绝经后雌激素与女性急性脑梗死发病关系的探讨

Relationship between estrogen levels in postmenopausal women and acute cerebral infarction

目的探讨绝经后女性脑梗死患者血浆雌二醇(E2)水平与急性脑梗死发病的关系,分析E2与相关代谢指标及炎性指标的相关性。方法收集我院神经内科住院的90例绝经后女性脑梗死急性期患者(脑梗死组)和40例同期绝经后女性健康体检者(正常对照组),比较两组年龄、高血压、糖尿病、冠心病、体重指数(BMI)、血清E2、血浆胰岛素(FINS)、胰岛素敏感指数(ISI)、血糖(FBS)、血脂及高敏C反应蛋白(hs-CRP)水平。结果与正常对照组相比,急性脑梗死组E2明显降低,差异有统计学意义(P<0.01)。Logistic回归分析显示在考虑了脑梗死其他的独立危险因素后,雌激素水平降低并不能使脑梗的发病风险增加(OR:1.173;95%CI:0.743～1.875,P=0.479)。相关分析发现,脑梗死组患者中雌激素水平与高密度脂蛋白胆固醇(HDL-C)、ISI呈正相关;与低密度脂蛋白胆固醇(LDL-C)、hs-CRP、FINS水平呈负相关,均有统计学意义(P<0.01);与空腹血糖、BMI、血压无相关。结论绝经后女性脑梗死患者的雌激素明显下降,雌激素不是绝经后女性脑梗死的独立危险因素,雌激素可能通过影响代谢及炎性指标而作用于脑梗死的发生。

Objective To investigate the relationship between Estrogen Levels in postmenopausal women with acute cerebral infarction,to analyze the correlation with specific metabolic parameters.Methods nighty postmenopausal women with acute cerebral infarction were admitted to our hospital,and forty postmenopausal women were recruited consecutively.After recording age,history of hypertension and diabetes as well as coronary heart disease,the levels of BMI、serum E2、INS、 ISI、FBS、blood fat、hs-CRP were measured.Results The levels of serum E2 in patients with acute cerebral infarction were markedly lower than that of the normal group（P 0.01）.Taking other risk factors of cerebral infarction into consideration,multiple regression showed E2 was not an independent risk factor of cerebral infarction（OR1.173;95% CI： 0.743 ～ 1.875,P = 0.479.Correlation analysis showed that serum E2 levels in patients with acute cerebral infarction was positively associated with HDL-C and ISI,and negatively correlated with LDL-C、hs-CRP and FINS.Conclusion The levels of serum E2 in postmenopausal women with acute cerebral infarction were markedly lower,E2 was not an independent risk factor of cerebral infarction in postmenopausal women,and E2 levels had the correlation with several pro-inflammaton markers and metabolic risk factors.