【摘要】 目的:探讨雌激素及脂蛋白与老年女性冠状动脉病变评分(CAC)之间的相关性。方法:选择绝经后女性患者160例,通过螺旋CT计算CAC积分,根据CAC积分分为3组:轻度钙化组(包括无CAC组)(0～10分)40例,中度钙化组(11～14分)32例,重度钙化组(≥15分)48例。记录患者的临床基本特征,检测血清性激素、LP(a)和血脂等指标。结果:重度钙化组的年龄、血清总胆固醇和低密度脂蛋白胆固醇(LDL-C)、LP(a)、糖尿病患病率均高于轻度钙化组;而血清载脂蛋白A、血清雌二醇(E2)明显低于轻度钙化组,差异均有统计学意义。随着钙化加重,LP(a)有增高趋势,差异有统计学意义。多元Logistic回归分析显示,血清E2和LDL-C、LP(a)、糖尿病、年龄是女性绝经后CAC加重(CAC积分>10)的独立危险因素。结论:女性绝经后雌激素水平下降、LP(a)升高是CAC加重的独立危险因素。更多还原

【Abstract】 Objective:To explore the correlation between estrogen,lipoprotein and coronary artery calcification(CAC) score among elderly women. Methods:160 postmenopausal women were selected,spiral computed tomography(MSCT) was used to calculate CAC score,then they were divided into three groups according to CAC score: mild calcification group(including non-CAC group)(0～10 points)(40 postmenopausal women),moderate calcification group(11～14 points)(32 postmenopausal women) and severe calcification group(≥15 points)(48 postmenopausal women).The basic clinical characteristics of the postmenopausal women were recorded,the indexes including serum sexual hormones,lipoprotein and blood lipids were detected. Results:The age,serum total cholesterol,low density lipoprotein cholesterol(LDL-C),lipoprotein and incidence of diabetes mellitus in severe calcification group were higher than those in mild calcification group;the levels of serum apolipoprotein A and estradiol in severe calcification group were lower than those in mild calcification group,there was significant difference.The level of lipoprotein showed a increasing trend with the aggravation of calcification,there was significant difference.Multivariate logistic regression analysis showed that serum estradiol,LDL-C,lipoprotein,diabetes mellitus and age were independent risk factors of aggravation of CAC(CAC score>10) among postmenopausal women. Conclusion:The decrease of estrogen level and increase of lipoprotein level are independent risk factors of aggravation of CAC among postmenopausal women.更多还原