绝经后女性血雌二醇/睾酮值IL-6与冠状动脉狭窄程度的关系及对血管损伤的影响

Correlation of female postmenopausal estradiol/testosterone ratio and interleukin-6 level with severity of coronary artery stenosis and its impact on vascular damage

目的观察绝经后女性性激素、白细胞介素-6(IL-6)水平变化与冠状动脉狭窄程度的关系及支架植入术对其影响。方法选择绝经2年以上初诊为冠心病并入院后行冠状动脉造影(CAG)的女性患者134例,按有无冠心病分为冠心病组(86例)及对照组(48例)。根据Gensini评分将冠心病组分为:冠心病A组(23例)﹑冠心病B组(36例)、冠心病C组(25例)。同时按支架植入与否分为:支架组(PCI组,50例),造影组(CAG组,36例)。检测并分析所有患者造影或支架植入前后血雌二醇(E_2)、睾酮(T)、IL-6水平。结果 1冠心病组患者与对照组比较,E_2、E_2/T明显降低,IL-6显著升高,差异均有统计学意义(P<0.05);2随冠状动脉狭窄程度加重,冠心病A、B、C三组E_2/T值逐渐降低,IL-6水平逐渐增高,差异均有统计学意义(P<0.05);3支架植入组与造影组相比,IL-6水平升高,差异有统计学意义(P<0.05)。结论绝经后女性冠状动脉狭窄严重程度与IL-6、E_2/T高度相关;血管损伤可诱发血IL-6水平快速升高;保持E_2/T的平衡可能有利于抑制冠状动脉的炎症活动。

Objective To observe the correlation of changes in the serum levels of female postmenopausal sex hormones and interleukin-6（ IL-6） with the severity of coronary artery stenosis,and the impact of stent implantation on it. Methods 134 female patients with more than 2 yearsof menopause,newly diagnosed with coronary heart disease（ CHD） and hospital ized for coronary angiography（ CAG）,were divided into 2 groups: the CHD group（ 86 cases） and the control group（ 48 cases）. Based on the Gensini score,patients in the CHD group were further divided into 3 subgroups: group A（ 23 cases）,group B（ 36 cases） and group C（ 25 cases）. According to whether or not receiving stent implantation,patients in the CHD group were again divided into the stent group（ the PCI group,50 cases） and the contrast group（ the CAG group,36 cases）. All patients underwent detection ofserum estradiol（ E2）,testosterone（ T） and IL-6levelsbefore and after CAG or stent implantation,and then the results of different groups werecompared and analyzed. Results Compared with the control group,patients in the CHD group showed apparently decreased E2 levels and estradiol/testosterone（ E2/T） ratios and largely increased IL-6 levels,with statistically significant differences（ P < 0. 05）. With aggravate on of the coronary artery stenosis,E2/T ratios of the CHD subgroup A,B and C reduced gradually,while the IL-6 levels increasing,and their differences were statistically significant（ P < 0. 05）. The blood IL-6levels of the PCI group increased significantly in comparison with those ofthe CAG group（ P < 0. 05）. Conclusion The severity of coronary artery stenosis inpost menopausal women is closely related with the serum IL-6level and E2/Tratio,and vascular damage may induce the rapidincrease of IL-6level,sokeeping the E2/T ratioconstan twouldbe helpful to inhibit the inflammation activity of coronaryartery.