绝经后妇女冠心病患者雌激素、凝血及纤溶系统的变化  

Changes of estrogen,coagulation and fibrinolytic system in postmenopausal women with coronary artery disease

作　　者：吕宝经[1] 郭晋村[1] 陆尚彪[1] 陈天适[1] 荣烨之[1] 沈霞[2] 

机构地区：[1]上海第二医科大学附属新华医院心内科,200092 [2]上海第二医科大学附属新华医院检验科,200092

出　　处：《中华心血管病杂志》2004年第1期33-35,共3页Chinese Journal of Cardiology

摘　　要：目的　探讨绝经后女性冠心病患者血中内源性雌激素、凝血及纤溶系统的变化。方法　以正常绝经≥ 1年的 6 2例因胸痛收住本院并经冠状动脉造影的妇女为研究对象 ,且无雌激素替代治疗者。根据冠状动脉造影结果分为冠心病与非冠心病两组 ,空腹测定血中雌激素、凝血及纤溶系统指标。结果　两组间年龄、绝经年数差异无显著性。冠心病组较非冠心病组雌二醇、孕酮明显降低(P <0 0 0 1,P <0 0 5 ) ,促卵泡刺激素和促黄体生成素升高 (P <0 0 1) ;而凝血系统中的纤维蛋白原、血管性血友病因子抗原 (vWF∶Ag)升高 (P <0 0 5 ) ;纤溶系统中的组织纤溶酶原激活剂 (tPA)降低 (P<0 0 5 ) ,PAI 1升高 (P <0 0 5 )。结论　绝经后女性冠心病患者较非冠心病患者血中雌二醇水平降低 。Objective To investigate the changes of endogenous estrogen, coagulation and fibrinolytic system in the blood in postmenopausal women with coronary artery disease(CAD). Methods Sixty two normal postmenopausal women (menopause≥1 year) were studied. All of them were admitted and undertaken coronary angiography because of complaining variable degrees of chest pain or discomfort, and did not adopt estrogen replacement therapy. According to the results of coronary angiography, the women were divided into coronary artery disease (CAD) group and non CAD(NCAD)group. The level of estradiol(E 2),some parameters of coagulation and fibrinolytic system in blood were investigated in two groups. Results The age and average menopausal period were not statistically different between the two groups. The levels of E 2 and progesterone were significantly lower, but follicle stimulating hormone and luteinizing hormone were higher in the CAD group than those in the NCAD group ( P <0 05, P <0 01 respectively).The content of fibrinogen and the activity of vWF∶Ag were increased in the CAD group in comparison with the NCAD group ( P <0 05, P <0 01).The activity of tissue plasminogen activator was obviously decreased, the activity of plasminogen activator inhibitor 1 was increased in the CAD group in comparison with the NCAD group( P <0 05). Conclusion It was shown in this study that the lower level of serum estradiol, hyperfunction of coagulation system and hypofunction of fibrinolytic system were more significant in postmenopausal women with CAD than women without CAD.

关 键 词：绝经后 妇女 冠心病 雌激素 凝血 纤溶系统 

分 类 号：R541.4[医药卫生—心血管疾病]