雌激素及脂蛋白水平与绝经后女性冠状动脉病变评分之间相关性研究

Study on the correlation between estrogen and lipoprotein levels and score of coronary artery disease among postmenopausal women

目的:探讨雌激素及脂蛋白与老年女性冠状动脉病变评分(CAC)之间的相关性。方法:选择绝经后女性患者160例,通过螺旋CT计算CAC积分,根据CAC积分分为3组:轻度钙化组(包括无CAC组)(0～10分)40例,中度钙化组(11～14分)32例,重度钙化组(≥15分)48例。记录患者的临床基本特征,检测血清性激素、LP(a)和血脂等指标。结果:重度钙化组的年龄、血清总胆固醇和低密度脂蛋白胆固醇(LDL-C)、LP(a)、糖尿病患病率均高于轻度钙化组;而血清载脂蛋白A、血清雌二醇(E2)明显低于轻度钙化组,差异均有统计学意义。随着钙化加重,LP(a)有增高趋势,差异有统计学意义。多元Logistic回归分析显示,血清E2和LDL-C、LP(a)、糖尿病、年龄是女性绝经后CAC加重(CAC积分>10)的独立危险因素。结论:女性绝经后雌激素水平下降、LP(a)升高是CAC加重的独立危险因素。

Objective：To explore the correlation between estrogen,lipoprotein and coronary artery calcification（CAC） score among elderly women. Methods：160 postmenopausal women were selected,spiral computed tomography（MSCT） was used to calculate CAC score,then they were divided into three groups according to CAC score： mild calcification group（including non-CAC group）（0～10 points）（40 postmenopausal women）,moderate calcification group（11～14 points）（32 postmenopausal women） and severe calcification group（≥15 points）（48 postmenopausal women）.The basic clinical characteristics of the postmenopausal women were recorded,the indexes including serum sexual hormones,lipoprotein and blood lipids were detected. Results：The age,serum total cholesterol,low density lipoprotein cholesterol（LDL-C）,lipoprotein and incidence of diabetes mellitus in severe calcification group were higher than those in mild calcification group;the levels of serum apolipoprotein A and estradiol in severe calcification group were lower than those in mild calcification group,there was significant difference.The level of lipoprotein showed a increasing trend with the aggravation of calcification,there was significant difference.Multivariate logistic regression analysis showed that serum estradiol,LDL-C,lipoprotein,diabetes mellitus and age were independent risk factors of aggravation of CAC（CAC score10） among postmenopausal women. Conclusion：The decrease of estrogen level and increase of lipoprotein level are independent risk factors of aggravation of CAC among postmenopausal women.