男性CHD患者血清脱氢表雄酮、游离睾酮浓度的分析

Study on Serum Concentrations of Dehydroepiandrosterone and Free Testosterone in Male Patients with Coronary Heart Disease (CHD)

目的:观察血清雄激素水平与男性冠心病(CHD)的相关性。方法:CHD诊断和狭窄程度判断通过冠状动脉造影检查,冠状动脉至少有一处内径狭窄≥50%为诊断标准;冠状动脉狭窄评分标准:主要冠脉即左主干、左前降支、左回旋支、右冠脉,狭窄程度计分如下:无狭窄为0分,狭窄≤25%为1分,狭窄26%～50%为2分,狭窄51%～75%为3分,狭窄76%～100%为4分。若单支血管有多处病变,则以最狭窄病变的分数作为该支血管狭窄分数;若多支血管有狭窄,则将各支血管狭窄分数相加,即为该患者冠脉病变评分;左主干病变计分加倍。血清雄激素检测脱氢表雄酮和游离睾酮两个指标。脱氢表雄酮和游离睾酮采用酶联免疫吸附试验检测;并同时检测空腹血糖、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿酸等生化指标。结果:CHD组血清脱氢表雄酮、游离睾酮水平显著低于无CHD组(P<0.001)。多元logistic回归分析显示,血清脱氢表雄酮(OR=0.526;95%CI:0.361～0.768;P<0.01)、游离睾酮(OR=0.995;95%CI:0.991～0.999;P<0.05)为CHD独立危险因素;血清脱氢表雄酮(t=3.424,P<0.01,r=-0.415)、游离睾酮(t=2.763,P<0.01,r=-0.359)与CHD冠状动脉狭窄程度呈负相关。结论:血清雄激素水平的降低可能是导致男性CHD发病率升高的重要因素,监测血清雄激素水平有助于判断CHD病变的程度。

Objective To study the relationship between serum concentrations of androgens and incidence of CHD in male patients. Methods Serum concentrations of dehydreepiandrosterone and free testosterone were measured with ELISA in 50 male patient with coronary atherosclerosis and 50 male controls without coronary abnormality. Those 100 subjects also underwent diagnostic coronary angiography, as well as determination of serum Triglycerides （TG）, total cholesterol（ TC）, HDL -eholosterol（ HDL- C ）, LDL- cholesterol（ LDL- C）, glucose and uric acid （URIC） levels. Results Male patients with coronary heart disease（CHD） had significant- ly lower levels of dehydroepiandrosterone and free testosterone than those in the controls, P 〈0.001. In multiple logistic regression analysis, dehydroepiandrosterone （ OR = 0.526, 95% CI：0. 361-0. 768, P 〈 0.01 ） and free testosterone （ OR = 0. 995, 95% CI： 0.991 - 0.999, P 〈 0.05 ） levels were associated with development of CHD independent of age, and serum TG, TC, HDL- C, LDL - C, BG, URIC levels. Conclusion Decrease of serum androgne concentration may play an important role in the development of coronary heart disease in male patients.