摘要
目的探讨绝经后女性冠状动脉粥样硬化性心脏病(coronary artry disease,CAD)患者血清雌激素水平及外周血单核细胞Notchl表达水平与冠状动脉钙化严重程度的关系。方法选择2016年1月至2017年6月在我院心内科住院并诊断为CAD的绝经后女性患者266例,入选病例均接受320排螺旋CT心脏冠状动脉成像检查,计算冠状动脉钙化积分(coronary artery calcium sore,CCS),其中CCS=0的患者46例作为对照组,CCS>0的患者按CCS的均值水平(CCS=95.4)分为低钙化积分组(CCS<95.4)组113例与高钙化积分组(CCS≥95.4)组107例,检测患者外周静脉血血清雌二醇(estradiol,E2)水平及外周血单核细胞Notchl表达水平。结果高钙化积分组患者血清B水平显著低于其他两组患者[(9.01±1.33)pg/ml比(9.95±1.42)pg/ml比(11.21±1.76)pg/ml],而外周血单核细胞Notchl表达水平高于另外两组患者[(6.93±0.71)比(6.15±0.68)比(5.89±0.65)],差异均有统计学意义(P<0.05)。Spearman相关分析显示,存在冠状动脉钙化的绝经后女性CAD患者血清E:水平与外周血单核细胞Notchl表达水平呈负相关(r=-0.467,P<0.01)。多因素Logistic回归分析显示,血清E2水平及外周血单核细胞Notchl表达水平均是影响绝经后女性CAD患者冠状动脉钙化严重程度的独立危险因素(P<0.05)。结论绝经后女性CAD患者雌激素水平降低是促进冠状动脉钙化的重要因素,雌激素通过干预Notchl信号通路表达可能是影响冠状动脉钙化形成和进展的重要机制之一。
Objective To investigate the effects of serum estrogen and Notchl express on peripheral blood mononuclear cell (PBMC)in post-menopause women with coronary artery disease (CAD)on coronary calcification.Methods 266 consecutive post-menopause women with CAD who hospitalizing in the Department of Cardiology in Guangzhou First People's Hospital from January 2016 to June 2017 were enrolled.All patients received 320-slice multi-detector row computed tomography scanning and coronary artery calcium sore (CCS) were measuredl Patients were divided three groups:control group (CCS=0),low CCS group (CCS<95.4)and high CCS group (CCS≥95.4)according to the mean value of patients'CCS (CCS=95.4).Patients'serum estradiol and Notchl of PBMC were examined and compared among three groups.Results The levels of serum estradiol in patients of high CCS group were lower than the other two groups while the Notchl expressing on the PBMC of patients in high CCS group were significant higher than the other two groups[(9.01±1.33)pg/ml vs.(9.95±1.42) pg /ml vs.(11.21±1.76)pg /ml,P<0.05 ].The Spearman correlation analysis showed that the levels of serum estradiol and Notch I of PBMC in enrolled patients with coronary calcification were negative correlated (r=-0.467, P<0.01 ).Multivariate Logistic regression analysis showed that serum estradiol and Notchl of PBMC were two strong independent risk factors for severity of coronary calcification in post-menopause women with CAD (P< 0.05).Conclusion The estrogen decreasing in post-menopause women is one main factor to promote coronary calcification.That the estrogen regulate the expression of the Notchl signal path may be one of the most important mechanisms in the formation and progress of coronary calcification.
作者
李韶南
刘震
吕何锦
李广镰
陈平安
雷晓明
LI Shao-nan;LIU Zhen;LYU He-jin;LI Guang-lian;CHEN Ping-an;LEI Xiao-ming(Department of Cardiology,Guangzhou First People's Hospital,Guangzhou 510180,China)
出处
《中国心血管病研究》
CAS
2019年第1期68-72,共5页
Chinese Journal of Cardiovascular Research
基金
广东省医学科学技术研究基金项目(201611119319867).
