绝经后妇女冠心病患者性激素变化的研究.doc

绝经后妇女冠心病患者性激素变化的研究 2010-08-02 梁万宁　吴赛珠　刘伊丽 裘宇容　范义湘　王淑娟 　　【摘要】　目的　探索与绝经后妇女冠心病发病有关的体内性激素(SH)的变化规律。方法　连续测定52例绝经1年以上的女性冠心病患者(Ⅰ组，平均年龄63.8±0.83岁)、38例绝经1年以上无冠心病的妇女（Ⅱ组，平均年龄64.6±0.79岁）及86例无冠心病的正常育龄行经妇女(Ⅲ组，平均年龄41.5±0.68岁）的血清雌二醇（E2）、孕酮（P）、促卵泡刺激素（FSH）、促黄体生成素（LH）及血脂谱。结果　Ⅰ组E2水平明显降低，分别为Ⅱ、Ⅲ组E2水平的53%及28%；P水平也有下降趋势，但三组之间差异无显著性；Ⅰ组FSH、LH水平较Ⅱ、Ⅲ组显著增高。Ⅰ、Ⅱ组与Ⅲ组相比，总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）水平均显著增高；而高密度脂蛋白胆固醇（HDL-C）水平显著降低；Ⅰ组较Ⅱ组TC、LDL-C水平更显著增高；HDL-C水平更显著降低（P均0.001）。线性相关分析发现，E2与FSH、LH、TC、TG、LDL-C水平呈显著负相关，与HDL-C水平呈显著正相关，总体相关系数分别为-0.68、-0.56、-0.63、-0.37、-0.53、0.22（P值均0.001）。结论　绝经后妇女冠心病患者存在着严重的性激素失调及脂代谢异常，其中血清雌二醇水平显著降低，可能为绝经后妇女冠心病发病及脂代谢异常的原因之一。 　　【关键词】　绝经　　冠状动脉病变　　雌二醇　　血脂 A study of endogenous sex hormone disorder in postmenopausal women with coronary heart disease　　Liang Wanning, Wu Saizhu, Liu Yili, et al. Department of Cardiovascular Disease, South Hospital, First Military Medical University, PLA, Guangzhou 510515. 　　【Abstract】　Objective　To investigate the endogenous sex hormone disorder and adverse change of serum lipid profiles in postmenopausal women with coronary heart disease (CHD). Methods　Fifty two postmenopausal women with CHD (group Ⅰ, 63.8±0.83 years), 38 postmenopausal women without CHD (group Ⅱ, 64.6±0.79 years) and 86 premenopausal women without CHD as control (group Ⅲ, 41.5±0.68 years) were selected to compare the serum levels of estradiol (E2), progesterone (P), follicle stimulating hormone (FSH), luteinizing hormone (LH), total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). Results　Analysis of variance demonstrated that menopause was associated with significantly higher serum levels of FSH,LH, TC, TG, LDL-C, and lower serum levels of E2, HDL-C. The changes of all the above indices were more pronounced in group Ⅰ than those in group Ⅱ. E2 level showed a 72% decrease in group Ⅰ compared with group Ⅲ. Correlation analysis showed that serum E2 level was negatively correlated to serum l