绝经期女性脑梗死患者雌激素水平与血脂关系研究

Study on the relation between the levels of estrogen and blood lipid in postmenopausal women with cerebral infarction

目的 研究绝经期女性脑梗死患者血清中雌二醇(E2)、血脂含量变化,探讨雌激素对缺血性脑血管疾病的关系。方法 取78名绝经期女性脑梗死患者和62名对照组患者空腹静脉血,测定血清E2、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋门胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白-AI(Apo-AI)及载脂蛋白B100(Apo-B100)。结果脑梗死组E2水平(12.86pg/ml)低于对照组(25.59pg/ml),有显著差异(P<0.01)。脑梗死组TG、TC、LDL-C、Apo-B100显著高于对照组(P分别<0.01、0.01、0.01、0.05),脑梗死组HDL-C显著低于对照组(P<0.01),脑梗死组ApoA-I与对照组相比无显著性差异(P>0.05)。雌激素水平与TG、TC、LDL-C、Apo-B100呈显著负相关(r分别为-0.63、-0.44、-0.57、-0.30,P<0.01),与HDL-C呈显著正相关(r=0.53,P<0.01)。结论 雌激素水平降低可导致血脂谱异常改变,从而促进动脉粥样硬化,低雌激素水平可能是缺血性脑血管病发生的危险因素之一。

Objective To study the changes of serum estradiol and lipid profile in postmenopausal women with cerebral infarction and explore the relationship between the levels of estrogen and ischemic cerebrovascular disease. Methods The serum levels of estradiol (E2) and blood lipid profile including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein-AI (Apo-AI), apolipoprotein-B100 (Apo-B100) in 78 postmenopausal women with cerebral infarction and 62 women without cerebral infarction (control group) were determined. Results The mean level of E2 was significantly lower in the cerebral infarction group than that in the control group (12.86 vs 25.59, t=4.39, P<0.01). There were significant increase of serum TG (1.99 vs 1.35 mmol/L, P<0.01), TC (5.86 vs 5.13 mmol/L, P0.01), LDL-C (3.70 vs 2.98 mmol/L, P<0.01), Apo-B100 (1.05 vs 0.94 mmol/L, P<0.05) and significant decrease of serum HDL-C (1.25 vs 1.47, P<0.01) in cerebral infarction group versus control group, but the mean level of Apo-AI(l .21 vs 1.26, P>0.05) showed no statistically marked difference between the two groups. The levels of TG (r= 0.63 ), TC ( r=0.44 ), LDL-C ( r=0.57 ), Apo-Bl00 ( r=0.30 ) were negatively associated with the E2 level, but HDL-C ( r= 0.53 ) was positively. Conclusion The decrease of estrogen level in women can induce the abnormal changes of blood lipid profile and expedite atherosclerosis. The low level of estrogen may be one of risky factors that lead to ischemic cerebral vascular disease.