绝经后女性冠状动脉病变评分与血脂及女性激素水平关系的研究

A study of the relationship beteween sex hormone , serum lipids and the severity of coronary arteriopathy in post- menopausal women

目的 了解绝经后女性冠状动脉病变评分与血脂及女性激素间的相互关系.方法 连续收集绝经1年以上并行冠状动脉造影的女性167例及正常年青女性93例,测定血脂质、雌、孕激素水平,并对冠状动脉病变进行评分.结果 绝经后女性与行经女性相比,血清性激素(E_2及P)水平明显下降,其中尤以绝经后有冠状动脉病变女性为著,三组之间相比均达到统计学差异,P<0.01或P<0.05.绝经后有冠状动脉病变女性血清TC、TG、ApoB、Lp(a)及LDL-C水平最高,绝经后无冠状动脉病变女性上述指标较有冠状动脉病变组明显下降,行经女性上述指标最低,三组之间相比均达到统计学差异,P<0.01或P<0.05.相反,HDL-C及ApoA_1水平则是绝经后有冠状动脉病变女性最低,绝经后非冠状动脉病变女性上述指标较有冠状动脉病变组明显上升,行经女性上述指标最高,三组之间相比均达到统计学差异,P<0.01或P<0.05.E_2与冠状动脉病变评分呈显著负相关,相关系数分别为 —0.51(P<0.01)及—0.31(P<0.01);E_2与TC、TG、ApoB及LDL-C之间里显著负相关,与HDL-C及APOA_1水平呈显著正相关.结论 绝经后女性血脂代谢紊乱与性激素水平下降有关;女性激素水平与冠状动脉病变评分呈负相关.

Objective To investigate the relationship beteween sex hormone, serum lipids and the severity of coronary arteriopathy in postmenopausal women. Methods In a cross sectional test, serum estradiol (E2) , progesterone (P ) and serum lipids of 167 postmenopausal women undergoing diagnostic coronary angiography (86 with coronary arteriopathy and 81 without coronary arteriopathy ) and 93 healthy young women were measured. The severity of coronary arteriopathy were described as scores. Results The mean serum E2 and P levels were significantly lower in postmenopausal women than in young women, especial in postmenopausal women with coronary arteriopathy, P<0. 01 or P<0. 05 . TG, TC, LDL-C, ApoB and Lp(a) levels were significantly higher in postmenopausal women than in young women, especial in postmenopausal women with coronary arteriopathy, P<0. 01 or P<0. 05. ApoA1 and HDL-C levels were significantly lower in postmenopausal women than in young women, especial in postmenopausal women with coronary arteriopathy, P<0. 01 or P<0. 05 . Correlation analysis showed that E2 level was negatively correlated with TG, TC, LDL-C, ApoB level. E2 level was positively correlated with ApoAi and HDL-C lvels. The severity of coronary arteriopathy was negatively correlated with E2 and P levels. Conclusion The results of our study showed that decreased E2 and P levels could induced adverse serum lipid profile, and negatively correlated with the severity of coronary arteriopathy.