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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。
Objective: To investigate the correlation between estrogen and lipoprotein and coronary artery disease (CAC) in elderly women. Methods: 160 postmenopausal female patients were selected and CAC scores were calculated by spiral CT. According to the CAC score, they were divided into 3 groups: 40 patients in mild calcification group (including no CAC group) (0-10), 40 patients in moderate calcification group ~ 14 points) 32 cases, severe calcification group (≥ 15 points) in 48 cases. The clinical features of the patients were recorded and the serum levels of sex hormones, LP (a) and lipids were measured. Results: The age, serum total cholesterol and low density lipoprotein cholesterol (LDL-C), LP (a) and diabetes mellitus in severe calcification group were higher than those in mild calcification group. Serum apolipoprotein A, Alcohol (E2) was significantly lower than mild calcification group, the differences were statistically significant. With the increase of calcification, LP (a) increased, the difference was statistically significant. Multiple logistic regression analysis showed that serum E2 and LDL-C, LP (a), diabetes mellitus and age were independent risk factors for CAC exacerbations (CAC score> 10) in postmenopausal women. CONCLUSION: Estrogen levels decrease and LP (a) increase in postmenopausal women is an independent risk factor for CAC exacerbation.