【摘要】 目的 分析绝经后急性冠脉综合征（acute coronary syndrome, ACS）患者雌激素与超敏C反应蛋白（hs-CRP）、N-末端脑钠肽前体（N-terminal pro-B-type natriuretic peptide, NT-proBNP）的相关性，探讨雌激素在ACS发病中可能的作用机制，以期为临床研究ACS雌激素替代疗法提供参考。方法 选取50例ACS患者，其中急性心肌梗死患者24例（AMI组）,不稳定心绞痛患者26例（UA组）,选取同期确诊为稳定型心绞痛患者25例（SAP组）及疑诊CHD行冠脉造影检查排除冠心病的绝经后女性25例为对照组，检测其血清雌二醇（E₂）水平、hs-CRP水平及血浆NT-proBNP水平。分析E₂与hs-CRP、NT-proBNP的相关性。结果E₂水平比较，AMI组<UA组<SAP组<对照组（P<0.01）,hs-CRP水平比较，AMI组>UA组>SAP组>对照组（P<0.01）,NT-proBNP水平比较，AMI组>UA组>SAP组>对照组（P<0.01）。经Pearson线性回归分析，E₂与hs-CRP、NT-proBNP均呈负相关。结论 ACS与SAP患者N-proBNP、hs-CRP水平均升高，升高程度与患者疾病程度相关，AMI患者升高最显著。ACS与SAP患者内源性E₂水平明显低于正常组，且与N-proBNP、hs-CRP水平呈负相关。雌激素对绝经后女性ACS患者具有重要影响，干预雌激素水平有可能对ACS预防、治疗有积极意义。更多还原

【Abstract】 Objective To analyze the correlation between estrogen and high-sensitivity C-reactive protein（hs CRP）,N-terminal pro-B-type natriuretic peptide（NT-proBNP）in postmenopausal patients with acute coronary syndrome（ACS）,and explore the possible mechanism of estrogen in the pathogenesis of ACS,so as to provide reference for clinical research on ACS estrogen replacement therapy.Methods A total of 50 patients with ACS were selected as the test group, including 24 patients with acute myocardial infarction（AMI group）,26 patients with unstable angina pectoris（UA group）.At the same time, 25 patients with stable angina pectoris（SAP group）and 25 postmenopausal women suspected of CHD who were excluded from coronary heart disease by coronary angiography were selected as the control group.Serum estradiol（E₂）level, serum hs-CRP level and plasma NT-proBNP level were measured.The correlation between E₂ and hs-CRP,NT-proBNP was analyzed.Results E₂ level comparison, AMI group<UA group<SAP group<control group（P<0.01）;hs-CRP level comparison, AMI group>UA group>SAP group>control group（P<0.01）;NT-proBNP level comparison, AMI group>UA group>SAP group>control group（P<0.01）.According to Pearson linear regression analysis, E₂ is associated with hs CRP and NT-proBNP,all showed negative correlation.Conclusion The levels of NT-proBNP and hs-CRP in patients with ACS and SAP increased, and the degree of increase was correlated with the disease degree of patients, especially in patients with AMI.The level of endogenous E₂ in patients with ACS and SAP was significantly lower than that in the normal group, and was negatively correlated with the levels of NT-proBNP and hs-CRP.Estrogen has a significant impact on postmenopausal female ACS patients, and intervening in estrogen levels may have positive implications for ACS prevention and treatment.更多还原