围绝经期女性性激素与血管内皮功能及冠心病的相关性研究  

Correlation between sex hormone with vascular endothelial function and coronary heart disease in peri⁃menopausal women

作　　者：雷梅先 蔡霜婷 Lei meixian;Cai shuangting(Department of Cardiology,the First People’s Hospital of Jiujiang,Jiujiang 332000,China)

机构地区：[1]江西省九江市第一人民医院心血管内科,332000 [2]江西省九江市第一人民医院超声科,332000

出　　处：《临床内科杂志》2021年第9期594-597,共4页Journal of Clinical Internal Medicine

基　　金：江西省卫生和计划生育委员会科技计划项目(20187107)。

摘　　要：目的探讨围绝经期女性性激素与血管内皮功能及冠心病的相关性。方法纳入2018年1月~2019年12月我院收治的围绝经期疑似冠心病女性患者92例,根据冠状动脉(简称冠脉)造影或冠脉CT检查结果将其分为冠心病组44例和非冠心病组48例,再根据是否停经将92例患者分为未停经组52例和停经组40例。分别比较各组患者性激素水平和血流介导的血管舒张功能(FMD),分析性激素水平与FMD及冠心病发病的相关性。结果冠心病组患者性激素结合球蛋白(SHBG)水平、雌二醇(E2)/总睾酮(TT)比值及FMD均低于非冠心病组(P<0.05),而两组患者E2、TT、游离睾酮(FT)、生物可利用睾酮(BT)水平比较差异均无统计学意义(P>0.05)。未停经组患者E2、E2/TT、FMD均高于停经组(P<0.05),而两组患者TT、FT、BT、SHBG水平比较差异均无统计学意义(P>0.05)。多元线性逐步回归分析结果显示,E2、SHBG与FMD呈正相关(调整后相关系数分别为0.337、0.407,P均<0.01)。二元多因素logistic回归分析结果显示,FMD(B=-1.609,OR=0.203,95%CI 0.091~0.441)、SHBG(B=-1.043,OR=0.190,95%CI 0.052~0.721)、E2/TT(B=-1.415,OR=0.341,95%CI 0.117~0.612)均与冠心病的发生呈负相关。结论围绝经期女性E2、SHBG对血管内皮功能具有保护作用,FMD、SHBG、E2/TT均与冠心病的发生呈负相关。Objective To explore the correlation between sex hormone with vascular endothelial function and coronary heart disease(CHD)in peri⁃menopausal women.Methods A total of 92 female patients with suspected CHD during peri⁃menopausal period admitted to our hospital from January 2018 to December 2019 were concluded.According to the results of coronary angiography or coronary CT examination,they were divided into CHD group(44 cases)and non⁃CHD group(48 cases).According to whether menopause or not,92 patients were divided into non⁃menopausal group(52 cases)and menopausal group(40 cases).Sex hormone levels and blood flow⁃mediated vasodilation(FMD)between above groups were compared respectively.Correlation between sex hormone levels with FMD and the occurrence of CHD were analyzed.Results Levels of sex hormone binding globulin(SHBG),estradiol(E2)/total testosterone(TT)and FMD in CHD group were lower than those in non⁃CHD group(P<0.05),while there were no significant differences of E2,TT,free testosterone(FT)and bioavailable testosterone(BT)between the two groups(P>0.05).E2,E2/TT and FMD of patients in non⁃menopausal group were higher than those in menopausal group(P<0.05),while there were no significant differences of levels of TT,FT,BT,and SHBG between the two groups(P>0.05).Multiple linear stepwise regression analysis showed that E2 and SHBG were positively correlated with FMD(the adjusted correlation coefficients were 0.337 and 0.407,P<0.01).Binary multivariate logistic regression analysis showed that FMD(B=-1.609,OR=0.203,95%CI 0.091⁃0.441),SHBG(B=-1.043,OR=0.190,95%CI 0.052⁃0.721),E2/TT(B=-1.415,OR=0.341,95%CI 0.117⁃0.612)were negatively correlated with the occurrence of CHD.Conclusion E2 and SHBG have protective effects on vascular endothelial function in peri⁃menopausal women,FMD,SHBG and E2/TT are negatively correlated with CHD.

关 键 词：围绝经期 性激素 血管内皮功能 冠心病 

分 类 号：R541[医药卫生—心血管疾病]