CAJ | 학술논문

目的：探讨免疫炎性反应相关因子及雌激素水平与绝经前女性冠心病的关系，分析其临床特征及冠状动脉造影特点。方法按照入选标准选取2013年1月至2014年10月于新乡医学院第一附属医院心血管内科住院拟诊冠心病的绝经前女性43例，根据冠状动脉造影结果分为冠心病组（19例）和对照组（24例），均抽血测定免疫球蛋白 IgG 、IgA 、IgM 和补体 C3、C4水平，同时检测超敏 C 反应蛋白及雌激素水平，观察冠心病患者的临床特征及冠状动脉病变特点。结果冠心病组 IgG 、hs‐CRP 水平显著高于对照组（P ＜0．05），IgM 、IgA 、C3及 C4的水平显著高于对照组（P＜0．05），冠心病组雌激素水平显著低于对照组（P ＜0．05）；绝经前女性冠心病患者冠状动脉造影显示病变以单支病变为主，所占比例为58％，罪犯血管为左前降支者占79％。结论绝经前女性冠心病患者存在体液免疫功能亢进，hs‐CRP 水平升高及雌激素的缺乏与绝经前女性冠心病发生有关，其临床症状不典型，以单支血管病变为主，易累及左前降支。
목적：탐토면역염성반응상관인자급자격소수평여절경전녀성관심병적관계，분석기림상특정급관상동맥조영특점。방법안조입선표준선취2013년1월지2014년10월우신향의학원제일부속의원심혈관내과주원의진관심병적절경전녀성43례，근거관상동맥조영결과분위관심병조（19례）화대조조（24례），균추혈측정면역구단백 IgG 、IgA 、IgM 화보체 C3、C4수평，동시검측초민 C 반응단백급자격소수평，관찰관심병환자적림상특정급관상동맥병변특점。결과관심병조 IgG 、hs‐CRP 수평현저고우대조조（P ＜0．05），IgM 、IgA 、C3급 C4적수평현저고우대조조（P＜0．05），관심병조자격소수평현저저우대조조（P ＜0．05）；절경전녀성관심병환자관상동맥조영현시병변이단지병변위주，소점비례위58％，죄범혈관위좌전강지자점79％。결론절경전녀성관심병환자존재체액면역공능항진，hs‐CRP 수평승고급자격소적결핍여절경전녀성관심병발생유관，기림상증상불전형，이단지혈관병변위주，역루급좌전강지。
Objective To investigate the correlation between immune inflammation reaction associated factors and estrogen levels with premenopausal female coronary heart disease ,and to analyze its clinical characteristics and the coronary arteriographic features .Methods 43 premenopausal women patients diagnosed as coronary heart disease (CHD) in the First Affiliated Hospital of Xingxiang Medical College from January 2013 and October 2014 were se‐lected according to the including criteria and divided into the CHD group(19 cases) and control group(24 cases) ac‐cording to the coronary angiography results .The levels of IgG ,IgA ,IgM ,complement C3 ,C4 ,hs‐CRP and E2 were detected .The clinical and angiographic features were observed .Results The IgG and hs‐CRP levels in the CHD group were significantly higher than those in the control group(P< 0 .05) ,the IgM ,IgA ,C3 and C4 levels were sig‐nificantly higher than those in the control group(P < 0 .05) ,while the E2 level in the CHD group was significantly lower than that in the control group (P < 0 .05) ;the coronary angiography in premenopausal women with CHD showed that the single vessel lesion was predominant ,accounting for 58% ,culprit vessel was left anterior descending coronary ,accounting for 79% .Conclusion The humoral immune hyperfunction exists in the premenopausal patients with CHD ,the elevation of hs‐CRP level and deficiency of E2 could be correlated with occurrence of CHD in prem‐enopause women ,its clinical symptoms are atypical ,the single vessel lesion is predominant and the left anterior de‐scending artery is most easily involved .