血液透析男性患者性激素与心血管疾病的研究

The Clinical Study of Sex Hormone Level in Male Maintenance Hemodialysis Patients with Cardiovascular Diseases

目的探讨血液透析男性患者性激素水平的变化对心血管疾病的影响及其相关因素分析。方法①选择广东省汕头市第二人民医院肾内科测定60例血液透析男性患者血清睾酮(T)、雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)、孕酮(P)的水平,与55例正常男性性激素水平进行对照研究。②监测60例维持性血液透析男性患者的血压、睾酮水平、血红蛋白、血清白蛋白、血尿素氮、肌酐、超滤量,彩色B超检查测量心脏腔径及心功能参数。观察患者心血管事件发生率。结果血液透析男性患者睾酮水平较正常男性组明显下降;伴发心血管疾病的血液透析男性患者的睾酮水平显著下降;年龄大,透析前肌酐、尿酸(UA)、血清白蛋白水平高,伴发高血压及有心血管家族史的比例显著增高。结论睾酮水平、年龄、高血压、血清白蛋白是心血管疾病的主要危险因素,通过调控上述因素可降低心血管病变的发生率。

Objective To explore the effect of sex hormone level in male maintenance hemodialysis patients on cardiovascular diseases and the associated factors of cardiovascular diseases. Methods （1）Testosterone （T） , estradiol （ E2 ） , follicular stimulating hormone（FSH） ,luteinizing hormone（LH） ,prolactin（PRL） ,and progesterone（P） in 60 male maintenance hemodialysis patients were determined and eompared with those of 55 healthy controls. （2）In the 60 male maintenance hemodialysis patients, the following data were collected ： blood pressure, testosterone level, hemoglobin, albumin, urea nitrogen, serum ereatinine, and uhrafihration volume ; the cardial structure and function were assessed by echocardiography. Results The testosterone level was signifieantly lower in maintenance hemodialysis group than that of the control group. The lower testosterone level may be the important risk factors of cardiovascular disease. There were also an increase in age, serum creatinine, uric acid, albumin levels, pre-hemodialysis and the ratios of hypertension, and the ratios of hypertension, family histories of cardiovascular disease in these patients. Conclusion Testosterone level, age, hypertension and albumin levels may be the important risk factors of cardiovascular disease.