内科

目的探讨绝经后急性冠脉综合征（ACS）患者雌激素水平与血脂及内皮素-1（ET-1）水平的关系。方法正常绝经的116例女性经冠脉造影检查分为ACS组（62例）和非ACS组（54例）。在冠脉造影前测定两组的血清雌激素、血脂和ET-1水平，并进行比较。结果（1）与非ACS组比较，ACS组的血清总胆固醇（TC）、甘油三酯（TG）和低密度脂蛋白（LDL）水平显著升高，而高密度脂蛋白（HDL）、载脂蛋白B（ApoB）水平显著降低，差异有统计学意义（P＜0.05）；两组的血清载脂蛋白A（ApoA）水平无差异。（2）ACS组的血清雌二醇（E2）和孕酮（P）水平显著低于非ACS组，而ET-1水平显著高于非ACS组，差异有统计学意义（P＜0.05）。（3）Pearson相关分析显示，E2与TG，TC及LDL之间呈负相关（r分别为-0.47、-0.62、-0.36），与HDL水平呈正相关（r=0.41）。P与ApoB呈负相关（r=-0.55），与ApoA呈正相关（r=0.32）。E2、P均与ET-1呈负相关（r=0.36、0.38，P＜0.05）。结论女性绝经后雌激素水平下降可能导致脂代谢紊乱和内皮功能障碍，后者与ACS的病理生理改变密切相关。

ObjectiveTo investigate the relationship between blood estrogen,lipoproteins and endothelin-1(ET-1) in post-menopausal women with acute coronary syndrome(ACS).Methods116 normal post-menopausal women were divided into ACS group(62 cases) and non-ACS group(54 cases) according to the result of coronary arteriongraphy.The levels of blood estrogen,lipoproteins and ET-1 were detected before coronary angiography and then were compared between the two groups.Results(1)Compared to the non-ACS group,ACS group has a higher level of total cholesterol(TC),triglyceride(TG) and low-density lipoprotein(LDL) and lower levels of high-density lipoprotein(HDL) and apolipoprotein B(ApoB),the differences are significant(P＜0.05).The level of Apolipoprotein A(ApoA) has no significant difference between the two groups.(2)Compared to non-ACS group,ACS group has a lower level of estradiol(E2) and progesterone(P) and a higher levels of ET-1,the differences are significant(P＜0.05).(3) Pearson correlation analysis showed negative correlations between E2 and TG, TC and LDL(r=-0.47,-0.62,-0.36),Positive correlation existed between E2 and HDL(r=0.41), P and ApoB (r=-0.55),P and ApoA(r=0.32).(4)Both E2 and P were negatively correlated with ET-1(r=0.36、0.38, P＜0.05).ConclusionsDecline of Estrogens in post-menopausal women can lead to lipid metabolic disturbance and endothelial functional impairment,which have a close relationship with the alteration of pathophysiology of acute coronary syndrome.