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目的探讨患者血浆雌二醇(E_2)水平与绝经后急性脑梗死发病的关系。方法选择2015年1月-2016年1月在该院住院的绝经后急性脑梗死患者100例作为观察组,另选择同期绝经1年以上的健康体检者50例作为对照组。收集两组研究对象性别、年龄、身高、体重、高血压病史、糖尿病病史及冠心病病史。检测两组舒张压(DBP)、收缩压(SBP)、血浆空腹胰岛素(FINS)、E2、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、空腹血糖(FBS)和高敏C-反应蛋白(hs-CRP)水平,并计算胰岛素敏感指数(ISI)。结果观察组患者高血压病史占比、糖尿病病史占比、冠心病病史占比、SBP、DBP、FBS、FINS、TC、TG、LDL-C及Hs-CRT均高于对照组,差异均有统计学意义(均P<0.05)。ISI、HDL-C和E2均低于对照组,差异均有统计学意义(均P<0.05)。Logistic回归分析结果显示:高血压病史、高脂血症病史和Hs-CRP是急性脑梗死发病的独立危险因素(P<0.05)。急性脑梗死患者血浆E2水平与ISI和HDL-C水平呈正相关(P<0.05),与FINS、LDL-C和Hs-CRP水平呈负相关(P<0.05)。血浆E2水平与SBP、DBP、FBS、TC、TG水平无相关性(P>0.05)。结论绝经后脑梗死妇女E2水平下降,E2通过影响炎症反应和糖脂代谢参与急性脑梗死的发病。
Objective To investigate the relationship between the level of plasma estradiol (E 2) and the incidence of post-menopausal acute cerebral infarction. Methods One hundred patients with postmenopausal acute cerebral infarction hospitalized in our hospital from January 2015 to January 2016 were selected as the observation group. Another 50 healthy subjects with over 1 year menopause at the same period were selected as the control group. Two groups of subjects were collected gender, age, height, weight, history of hypertension, diabetes history and history of coronary heart disease. The levels of DBP, SBP, FINS, E2, TC, HDL-C, LDL-C (TG), fasting blood glucose (FBS) and high-sensitivity C-reactive protein (hs-CRP) were measured and insulin sensitivity index (ISI) was calculated. Results The proportion of patients with hypertension in the observation group was higher than that in the control group, the proportion of history of diabetes, the history of coronary heart disease, SBP, DBP, FBS, FINS, TC, TG, LDL-C and Hs- Significance (both P <0.05). ISI, HDL-C and E2 were lower than the control group, the difference was statistically significant (P <0.05). Logistic regression analysis showed that the history of hypertension, history of hyperlipidemia and Hs-CRP were independent risk factors of acute cerebral infarction (P <0.05). Plasma E2 levels in patients with acute cerebral infarction were positively correlated with ISI and HDL-C levels (P <0.05), and negatively correlated with FINS, LDL-C and Hs-CRP levels (P <0.05). There was no correlation between plasma E2 level and SBP, DBP, FBS, TC, TG levels (P> 0.05). Conclusion The level of E2 in postmenopausal women with cerebral infarction is decreased. E2 is involved in the pathogenesis of acute cerebral infarction by affecting inflammation and glucose and lipid metabolism.