血清性激素水平与老年男性冠心病关系及其对脂代谢的影响

The association between the serum gonadal hormone level and coronary artery disease in elder male and its influence on lipid metabolism

目的通过测定男性CHD患者血清睾酮、雌二醇含量和血脂水平,以探讨性激素在男性CHD发生、发展中的作用及可能机制。方法经冠脉造影证实男性患者72例(年龄62.45±8.90岁)为CHD组;正常对照组60例(年龄61.65±7.60岁)。CHD各亚组:其中稳定性心绞痛(SAP)组14例;不稳定性心绞痛(UAP)组28例;心肌梗死(MI)组16例;缺血性心肌病(ICM)组14例。测定血清雌二醇(E2)、睾酮(T)及血脂。结果①CHD组血清T水平明显低于正常对照组(P<0.05),E2/T明显高于正常对照组(P<0.05)。②CHD各亚组间比较,UAP组、MI组I、CM组E2/T明显高于SAP组(P<0.05)。③血清T水平与TC、LDL-C呈负相关(r分别为-0.487、-0.53,P<0.05);与HDL-C、apoAⅠ/apoB呈正相关(r分别为0.376、0.416,P<0.05)。结论血清T水平的降低、E2/T比值增高可能是男性CHD的独立危险因子,其机制可能与脂代谢紊乱有关;E2/T比值增高与老年CHD的严重程度有关。

Objective For further study of the pathogenesy of male gonadal hormone in the development of CHD by detect gonadal hormone and blood fat level in male coronary heart disease patients.Methods The sample take from 72 male patients with CHD(age 62.45±8.90) who at least have 1 coronary artery narrowed≥50%,and 60 health males as control group(age 61.65±7.60).We devide CHD group into 4 subsets.There are 14 patients in stable angina pectoris(SAP) group,28 patients in unstable angina pectoris(UAP) group,16 patients in myocardial infarction(MI) group and 14 patients in ischemic cardiomyopathy(ICM) group.we detect the serum of estradiol(E2)、testosterone(T) and blood fat.Results ①The serum testosterone level in patient of CHD group is obviously lower than control group(P<0.05);E2/T is obviously higher than control group(P<0.05).②E2/T of UAP、MI and ICM group is obviously higher than SAP group(P<0.05).③T and TC、LDL-C offer negative correlation(r=-0.487、-0.53 respectively,P<0.05);T and HDL-C、apoAⅠ/apoB offer positive correlation(r=0.376、0.416 respectively,P<0.05).Conclusion Low T level and the increase of E2/T will promote the disorder of lipid metabolism and the development of AS and CHD;the increase of E2/T has relation to the severity of CHD in old patient.