绝经后女性性激素水平与非瓣膜病性心房颤动的相关性研究  

Correlation between sex hormone level and non-valvular atrial fibrillation in postmenopausal women

作　　者：马俊丽 米琴 任艳霞 李言鹏 魏涛涛[1] 陈刚[1] 车千秋 梁宇博 许广莉[1] 郭雪娅[1] Ma Junli;Mi Qin;Ren Yanxia;Li Yanpeng;Wei Taotao;Chen Gang;Che Qianqiu;Liang Yubo;Xu Guangli;Guo Xueya(Department of Cardiology,Second Hospital of Lanzhou University,Lanzhou 730030,China;不详)

机构地区：[1]兰州大学第二医院心内科,兰州730030 [2]兰州大学第二医院急诊科,兰州730030

出　　处：《中国循证心血管医学杂志》2020年第8期1010-1013,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的分析绝经后女性雌二醇、睾酮等性激素及血脂、尿酸对非瓣膜病性心房颤动(NVAF)的影响。方法选取2016年10月至2018年10月于兰州大学第二医院心内科住院的绝经后女性患者179例(年龄≥50岁)为研究对象,其中,107例为NVAF患者(房颤组),72例为无心房颤动的患者(对照组。收集所有研究对象的基线资料,采用SPSS20.0统计软件对数据进行统计分析,并采用Logistics回归分析房颤的独立危险因素。结果房颤组与对照组在血浆同型半胱氨酸(Hcy)、血尿酸(UA)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、尿素氮(BUN)、血肌酐(CREA)、左房内径(LAD)等方面相比,差异均有统计学意义(P均<0.05);进一步的多因素Logistic回归分析显示:左房内径(OR=1.123,95%CI:1.013~1.245,P<0.05),血BUN(OR=2.083,95%CI:1.171~3.704,P<0.05)是NVAF的独立危险因素。在≥75岁的老年人群中,房颤组与对照组在LAD、LDL-C、雌二醇(E2)方面具有统计学意义(P<0.05),进一步单因素Logistic回归分析显示,LAD(OR=1.187,95%CI:1.049~1.344,P<0.05),LDL-C(OR=0.310,95%CI:0.132~0.728,P<0.05),E2(OR=1.116,95%CI:1.014~1.228,P<0.05)是绝经后女性NVAF的危险因素。结论左房内径增大、血尿素氮增高是绝经后女性非瓣膜病性心房颤动发生的独立危险因素;进一步的分析发现,左房内径增大、雌二醇升高、LDL-C降低是75岁以上女性非瓣膜病性心房颤动发生的危险因素。Objective To analyze the influence of sex hormones including estradiol(E2)and testosterone(T),blood fat and uric acid(UA)on non-valvular atrial fibrillation(NVAF)in postmenopausal women.Methods The postmenopausal patients(n=179,aged≥50)were chosen from Department of Cardiology in the Second Hospital of Lanzhou University from Oct.2016 to Oct.2018.The patients divided into NVAF group(n=107)and control group(n=72).The baseline materials were collected from all patients,and data was statistically analyzed by using SPSS 20.0 software.The independent risk factors of NVAF were analyzed by using Logistics regression analysis.Results The differences in homocysteine(Hcy),blood uric acid(BUA),total cholesterol(TC),triglyceride(TG),low-density lipoprotein-cholesterol(LDL-C),blood urea nitrogen(BUN),serum creatinine(SCr)and left atrial diameter(LAD)had statistical significance(all P<0.05).The results of multi-factor Logistic regression analysis showed that LAD(OR=1.123,95%CI:1.013~1.245,P<0.05)and BUN(OR=2.083,95%CI:1.171~3.704,P<0.05)were independent risk factors of NVAF.In elderly population aged≥75,LAD,LDL-C and estradiol(E2)had statistical significance between NVAF group and control group(P<0.05).The results of single-factor Logistic regression analysis showed that LAD(OR=1.187,95%CI:1.049~1.344,P<0.05),LDL-C(OR=0.310,95%CI:0.132~0.728,P<0.05)and E2(OR=1.116,95%CI:1.014~1.228,P<0.05)were risk factors of NVAF in postmenopausal women.Conclusion The increases of LAD and BUN are independent risk factors of NVAF in postmenopausal women.The further analysis indicates that increases of LAD and E2 and decrease of LDL-C are risk factors of NVAF in elderly women aged over 75 years old.

关 键 词：绝经后女性 非瓣膜病性心房颤动 雌二醇 睾酮 

分 类 号：R541.75[医药卫生—心血管疾病]