河北医科大学学报 ›› 2020, Vol. 41 ›› Issue (12): 1389-1392,1449.doi: 10.3969/j.issn.1007-3205.2020.12.006

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绝经期前女性冠心病患者激素水平与血浆炎症标记物和冠状动脉斑块稳定性相关性研究

  

  1. 河北省邢台市人民医院心内科，河北 邢台 054000
  • 出版日期:2020-12-25 发布日期:2020-12-31
  • 作者简介:王世杰（1984-），男，河北邢台人，河北省邢台市人民医院主治医师，医学硕士，从事心内科疾病诊治研究。
  • 基金资助:
    邢台市科技计划项目（2018ZC149）

Study on the relationship between the level of hormone and plasma inflammatory markers and coronary plaque stability in female patients with coronary heart disease before menopausal period

  1. Department of Cardiology, Xingtai People′s Hospital, Hebei Province, Xingtai 054000， China
  • Online:2020-12-25 Published:2020-12-31

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摘要： 目的 探讨绝经期前女性冠心病（coronary heart disease,CHD）患者激素水平与血浆炎症标记物和冠状动脉斑块稳定性相关性。
方法 选取行冠状动脉造影确诊为CHD的绝经期前女性患者62例，根据患者具体的临床表现分为急性冠状动脉综合征（acute coronary syndrome,ACS）组（n=30）和稳定型心绞痛（stable angina pectoris,SAP）组（n=32），同期选取冠状动脉造影表现正常者为对照组（n=30）。采用血管内超声检查ACS组和SAP组斑块分布情况，采用化学发光法检测所有受试者血浆性激素［雌二醇（estradiol,E2）、孕酮（progesterone,P）］水平，双抗体夹心酶联免疫吸附试验检测血浆同型半胱氨酸（homocysteine,Hcy）、髓过氧化物酶(myeloperoxidase,MPO)水平。分析绝经期前女性CHD患者激素水平与血浆炎症标记物相关性。
结果 观察组2组不稳定斑块、稳定性斑块比例比较差异有统计学意义（P＜0.05），混合斑块比例比较差异无统计学意义（P＞0.05）。 与对照组比较，ACS组和SAP组血浆E2水平显著降低，P水平显著升高（P＜0.05）；与ACS组比较，SAP组E2水平显著升高，P水平显著降低（P＜0.05）。与对照组比较，ACS组和SAP组血浆Hcy和MPO水平显著升高（P＜0.05）；与ACS组比较，SAP组Hcy和MPO水平显著降低（P＜0.05）。 经Pearson相关性分析，血清P水平与血浆Hcy水平呈正相关（r=12.643,P=0.014），与MPO水平呈正相关（r=10.316,P=0.008）；血清E2水平与血浆Hcy水平呈负相关（r=-3.736,P=0.025），与MPO水平呈负相关（r=-6.124,P=0.017）。
结论 绝经期前女性CHD患者血清激素及血浆炎症因子水平与冠状动脉斑块的稳定性相关，较低的血清E2水平、较高的血清P水平及血浆Hcy、MPO水平可能提示斑块易损或破裂。

关键词: 冠心病, 绝经前期, 激素类

Abstract: Objective To study the relationship between the level of hormone and plasma inflammatory markers and coronary plaque stability in female patients with coronary heart disease before menopausal period. 
Methods A total of 62 pre-menopausal female patients with coronary heart disease(CHD) diagnosed by coronary angiography were selected.According to the clinical manifestations of the patients, they were divided into acute coronary syndrome(ACS) group(n=30) and stable angina pectoris(SAP) group(n=32). At the same time, the patients with normal coronary angiography were selected as the control group(n=30). The distribution of plaques in ACS group and SAP group was examined by intracoronary ultrasound imaging. The level of plasma sex hormone(E2, P) were measured by chemiluminescence in all subjects. The level of Hcy and MPO were measured by double antibody sandwich enzyme-linked immunosorbent assay. The correlation between the level of hormone and plasma inflammatory markers in female patients with coronary heart disease(CAD) before menopausal period were analyzed. 
Results There was significant difference in the proportion of unstable plaques and stable plaques between the two groups(P＜0.05).There was no significant difference in the proportion of mixed plaques(P＞0.05). Compared with the control group, the level of plasma E2 and P in ACS group and SAP group were significantly lower than those in control group(P＜0.05). Compared with the control group, the level of plasma Hcy and MPO in ACS group and SAP group were significantly higher than those in control group(P＜0.05).Compared with ACS group, the level of Hcy and MPO were significantly decreased in SAP group(P＜0.05).  Pearson correlation analysis showed that the level of serum P was positively correlated with the level of plasma Hcy(r=12.643, P=0.014), and positively correlated with the level of MPO(r=10.316, P=0.008). The level of serum E2 was negatively correlated with plasma Hcy level(r=-3.736, P=0.025) , and negatively correlated with the level of MPO(r=-6.124, P=0.017).
Conclusion The levels of serum hormones and plasma inflammatory factors in female patients with CHD before menopausal may be related to the stability of coronary plaques. Lower level of serum E2, higher level of serum P and plasma Hcy, MPO may indicate plaque vulnerability or rupture.


Key words: coronary disease, premenopause, hormones

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