绝经与女性冠心病关系研究

Correlation between menopause and coronary artery disease

目的:研究绝经后冠心病(CAD)女性及无冠心病女性血脂水平是否存在差异,探讨激素、血脂对女性冠心病的影响。方法:以39例经冠脉造影证实有一支以上主要冠状动脉狭窄≥50%的绝经后女性CAD患者为CAD组,40例经造影冠脉无明显狭窄的绝经后女性为正常对照组,测定所有对象的总胆固醇(TC)、甘油三脂(TG)、脂蛋白-a[LP(a)]、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白(Apo)A、ApoB及B/A比值,以放免法测定雌激素(E2)、雄激素(T)、卵泡刺激素(FSH)、黄体生成素(LH)。对两组结果进行比较,并作Logistic多元回归分析。结果:①CAD组的TG、TC、LDL-C、LP(a)和Apo B水平均高于正常对照组,但无显著差异,CAD组的HDL-C及Apo A水平均显著低于正常对照组[(0.85±0.52)mmol/L∶(1.23±0.54)mmol/L,(1.24±0.24)mmol/L∶(1.86±0.33)mmol/L,P均<0.05];②CAD组的E2、LH水平[(11.99±6.81)ng/ml,(22.33±13.45)mI U/ml]显著低于正常对照组[(15.40±5.41)ng/ml,(35.96±23.39)mI U/ml],P<0.05～<0.01;③经Logistic多元回归分析:Apo B、HDL-C、E2和LH是对女性绝经后对冠心病有影响的因素(β=3.592,-1.496,-0.183,-0.056,P均<0.01)。结论:HDL-C、E2和LH是绝经后女性免于冠心病的保护因素。血脂水平对绝经后女性冠心病的发生有一定影响。

Objective： To investigate the correlation between menopause and coronary artery disease. Methods： Thirty- nine postmenopause female patients with coronary artery disease （CAD） documented by angiography were selected as CAD group and 40 normal female subjects documented by angiography were as normal control group. To compare the serum levels of total cholesterol （TC）, triglyceride （TG）, lipoprotein--a [LP （a）], low density lipoprotein-choles- terol （LDL-C）, high density lipoprotein-cholesterol （HDL-C）, apolipoprotein A （Apo A）, Apo B, and estradiol （E2）, luteotrophic hormone （LH）. Results： （1） The TG, TC, LDL-C, LP （a） and Apo B levels of CAD group were higher but not statistical difference with control group （P〉0.05）, but HDL-C and Apo A levels of group CAD were lower than those of normal control group （P〈0.05） ; （2） The E2, LH levels of CAD group [（11.99±6.81） ng/ml, （22.33±13.45） mIU/ml] were lower than those of normal control group[ （15.40±5.41） ng/ml, （35.96±23.39） mIU/ml], P〈0. 05-〈0. 01; （3）By Logistic multiple regression analysis： ApoB, HDL-C, E2 and LH were factors affecting CAD in postmenopause women （β= 3. 592, - 1. 496, - 0. 183, - 0. 056, P〈0. 01 all）. Conclusion： HDL-C, E2 and LH are protective factors in postmenopause women for coronary artery disease. The blool lipid levels have a certain impact on development of coronary artery disease in postmenopause women.