血浆雌二醇水平与绝经后急性脑梗死发病的关系

Rrelationship between plasma E_2 level and onset of acute cerebral infarction in postmenopausal women

目的探讨患者血浆雌二醇(E_2)水平与绝经后急性脑梗死发病的关系。方法选择2015年1月-2016年1月在该院住院的绝经后急性脑梗死患者100例作为观察组,另选择同期绝经1年以上的健康体检者50例作为对照组。收集两组研究对象性别、年龄、身高、体重、高血压病史、糖尿病病史及冠心病病史。检测两组舒张压(DBP)、收缩压(SBP)、血浆空腹胰岛素(FINS)、E2、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、空腹血糖(FBS)和高敏C-反应蛋白(hs-CRP)水平,并计算胰岛素敏感指数(ISI)。结果观察组患者高血压病史占比、糖尿病病史占比、冠心病病史占比、SBP、DBP、FBS、FINS、TC、TG、LDL-C及Hs-CRT均高于对照组,差异均有统计学意义(均P<0.05)。ISI、HDL-C和E2均低于对照组,差异均有统计学意义(均P<0.05)。Logistic回归分析结果显示:高血压病史、高脂血症病史和Hs-CRP是急性脑梗死发病的独立危险因素(P<0.05)。急性脑梗死患者血浆E2水平与ISI和HDL-C水平呈正相关(P<0.05),与FINS、LDL-C和Hs-CRP水平呈负相关(P<0.05)。血浆E2水平与SBP、DBP、FBS、TC、TG水平无相关性(P>0.05)。结论绝经后脑梗死妇女E2水平下降,E2通过影响炎症反应和糖脂代谢参与急性脑梗死的发病。

Objective To explore the relationship between plasma estradiol（ E2） level and onset of acute cerebral infarction in postmenopausal women. Methods A total of 100 postmenopausal women with acute cerebral infarction were selected from the hospital from January 2015 to January 2016 as observation group,50 healthy postmenopausal women after physical examination with menopause time more than one year were selected as control group. Gender,age,height,weight,history of hypertension,diabetes mellitus and coronary heart disease history were collected in the two groups. Diastolic blood pressure（ DBP）,systolic blood pressure（ SBP）,plasma fasting insulin（ FINS）,E2,total cholesterol（ TC）,high-density lipoprotein cholesterol（ HDL-C）,low-density lipoprotein cholesterol（ LDL-C）,triglyceride（ TG）,fasting blood glucose（ FPG） and high-sensitivity C-reactive protein（ hs-CRP） levels in the two groups were detected,insulin sensitivity index（ ISI） was calculated. Results The proportion of postmenopausal women with hypertension history,diabetes mellitus history and coronary heart disease history,SBP,DBP,FBS,FINS,TC,TG,LDL-C and Hs-CRT levels in observation group were statistically significantly higher than those in control group（ P 〈0. 05）. ISI,HDL-C and E2 levels in observation group were statistically significantly lower than those in control group（ P〈0. 05）. Logistic regression analysis showed that hypertension history,hyperlipidemia history and Hs-CRP level were independent risk factors of onset of acute cerebral infarction（ P〈0. 05）. Plasma E2 level in patients with acute cerebral infarction was positively correlated with ISI and HDL-C levels（ P〈0. 05）; and plasma E2 level was negatively correlated with FINS,LDLC and Hs-CRP levels（ P〈0. 05）. There was no correlation between plasma E2 level and SBP,DBP,FBS,TC,TG levels（ P〉0. 05）.Conclusion E2 level in postmenopausal women with cerebral infarction decreases,E2 is involved in the pathogenesis of acute cerebral infarction by affecting inflammatory reaction and glycolipid metabolism.