绝经后脑梗死患者的雌激素水平与纤维蛋白原水平的相关性研究

Correlation between estrogen and fibrinogen in postmenopausal patients with cerebral infarction

目的探讨绝经后妇女脑梗死患者性激素与纤维蛋白原的相关性研究,以期为绝经后女性脑梗死患者提供临床诊治参考。方法选取2017年2月~2018年2月在贵阳市第一人民医院神经内科住院的绝经1年以上的女性脑梗死急性期患者(发病72 h以内)90例,年龄59~76岁,平均(70.3±5.5)岁;同时选取同期在贵阳市第一人民医院体检,绝经1年以上的女性健康体检者作为对照40 例,年龄60~77岁,平均(68.3±5.1)岁。测定脑梗死患者及对照组患者的血清雌二醇(E2),同时测定血清中纤维蛋白原(Fg)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)水平。结果脑梗死组与正常对照组比较显示:E2水平显著降低,Fg水平显著升高,TT缩短,线性相关分析显示,E2水平与Fg具有明显的负相关,E2水平与PT之间呈正相关,E2水平与APTT、TT之间进行相关性检测中,没有发现其存在相关性。结论绝经后妇女脑梗死患者存在着严重的性激素失调、凝血功能异常,雌激素可以通过调节女性体内Fg的降解,影响血流动力学来发挥其心脑血管的保护作用。

Objective To investigate the relationship between sex hormones and fibrinogen in postmenopausal women with cerebral infarction, in order to provide clinical diagnosis and treatment reference for postmenopausal women with cerebral infarction. Methods A total of 90 patients with acute cerebral infarction(within 72 hours of onset) aged 59-76 years, averaged(70.3±5.5) years old, who were hospitalized for more than 1 year in the Department of Neurology, Guiyang First People's Hospital from February 2017 to February 2018 were chosen. At the same time, 40 women aged 60-77 years old, with an average of(68.3±5.1) years old, who underwent physical examinations for more than one year of menopause in the physical examination of the First People's Hospital of Guiyang were selected. Serum estradiol(E2) was measured in patients with cerebral infarction and control group. Fibrinogen(Fg), activated partial thromboplastin time(APTT), TT (thrombin time), PT(prothrombin time) levels were also detected at the same time. Results Compared with the normal control group, the cerebral infarction group showed a significant decrease in E2 level, a significant increase in Fg level, and a shortened TT. Linear correlation analysis showed that E2 level had a significant negative correlation with Fg, and E2 level was positively correlated with PT, while no correlation was found in the correlation test between the level of E2 and APTT, TT. Conclusion There are severe sex hormone disorders and abnormal blood coagulation in postmenopausal women with cerebral infarction. Estrogen can exert its protective effect on cardiovascular and cerebrovascular diseases by regulating the degradation of Fg in women and affecting hemodynamics.