中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2012年
7期
563-566
,共4页
付真彦%杨红%马依彤%黄定%于子翔%谢翔%刘芬
付真彥%楊紅%馬依彤%黃定%于子翔%謝翔%劉芬
부진언%양홍%마의동%황정%우자상%사상%류분
冠心病%睾酮%绝经期
冠心病%睪酮%絕經期
관심병%고동%절경기
Coronary disease%Testosterone%Menopause
目的 探讨绝经后女性血清总睾酮水平与冠心病及冠状动脉狭窄程度的相关性. 方法 采用病例对照研究,选择2006年1月至2011年6月在新疆医科大学第一附属医院心脏中心住院的绝经后女性患者394例,冠心病组183例,为连续冠状动脉造影检查确诊为冠心病的绝经后女性,平均年龄(62.7±8.0)岁,将其分为单支,双支及多支病变组；对照组211例,为连续行冠状动脉造影检查结果正常的绝经后女性,平均年龄(60.0±8.8)岁.对所有纳入对象测定空腹血清总睾酮、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血糖水平,并结合冠状动脉造影情况,探讨血清总睾酮水平与冠心病及冠状动脉狭窄程度的关系.检测总睾酮水平的参考范围为3.5～26.0 nmol/L,用四分位间距法把入选者分为4组,Q1组＜3.5 nmol/L;3.5 nmol/L≤Q2组＜10.4nmol/L; 10.4 nmol/L≤Q3组＜26.0 nmol/L;Q4组≥26.0 nmol/L.对总睾酮水平与冠心病进行分析. 结果 冠心病组血清总睾酮水平(10.4±24.3)nmol/L,对照组为(6.9±17.4)nmol/L,两组比较差异无统计学意义(Z=0.79,P=0.555)；用四分位间距法比较,Q1～Q4组例数分别为190例、64例、120例、20例,其中冠心病例数分别为89例(46.8％)、26例(40.6％)、53例(44.2％)、15例(75.0％),Q4组的冠心病发生率大于Q1组、Q2组、Q3组(x2 =7.69 P=0.048),Q1组、Q2组、Q3组间比较,差异无统计学意义.Logistic回归分析中以Q3组为参照,Q4组患冠心病的风险是Q3组的3.73倍(OR=3.73,95％CI:1.18～11.83,P＜0.05),校正其他危险因素后,Q4组患冠心病的风险是Q3的3.47倍(OR=3.47,95％CI:1.06～11.32,P＜0.05),且随着血清总睾酮水平升高,冠状动脉病变累及支数增加(F=12.94,P＜0.05). 结论 血清总睾酮水平较高人群冠心病发生风险高,绝经后女性中高睾酮水平可能是冠心病发生的一个独立危险因素,且和冠状动脉病变程度相关.
目的 探討絕經後女性血清總睪酮水平與冠心病及冠狀動脈狹窄程度的相關性. 方法 採用病例對照研究,選擇2006年1月至2011年6月在新疆醫科大學第一附屬醫院心髒中心住院的絕經後女性患者394例,冠心病組183例,為連續冠狀動脈造影檢查確診為冠心病的絕經後女性,平均年齡(62.7±8.0)歲,將其分為單支,雙支及多支病變組；對照組211例,為連續行冠狀動脈造影檢查結果正常的絕經後女性,平均年齡(60.0±8.8)歲.對所有納入對象測定空腹血清總睪酮、三酰甘油、總膽固醇、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、血糖水平,併結閤冠狀動脈造影情況,探討血清總睪酮水平與冠心病及冠狀動脈狹窄程度的關繫.檢測總睪酮水平的參攷範圍為3.5～26.0 nmol/L,用四分位間距法把入選者分為4組,Q1組＜3.5 nmol/L;3.5 nmol/L≤Q2組＜10.4nmol/L; 10.4 nmol/L≤Q3組＜26.0 nmol/L;Q4組≥26.0 nmol/L.對總睪酮水平與冠心病進行分析. 結果 冠心病組血清總睪酮水平(10.4±24.3)nmol/L,對照組為(6.9±17.4)nmol/L,兩組比較差異無統計學意義(Z=0.79,P=0.555)；用四分位間距法比較,Q1～Q4組例數分彆為190例、64例、120例、20例,其中冠心病例數分彆為89例(46.8％)、26例(40.6％)、53例(44.2％)、15例(75.0％),Q4組的冠心病髮生率大于Q1組、Q2組、Q3組(x2 =7.69 P=0.048),Q1組、Q2組、Q3組間比較,差異無統計學意義.Logistic迴歸分析中以Q3組為參照,Q4組患冠心病的風險是Q3組的3.73倍(OR=3.73,95％CI:1.18～11.83,P＜0.05),校正其他危險因素後,Q4組患冠心病的風險是Q3的3.47倍(OR=3.47,95％CI:1.06～11.32,P＜0.05),且隨著血清總睪酮水平升高,冠狀動脈病變纍及支數增加(F=12.94,P＜0.05). 結論 血清總睪酮水平較高人群冠心病髮生風險高,絕經後女性中高睪酮水平可能是冠心病髮生的一箇獨立危險因素,且和冠狀動脈病變程度相關.
