雄激素对高原地区老年男性脑梗死的影响

Effects of Androgen on Acute Cerebral Infarction in Elderly Men at High Altitude

目的探讨高原地区急性脑梗死(acute cerebral ischemic,ACI)与雄激素(androgen)水平的关系。方法采用放射免疫法检测高原地区(海拔2260m以上)男性ACI患者和对照组各60例血清睾酮、雌二醇(E2)、促红细胞生成素(EPO)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)和IL-6的水平。比色法检测甘油三脂(TG)、胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、载脂蛋白-A1(Apo-A1)和载脂蛋白-B(Apo-B)等含量。结果与对照组相比,高原地区男性ACI患者血清睾酮水平明显下降(P<0.01),血清E2水平无明显变化;ACI患者TG、LDL和Apo-B的含量增高,TC、HDL和Apo-A1含量无明显变化。病例组TNF-α、1L-1β和1L-6的水平明显高于对照组,EPO水平与对照组相比无统计学意义。相关性分析显示,男性ACI患者睾酮水平下降与TG、LDL、Apo-B、TNF-α、IL-1β和IL-6的水平间呈负相关,与E2、TC、HDL、Apo-A1和EPO相关不显著。结论低睾酮水平与高原男性ACI相关。雄激素水平的降低可能通过影响脂质代谢和参与炎症反应环节促进高原地区老年男性ACI的发生。

Objective To study the relationship between androgen levels and acute cerebral infarction(ACI) in elderly men at high altitude. Methods Serum levels of testosterone(T) and estradiol (E2)were determined in 60 elderly men with ACI and 60 healthy elderly men at high altitude (2260 m sea levels above). Serum levels of interleukin(IL)-1, IL-6, tumor necrosis factor(TNF)-α and erythropoietin (EPO) were measured by radioimmunoassay. We also measured the serum levels of triglyeride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high density lipoprotein (HDL), apolipoprotein (Apo)-A1 and Apo-B by colorimetry. Results (1) T was significantly lower in patients than in control subjects at high altitude (P<0.001). There was no statistical difference between patients and control subjects in E2, TC, HDL and Apo-A1 levels. Compared with control subjects, the levels of TG, LDL and Apo-B in patients were significantly higher (P<0.05). (2) Serum levels of IL-1β, IL-6 and TNF-α were increased significantly in patients when compared with control subjects. EPO remained no significant difference in two subjects at high altitude. (3) T was significantly negatively correlated with TG, LDL, Apo-B, TNF-α, IL-1 and IL-6. However, there was no correlated between E2, TC, HDL, Apo-A1, EPO and T. Conclusion These results support the idea that low T level is a risk factor of acute cerebral infarction in men at high altitude, maybe by influencing upon lipid metabolism and inflammation.