绝经后心肌梗死患者性激素与脂代谢的关系

Relation between sex hormone and lipid metabolism in postmenopausal women with myocardial infarction

目的:探讨绝经后心肌梗死患者性激素与脂代谢之间的关系。方法:利用放免法、免疫酶法、酶法分别检测绝经后心肌梗死组(30例)和绝经后对照组(30例)血中雌二醇、孕酮、睾酮、脂蛋白(a)、三酰甘油、总胆固醇、高密度脂蛋白胆固醇(highdensitylipoproteinchoesterol,HDL-C)、低密度脂蛋白胆固醇(lowdensitylipoproteinchoesterol,LDL-C)水平。结果:绝经后心肌梗死组雌二醇、雌二醇/孕酮、雌二醇/睾酮、HDL-C水平显著比绝经后对照组低(t=4.834,P<0.01;t=2.760,2.539,P<0.05),脂蛋白(a)、LDL-C、三酰甘油、总胆固醇水平犤(21.31±17.93)mg/L,(2.98±1.04),(1.63±1.44),(4.23±0.94)mmol/L犦明显比绝经后对照组高犤(13.52±13.04)mg/L,(2.15±1.19),(1.13±0.55),(3.50±1.36)mmol/L犦(t=2.279～2.884,P<0.05),雌二醇与脂蛋白(a)、LDL-C均呈负相关(r=-0.373,P<0.05;r=-0.635,P<0.01),与HDL-C呈正相关(r=0.378,P<0.05)。结论:绝经后心肌梗死患者存在明显的以雌二醇水平不足为主的性激素紊乱和脂代谢异常,脂代谢异常和血中雌二醇水平不足密切相关;血中雌二醇水平不足促进脂代谢异常,可能是绝经后妇女心肌梗死发生的重要原因之一。

AIM:To explore the relationship of sex hormone(SH) with lipid metabolism in postmenopausal women with myocardial infarction(MI). METHODS:The serum levels of E2 17β(E2),progesterone(P),testosterone(T),lipoprotein,triglycerides(TG),total cholesterol(TC),high density lipoprotein choesterol(HDL C) and low density lipoprotein choesterol(LDL C) were determined by using the techniques of radioimmunoassay,enzyme linked immunoadsordent assay(ELISA) and enzymatic method in postmenopausal Ml group(n=30) and postmenopausal control group(n=30),respectively. RESULTS:The blood levels of E2,E2/P,E2/T,HDL C in the postmenopausal MI group were significantly lower than those in the control group(t=4.834,P< 0.01;t=2.760,2.539,P< 0.05),while the levels of lipoprotein,LDL C,TG and TC[(21.31±17.93) mg/L,(2.98±1.04),(1.63±1.44),(4.23±0.94) mmol/L] were obviously higher than those in the control group[(13.52±13.04) mg/L,(2.15±1.19),(1.13±0.55),(3.50±1.36)mmol/L](t=2.279-2.884,P< 0.05).E2 was negatively related with lipoprotein and LDL C(r=-0.373,P< 0.05,r=-0.635,P< 0.01),and positively related with HDL C(r=0.378,P< 0.05).CONCLUSION:There are obvious SH disorders(mainly on the deficiency of E2) and lipid metabolic disorder, which is closely related with the deficiency of E2,in postmenopausal women with MI.The lipid metabolic disorder caused by deficiency of E2 may be one of the important reasons for the occurrence of MI in postmenopausal women.