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目的:本研究探讨内源性雌激素水平对绝经后女性急性心肌梗死(AMI)发生的影响。方法:本研究共计纳入30例绝经后女性AMI患者(AMI组)和60例健康绝经后女性(对照组)。所有患者均检测内源性性激素水平(包括血雌酮、雌二醇、雄烯二醇和睾酮水平)。多因素Logistic回归分析性激素水平与AMI发生风险的关系。结果:与对照组相比,AMI组的血雌酮、雌二醇、雄烯二醇和睾酮水平明显升高(P<0.05),而性激素结合球蛋白(SHBG)水平却减低(P<0.05)。单因素Logistic回归分析显示,雌酮、雌二醇、睾酮、臀腰比、体质指数、糖尿病和高血压均与AMI发生呈正相关(P<0.05)。校正这些因素后,雌二醇[比值比(OR)4.75,95%可信区间(CI):1.07~21.10,P<0.05]和腰臀比(OR=6.46,95%CI:1.09~38.39,P<0.05)仍和AMI呈正相关。结论:高雌二醇水平与绝经后女性AMI的发生呈正相关,提示内源性高雌激素可能是绝经后女性AMI发生的独立危险因素。
Objective: This study was to investigate the effect of endogenous estrogen levels on the incidence of acute myocardial infarction (AMI) in postmenopausal women. METHODS: A total of 30 AMI patients (AMI group) and 60 healthy postmenopausal women (control group) were enrolled in this study. All patients were tested for endogenous sex hormone levels (including blood estrone, estradiol, androstenedione and testosterone levels). Multivariate logistic regression analysis of the relationship between sex hormones and AMI risk. Results: Compared with the control group, the levels of E2, E2, and E2 in AMI group were significantly increased (P <0.05), while the levels of sex hormone binding globulin (SHBG) . Univariate logistic regression analysis showed that estrone, estradiol, testosterone, hip-waist ratio, body mass index, diabetes and hypertension were positively correlated with AMI (P <0.05). After adjusting for these factors, estradiol [odds ratio (OR) 4.75, 95% CI: 1.07-21.10, P <0.05] and waist-to-hip ratio (OR 6.41, 95% CI 1.09-38.39, P <0.05) still had a positive correlation with AMI. CONCLUSION: The correlation between estrogen level and the incidence of AMI in postmenopausal women is positively correlated, suggesting that endogenous estrogen may be an independent risk factor for AMI in postmenopausal women.