绝经后女性ACS患者雌二醇、C反应蛋白、脂蛋白a与GRACE评分的相关性研究

Correlation between estradiol,c-reactive pro tein,lipoprotein a and GRACE score in postmenopausal women with ACS

目的检测绝经后女性急性冠脉综合征(ACS)患者血浆雌二醇(E2)、C反应蛋白(CRP)、脂蛋白a[Lp(a)]的水平并探讨其与GRACE评分的相关性。方法选取绝经后女性经冠脉造影检查确诊为ACS的患者60例,并分为急性ST段抬高型心肌梗死(STEMI)组和非ST段抬高型急性冠脉综合征(NSTE-ACS)组,另选取经冠脉造影检查排除冠心病的绝经后女性60例为对照组。采集其年龄、绝经年龄、体表面积、体重指数等基本信息,并检测其E2、CRP、Lp(a),ACS组患者入院后24h内进行GRACE评分。结果 ACS组与对照组在年龄、绝经年龄、体表面积、体重指数等基线资料方面比较差异均无统计学意义(P>0.05)。STEMI组较NSTE-ACS组及对照组血浆E2、CRP、Lp(a)水平升高,差异均有统计学意义(P<0.05)。对ACS组内患者按照GRACE评分进行分组后,GRACE评分高危组(>140分)患者E2、CRP水平显著高于中危组(109-140分)和低危组(<109分)(P<0.05)。GRACE评分高危组患者Lp(a)水平高于中危组和低危组但无统计学意义(P>0.05)。Pearson直线相关分析表明,ACS组GRACE评分与E2、CRP呈正相关关系(r=0.712,P<0.01;r=0.276,P<0.05)。结论绝经后女性ACS患者血浆E2、CRP、Lp(a)水平升高,随着GRACE危险程度升高,血浆E2、CRP、Lp(a)水平升高,且E2、CRP水平与GRACE评分呈正相关,在绝经后女性ACS患者中联合应用可能对疾病早期风险评估及预后有重要的临床参考价值。

Objective To detect the plasma estradiol(E2),c-reactive protein(CRP)and lipoprotein a[Lp(a)]levels in postmenopausal women with acute coronary syndrome(ACS)and explore their correlation with GRACE score.Methods A total of 60 postmenopausal women with ACS diagnosed by coronary angiography,and divided into the acute st-elevation myocardial infarction(STEMI)grope and non-st-elevation acute coronary syndrome(NSTE-ACS)grope,60 postmenopausal women without coronary heart disease diagnosed by coronary angiography were selected as the control group.Age,menopause age,body surface area,body mass index and other basic informations were collected,and E2,CRP,Lp(a)were examined.GRACE score was calculated in ACS group within 24 hours after admission.Results There was no statistically significant difference between ACS group and control group in age,menopausal age,body surface area,body mass index and other baseline datas(P>0.05).The plasma E2,CRP,Lp(a)levels in STEMI group were higher than those in NSTE-ACS group and control group,with statistically significant differences(P<0.05).After grouping patients in ACS group according to GRACE score,E2 and CRP levels in high risk GRACE group(>140)were significantly higher than those in medium risk group(109-140)and low risk group(<109)(P<0.05).Lp(a)level in high risk group was higher than those in medium risk group and low risk group,but there was no statistical significance(P>0.05).Pearson linear correlation analysis showed that GRACE score in ACS group was positively correlated with E2 and CRP(r=0.712,P<0.01;r=0.276,P<0.05).Conclusion Plasma E2,CRP,Lp(a)levels increased in postmenopausal women with ACS.With the increase of GRACE risk level,the levels of plasma E2,CRP were increased.Moreover,the levels of E2 and CRP were positively correlated with GRACE score.Combination of these indexes in postmenopausal women with ACS may have important clinical value on early risk assessment and prognosis.