男性冠心病患者血清性激素结合球蛋白水平变化的临床观察

Analysis of Serum sex Hormone-binding Globulin Concentration in Male Patients with Coronary Heart Disease

目的探讨性激素结合球蛋白(SHBG)在男性冠心病(CHD)患者中的变化及其临床意义。方法选择住院并接受冠状动脉造影检查的男性患者,并根据冠脉造影结果分为冠脉造影正常组(对照组)33例;冠脉造影异常组(CHD组)52例,同时测定两组患者血清SHBG、睾酮(TT)、血脂、血糖、胰岛素等水平的变化,计算体质指数(BMI)。结果 CHD组和对照组相比hs-CRP、TC、GLU、空腹胰岛素显著增高(P<0.05),HDL-C、SHBG、TT、胰岛素敏感指数显著减低(P<0.05),BMI、LDL-C、TG差异无统计学意义。相关分析显示SHBG与BMI、LDL-C及空腹血糖呈负相关(r=-0.25～0.87,P<0.05),与胰岛素敏感指数呈正相关(r=0.45,P<0.05),但是其与TC、TG、HDL-C及hs-CRP间未见显著的相关关系(r=-0.19～0.02,P>0.05)。结论男性冠心病患者血清SHBG含量降低可能是导致男性冠心病发病率显著升高的重要因素。

Objective To investigate the level of sex hormone binding globulin （SHBG） in men with coronary heart disease （CHD） and its clinical significance. Methods To choose hospitalized male patients undergoing coronary anglography and all patients are divid- ed into normal group and abnormal coronary angiography group （CHD group） according to coronary angiography results. Determination of serum level in SHBG, testosterone （TT）, blood lipids, blood glucose, insulin and body mass index were conducted. Results Compared with control group, hs-CRP, TC, GLU and insulin in CHD group significantly increased, HDL-C, SHBG, TF and insulin sen- sitivity index significantly reduced, and there was no significant difference in BMI, LDL-C, TG. SHBG was no significant relationship between TC, TG, HDL-C and hs-CRP （r- 0.10,0.074, - 0.19,0.02, P 〉 0.05）, but was negatively correlated with BMI, LDL- C, and fasting glucose （r = - 0.25, - 0.87, - 0.35, P 〈 0.05）. At the same time, SHBG was positively correlated with insulin sensitivity index （ r = - 0.423, P 〈 0.05） o Conclusions The serum SHBG of male patients with coronary heart disease is significantly lower than the control group and it may be an important factor to lead to a significant increase in the incidence of coronary heart disease in men.