍对预防骨质疏松和原发性心血管疾患的益处。同时对替代治疗的危险性加以讨论。骨质疏松症与骨密度逐渐减少有关,骨密度随年龄增长而降低,因骨吸收超过新骨形成,这种变化在绝经后加速。绝经期开始骨小梁每年丢失5%;其后每年约丢失1%左右,卵巢功能丧失是骨质疏松最主要的因素。雌激素替代治疗能预防绝经期后的骨丢失与骨质疏松,即使已经形成了骨质疏松,也可预防其进一步骨丢失,甚至还能增加骨密度。当替代治疗撤消时,骨丢失可能再现,但也只是与治疗前速率相同。理想的是,治疗从绝经后即开 The authors describe in this article the long-term impact of estrogen replacement therapy on prevention of estrogen deficiency, focusing on the benefits of prevention of osteoporosis and primary cardiovascular disease. At the same time, the risk of alternative treatment is discussed. Osteoporosis is associated with a gradual decrease in bone mineral density, which decreases with age, as bone resorption exceeds new bone formation and this change is accelerated after menopause. Trabecular bone loss at the beginning of menopause 5% every year; then lost about 1% each year, loss of ovarian function is the most important factor of osteoporosis. Estrogen replacement therapy can prevent bone loss and osteoporosis after menopause, even if it has formed osteoporosis, but also prevent further bone loss, and even increase bone mineral density. When replacement therapy is withdrawn, bone loss may recur, but only at the same rate as before treatment. Ideally, treatment starts after menopause