목적 탐토절경후녀성혈청총고동수평여관심병급관상동맥협착정도적상관성. 방법 채용병례대조연구,선택2006년1월지2011년6월재신강의과대학제일부속의원심장중심주원적절경후녀성환자394례,관심병조183례,위련속관상동맥조영검사학진위관심병적절경후녀성,평균년령(62.7±8.0)세,장기분위단지,쌍지급다지병변조；대조조211례,위련속행관상동맥조영검사결과정상적절경후녀성,평균년령(60.0±8.8)세.대소유납입대상측정공복혈청총고동、삼선감유、총담고순、고밀도지단백담고순、저밀도지단백담고순、혈당수평,병결합관상동맥조영정황,탐토혈청총고동수평여관심병급관상동맥협착정도적관계.검측총고동수평적삼고범위위3.5～26.0 nmol/L,용사분위간거법파입선자분위4조,Q1조＜3.5 nmol/L;3.5 nmol/L≤Q2조＜10.4nmol/L; 10.4 nmol/L≤Q3조＜26.0 nmol/L;Q4조≥26.0 nmol/L.대총고동수평여관심병진행분석. 결과 관심병조혈청총고동수평(10.4±24.3)nmol/L,대조조위(6.9±17.4)nmol/L,량조비교차이무통계학의의(Z=0.79,P=0.555)；용사분위간거법비교,Q1～Q4조례수분별위190례、64례、120례、20례,기중관심병례수분별위89례(46.8％)、26례(40.6％)、53례(44.2％)、15례(75.0％),Q4조적관심병발생솔대우Q1조、Q2조、Q3조(x2 =7.69 P=0.048),Q1조、Q2조、Q3조간비교,차이무통계학의의.Logistic회귀분석중이Q3조위삼조,Q4조환관심병적풍험시Q3조적3.73배(OR=3.73,95％CI:1.18～11.83,P＜0.05),교정기타위험인소후,Q4조환관심병적풍험시Q3적3.47배(OR=3.47,95％CI:1.06～11.32,P＜0.05),차수착혈청총고동수평승고,관상동맥병변루급지수증가(F=12.94,P＜0.05). 결론 혈청총고동수평교고인군관심병발생풍험고,절경후녀성중고고동수평가능시관심병발생적일개독립위험인소,차화관상동맥병변정도상관.
Objective To study the association between serum concentrations of total testosterone levels and coronary heart disease (CHD) in the postmenopausal women. Methods The study was designed as a case-control study.394 postmenopausal female patients were selected from Cardiology Center of the First Affiliated Hospital of Xinjiang Medical University.The case group included 183 women patients with CHD aged (62.7±8.0) years,the control group,211 women with normal coronary aged (60.0 ± 8.8) years. Blood samples were collected to determine total testosterone,fasting glucose and lipid profile. CHD severity was expressed as the numbers of coronary arteries that had a stenosis ≥50％.According to the level of testosteron,all cases were divided into 4 groups by interquartile range method:Q1＜3.5 nmol/L(n=190),3.5 nmol/L≤Q2 ＜10.4 nmol/L(n=64),10.4 nmol/L≤Q3 ＜26.0 nmol/L(n=120) and Q4≥26.0 nmol/L(n=20).The association between the serum total testosterone levels and severity of coronary atherosclerosis was analyzed. Results The average total testosterone was higher in case group than in control group[(10.4 ± 24.3 ) nmol/L vs. ( 6.9 ± 17.4 ) nmol/L,Z =0.79,P =0.555].In Quantitative adjusted models,higher levels of total testosterone had strong correlation with CHD,Q4 incidence of CHD (75.0％,15 cases) was significantly higher than Q1 (46.8％,89 cases),Q2 (40.6％,26 cases)and Q3 (44.2％,53 cases) (x2 =7.69,P=0.048).After adjustment for other risk factors,women in the top quartile of total testosterone levels had a more than 3-fold increase in odds of CHD(OR=3.47,95％CI:1.06-11.32,P＜0.05).In addition,the serum concentrations of total testosterone level were significantly associated with the severity of CHD (F=12.94,P＜0.05). Conclusions Higher levels of total testosterone may be associated with high prevalence and severity of CHD as an independent factor in postmenopausal women.
