老年男性慢性心力衰竭并高血压患者血雌激素的变化特点及临床意义  

The significance of plasma estradiol in chronic heart failure of elderly male patients with hypertenstion

作　　者：吴泳亮 邹宝明[1] 王景武[1] 徐峰[1] 徐敏[1] 孙克陆[1] 梁爱霞[1] 李彬彬[1] 

机构地区：[1]安徽医科大学解放军临床学院解放军第105医院四病区心内科,安徽合肥230031

出　　处：《中国急救医学》2015年第6期522-525,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的：观察老年男性慢性心力衰竭（ CHF）合并高血压患者血雌激素水平的变化特点及意义。方法老年男性CHF患者124例，心功能Ⅱ～Ⅳ级（ NYHA分级），依患者入院时血压及高血压病史分为：高血压组（77例）和正常血压组（47例）。分别于治疗前后测定患者血浆雌二醇（E2）、睾酮（T）、N末端B型利钠肽原（NT－proBNP）水平，并对患者行6 min步行试验（6MWT）及NYHA分级评定。结果①两组患者经治疗后CHF明显好转，6MWT距离增加，NT－proBNP水平下降（P＜0．05）；②CHF纠正后E2水平明显下降（P＜0．05），T水平变化不明显，E2水平变化与CHF程度呈同步关系；③CHF合并高血压患者E2水平较正常血压组明显增高（P＜0．05），治疗后E2水平明显下降（ P＜0．05）。结论内源性E2水平变化与老年男性CHF严重程度呈同步变化，合并高血压者血E2水平升高更为明显，提示雌激素与老年男性CHF并高血压患者心功能可能高度相关。Objective To observe the variation and clinical significance of plasma estradiol （ E2 ） in chronic heart failure （ CHF） of elderly male patients with hypertenstion.Methods This study included 124 elderly men with CHF, New York Heart Association （ NYHA） class： Ⅱ~Ⅳ, grouped according to the admission blood pressure： 77 patients with hypertension and 47 patients with normotension.Plasma E2 , testosterone （ T ） , and N terminal of B type natriuretic peptide （ NT -proBNP） levels were detected before and after treatment.At the same time, 6 -min walking test （6MWT） and NYHA classification were also performed for these patients.Results ①After treatment, heart failure degree of the two groups were significantly improved, walking distance in 6MWT was longer （P〈0.05）, and NT-proBNP level was decreased （P〈0.05）.②After CHF was corrected, E2 level was decreased significantly （P〈0.05）; but T level was not obviously changed （P〉0.05）; before treatment, E2 level and the CHF degree were synchronously changed.③Before treatment, the plasma E2 level in CHF patients with hypertension was higher than normotensive patients （ P 〈0.05 ）; after treatment, E2 was decreased significantly （P〈0.05）.Conclusion Endogenous E2 level is related to the degree of CHF in elderly men.Plasma E2 level is significantly higher in CHF patients with hypertension.These results suggest that E2 has a protective effect on the elderly men of CHF with hypertension.

关 键 词：雌二醇( E2 ) 慢性心力衰竭( CHF) 高血压 老年男性 

分 类 号：R544.1[医药卫生—心血管疾病]