绝经后女性冠心病患者性激素水平与年龄及高敏C反应蛋白的相关性分析

Study on relationship between age,hs-CRP level and sex hormone in postmenopausal women with coronary artery disease

目的探讨绝经后女性冠心病患者性激素水平变化与年龄及高敏C反应蛋白(hs-CRP)的相关性。方法选择正常绝经时间≥1年的无性激素替代治疗的女性患者362例,根据冠状动脉造影结果分为冠心病组127例和对照组235例。其中年龄≤60岁患者107例;61～70岁患者113例;>70岁患者142例。检测血浆雌二醇、睾酮、血脂和hs-CRP水平,分析不同年龄段冠心病患者性激素水平与hs-CRP的相关性。结果与对照组同年龄段比较,冠心病组≤60岁患者雌二醇、雌二醇/睾酮明显降低,睾酮明显升高(P<0.05,P<0.01),年龄61～70岁和>70岁患者hs-CRP明显升高(P<0.01)。性激素水平与年龄呈负相关,与体重指数呈正相关(P<0.05,P<0.01)。logistic回归分析显示,雌二醇是冠心病的重要保护因子(P<0.01)。结论绝经后初期,女性冠心病患者性激素水平失衡明显,而年龄>60岁患者血脂及炎症水平明显升高,绝经后不同年龄段女性防治策略应有所不同。

Objective To explore the relationship between age, high sensitivity C-reactive protein （hs-CRP） level and changes of sex hormone levels in postmenopausal women with coronary heart disease（CHD）. Methods 362 postmenopausal women（menopause≥1 year） were studied and divided into CHD group（127 cases） and control group（235 cases） according to the result of coronary angiography. Then the cases were divided into three groups according to age： 107 patients were≤ 60 years old,113 patients were 61-70 years old and 142 patients were 〈70 years. Plasma levels of estradiol（E2 ）, testosterone（T）, follicular estrogen, luteinizing hormone, blood lipids and hs-CRP were examined. The relationship of sex hormone with hs-CRP in different age groups were analysed and compared. Results Compared with the control cases of the same age group, significantly lower E2 level and E2/T ratio,higher T level were observed in CHD patients≤60 years old （P 〈 0.05,P 〈 0. 01） , while the level of hs-CRP was significantly higher in CHD patients〉60 years old （P 〈 0.01）. The difference in sex hormone level was not statistically significent. Linear regression analysis showed that sex hormone levels were negatively correlated with age and positively correlated with BMI （P 〈0.05, P 〈 0.01）. After adjusted for age and BMI, sex hormone level was not correlated with hs-CRP. Logistic regression analysis showed that E2 was an important protective factor for CHD （P〈 0. 01）. Conclusion The prevention and treatment strategies in postmenopausal women of different ages should be different.