老年冠心病患者血清GH、T和E_2的变化探讨

Study on the Changes of Serum GH,T and E_2 Levels in Elderly Patients with Coronary Heart Disease

目的:探讨老年冠心病患者血清生长激素(GH)、睾酮(T)和雌二醇(E2)水平的变化及其临床意义。方法:采用放射免疫分析测定了112例老年冠心病患者和40例健康对照组的血清GH、T和E2水平。结果:老年冠心病组血清GH和E2水平显著低于对照组(P<0.01,P<0.05),T与对照组无显著差异(P>0.05)。GH与E2水平呈显著的正相关(P<0.05),但两者与T均无相关性(P均>0.05)。Ⅰ、Ⅱ、Ⅲ和Ⅳ级心功能组患者血清GH、T、E2均依次显著递减(P<0.05,P<0.01,P<0.01)。伴急性心肌梗死组血清GH和E2水平显著低于无心肌梗死组(P均<0.01),但T却无显著差异(P>0.05)。住院死亡组血清GH、T、E2均显著低于好转出院组(P<0.05,P<0.01,P<0.01)。结论:EH组血清GH和E2水平显著降低,GH、T和E2均随心功能降低而依次显著递减,伴急性心肌梗死组GH和E2水平显著降低,死亡组血清GH、T、E2均显著降低。

Objective To investigate the clinical significance of changes of serum growth hormone （GH）, testosterone （T） and estradiol （E2 ） levels in elderly patients with coronary heart disease （CHD）. Methods Serum GH, T and E2 levels were determined with RIA in 112 elderly patients with CHD and 40 controls. Results The serum levels of GH and E2 in the elderly patients with CHD were significantly lower than those in controls （P 〈0.01, P 〈0.05）, but the T levels were not （P 〉0.05）. Levels of GH and E2 were mutually positively correlated （ P 〈 0.05 ）, both were not correlated with levels of T （ P 〉 0.05 ）. The serum levels of GH, T, and E2 decreased gradually with the advancement of cardiac function impairment from grade I to grade Ⅳ （P 〈0.05, P 〈0.01, P 〈 0.01 ）. Levels of GH and E2 were significantly lower in patients with myocardial infarction than those in patients without myocardial in- farction （P 〈 0.01 ）, but levels of T were not much different in these two groups （P 〉 0.05 ）. Serum levels of GH, T and E2 were significantly lower in the patients succumbed in hospital （ n = 8） than those in patients discharged. Conclusion The serum GH, T and E2 levels were much lower in the patients with more advanced coronary heart disease, with least changes in T levels.