【摘要】 目的探讨男性性激素水平与凝血纤溶系统变化的相关性、二者在男性急性心肌梗死(AMI)发生过程中的作用及对梗死面积(MIS)的影响。方法选择因疑似或已确诊冠心病(CHD)而在我院心脏中心住院并接受冠状动脉造影的男性患者91例,分为AMI组、不稳定型心绞痛(UAP)组和正常对照组。在进行抗凝或溶栓治疗前,采集静脉血并分别用放射免疫法、Clauss法及酶联免疫吸附法(ELISA)测雌二醇(E2)、睾酮(T)、孕酮(P)、血浆纤维蛋白原(Fg)、组织型纤溶酶原激活剂(t-PA)、组织型纤溶酶原激活剂抑制物-1(PAI-1)、血管性血友病因子(vWF)。结果三组中E2与PAI-1、PAI-1/tPA、Fg水平呈正相关,T与vWF水平成正相关,E2/T与PAI-1、PAI-1/tPA、Fg、vWF水平均呈正相关;经Logistic回归分析,吸烟史、高血压病史、E2/T、Fg是AMI发生的独立危险因素。结论男性AMI患者存在性激素内环境紊乱,且性激素内环境紊乱可能影响凝血纤溶系统功能并可能是决定MIS大小的因素之一;性激素内环境紊乱可能是导致AMI发生的独立危险因素。更多还原

【Abstract】 Objective To explore the correlation between sex hormones and coagulative-fibrinolytic system, the function of sex hormone internal environment and coagulative-fibrinolytic system in the incidence of acute myocardial infarction（AMI） and their influences on myocardial infarction size（MIS）. Methods Ninety-one male patients, who received coronary angiography were divided into three groups: AMI group, unstable agina pectoris（UAP） group, and healthy control group. Venous blood samples were taken for examination before anticoagulation and thrombolysis. The examination items includes estrogen（E₂）, testosterone（T）, progesterone（P）, fibrinogen（Fg）, tissue plasminogen（t-PA）, plasminogen activator inhibitor（PAI-1）, von Willebrand factor（vWF）. Results E₂ positively correlated with PAI-1, PAI-1/tPA and Fg, but T negatively correlated with vWF, while E₂/T all positively correlated with PAI-1, PAI-1/tPA, vWF and Fg in three groups. The logistic regressive analysis showed that smoking and hypertension history, E₂/T and Fg were independent risk factors for AMI in male patients. Conclusion The disturbance of sex hormone internal environment is one of the factors which influence the function of coagulative-fibrinolytic system and MIS. Perhaps the disturbance of sex hormone internal environment is an independent risk factor for the incidence of AMI in men.更多还原