摘要
目的探讨女性X综合征患者血清雌二醇(E2)、氧化应激水平与冠状动脉微循环阻力的关系。方法连续入选2015年1月至2019年1月在广州市第一人民医院住院的女性X综合征患者120例,均接受冠状动脉造影,通过压力导丝精确定位技术,测量并计算冠状动脉微循环阻力指数(IMR)。根据IMR值将患者分为低IMR组和高IMR组,另外选择同期体检中心的40名健康体检者作对照组。检测3组受试者血清E2、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、超氧化物歧化酶(SOD)水平。结果高IMR组合并糖尿病比率高于对照组和低IMR组(P<0.05),低IMR组与对照组比较差异无统计学意义(P<0.05)。高IMR组血清E2、SOD水平明显低于对照组和低IMR组,血清IL-1、TNF-α水平明显高于对照组和低IMR组(P<0.05);低IMR组血清E2、SOD水平低于对照组,血清IL-1、TNF-α水平高于对照组(P<0.05)。高IMR组和低IMR组患者血清E2水平与IL-1、TNF-α水平呈负相关(P<0.05),与SOD水平呈正相关(P<0.05)。多因素logistic回归分析显示糖尿病、血清E2水平降低、SOD水平降低、IL-1水平升高、TNF-α水平升高为女性X综合征患者冠脉微循环阻力增加的独立危险因素(P<0.05)。结论女性X综合征患者血清E2水平降低是诱发冠状动脉微循环障碍的重要因素,血清E2水平降低导致机体在氧化应激状态时失去相应拮抗作用,可能是冠状动脉微循环障碍形成和进展的重要机制之一。
Objective To investivate the relationship of serum estradiol and oxidative stress with microcirculation resistance in women with syndrome X.Methods A total of 120 patients with syndrome X who were hospitalized in the Department of Cardiology in Guangzhou First People's Hospital from January 2015 to January 2019 were enrolled.All patients underwent coronary angiography and pressure wire examination and were divided into two groups according to the index of microcirculation resistance(IMR).Forty healthy people in the medical examination center were used as controls in the same period.The level of serum estradiol,interleukin-1(IL-1),tumor necrosis factor-α(TNF-α),superoxide dismutase(SOD)were measured among three groups.Results The rate of diabetes mellitus in high IMR group was higher than that in control group and low IMR group(P<0.05).There was no significant difference between low IMR group and control group(P>0.05).The levels of serum estradiol and SOD were significantly lower in high IMR group than those in low IMR group and control group.The levels of IL-1 and TNF-αwere significantly higher in high IMR group than those in low IMR group and control group(P<0.05).These indexes have the same relationship between low-IMR group and control group(P<0.05).The level of serum estradiol was negatively correlated with the levels of IL-1 and TNF-αin high and low IMR groups and positively correlated with the level of SOD in these groups.Multivariate logistic regression analysis showed that diabetes,low serum estradiol level,low SOD level,high IL-1 level,high TNF-αlevel were the independent risk factors for microcirculation resistance in women with syndrome X(P<0.05).Conclusions The decreased serum estradiol is an important factor for coronary microcirculation disorders in women with syndrome X.The decrease of serum estradiol level leads to the loss of the corresponding antagonistic effect in oxidative stress state,which may be one of the important mechanisms of the formation and progress of coronary microcirculation
作者
赵斌
潘宜智
李韶南
陈平安
雷晓明
Zhao Bin;Pan Yizhi;Li Shaonan;Chen Ping′an;Lei Xiaoming(Department of Cardiology,Guangzhou First People′s Hospital,Guangzhou 510180,China)
出处
《中国医师杂志》
CAS
2021年第1期39-42,47,共5页
Journal of Chinese Physician
基金
广东省医学科学技术研究基金(201611119319867)。
