男性冠心病患者性激素水平与冠状动脉狭窄程度关系的研究  

Relationship between sex hormone level and coronary artery stenosis degree of male patients with coronary heart disease

作　　者：高磊[1] 郝咏梅[2] 刘君[1] 张思洁[3] 谭慧莲[1] 陈屿[1] 高义双[1] 王震[1] 解启莲[1] 张密林[1] 

机构地区：[1]河北医科大学第一医院心内科,河北石家庄050031 [2]河北医科大学第二医院内分泌科,河北石家庄050000 [3]河北医科大学第四医院心内科,河北石家庄050011

出　　处：《临床荟萃》2010年第21期1855-1858,共4页Clinical Focus

摘　　要：目的探讨男性性激素水平与冠心病(CHD)患者冠状动脉狭窄程度的关系。方法根据冠状动脉造影结果将135例男性患者分为CHD组和对照组,CHD组又分为单支病变组、双支病变组和多支病变组,并以病变支数和Gensini总积分表示冠状动脉狭窄程度。采用放射免疫法检测所有患者的静脉血性激素5项,包括雌二醇(E2)、睾酮(T)、孕酮(P)、脱氢表雄酮(DHEA)、硫酸脱氢表雄酮(DHEAS)。比较各组间性激素水平并分析性激素水平与冠状动脉狭窄程度之间的关系。结果 CHD组的T、DHEA、DHEAS水平均低于对照组,T(18.6±8.6)nmol/L vs(29.7±11.5)nmol/L、DHEA(22.9±15.3)nmol/Lvs(57.9±27.1)nmol/L、DHEAS(5.5±1.3)μmol/Lvs(6.4±2.4)μmol/L(P<0.05);E2、P和E2/T在两组及不同支数病变组之间差异无统计学意义。病变支数越多,T及DHEA水平越低(P<0.05或<0.01);DHEA、DHEAS进入以Gensini积分为因变量的多元回归方程,标准回归系数分别为-0.229、-0.230。结论男性冠心病患者雄激素水平较低;男性雄激素水平可能影响冠状动脉狭窄程度。Objective To discuss the relationship between the sex hormone level and coronary artery stenosis degree of male patients with coronary heart disease（CHD）.Methods According to the results of coronary artery angiography,135 male patients were divided into CHD group and control group,and CHD group were subdivided into single branch group,double branch group and multiple branch group,and the stenosis degree of coronary artery was figured by stenosis branch number and Gensini score.The serum concentrations of five sex hormones were detected in all the subjects with radioimmunoassay,including stradiol（E2）,testosterone（T）,progestone（P）,dehydro-epiandrosterone（DHEA） and dehydroepiandrosterone sulfare（DHEAS）.The sex hormone levels between different groups were compared and the relationship between sex hormones and coronary artery stenosis level were analyzed.Results The values of T,DHEA and DHEAS were significantly lower in CHD group than those in control group,T（18.6±8.6） nmol/L vs（29.7±11.5） μmol/L,DHEA（22.9±15.3） nmol/L vs（57.9±27.1） nmol/L,DHEAS（5.5±1.3） μmol/L vs（6.4±2.4） μmol/L（P0.05）.E2,P and E2/T showed no statistic significance between the two groups or different branch lesions.With the increasing of stenosis branch number,the values of T and DHEA increased（P0.05 or 0.01）.DHEA and DHEAS were enrolled into the multiple regression equation,the standard regression coefficients were-0.229 and-0.230.Conclusion The levels of androgens are lower in male patients with CHD.The levels of androgens in men are likely to influence the stenosis degree of coronary artery.

关 键 词：冠状动脉疾病 冠状动脉狭窄 放射免疫测定 性腺甾类激素 男(雄)性 

分 类 号：R541.4[医药卫生—心血管疾病]