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目的探讨男性性激素水平与冠心病(CHD)患者冠状动脉狭窄程度的关系。方法根据冠状动脉造影结果将135例男性患者分为CHD组和对照组,CHD组又分为单支病变组、双支病变组和多支病变组,并以病变支数和Gensini总积分表示冠状动脉狭窄程度。采用放射免疫法检测所有患者的静脉血性激素5项,包括雌二醇(E2)、睾酮(T)、孕酮(P)、脱氢表雄酮(DHEA)、硫酸脱氢表雄酮(DHEAS)。比较各组间性激素水平并分析性激素水平与冠状动脉狭窄程度之间的关系。结果 CHD组的T、DHEA、DHEAS水平均低于对照组,T(18.6±8.6)nmol/L vs(29.7±11.5)nmol/L、DHEA(22.9±15.3)nmol/Lvs(57.9±27.1)nmol/L、DHEAS(5.5±1.3)μmol/Lvs(6.4±2.4)μmol/L(P<0.05);E2、P和E2/T在两组及不同支数病变组之间差异无统计学意义。病变支数越多,T及DHEA水平越低(P<0.05或<0.01);DHEA、DHEAS进入以Gensini积分为因变量的多元回归方程,标准回归系数分别为-0.229、-0.230。结论男性冠心病患者雄激素水平较低;男性雄激素水平可能影响冠状动脉狭窄程度。
Objective To investigate the relationship between male sex hormone levels and coronary artery stenosis in patients with coronary heart disease (CHD). Methods According to the results of coronary angiography, 135 male patients were divided into CHD group and control group. CHD group was divided into single vessel disease group, double vessel disease group and multi-vessel disease group. The coronary lesion count and Gensini total score Artery stenosis. All patients were tested for venous hemoglobin by radioimmunoassay, including E2, T, P, DHEA, DHEAS ). The levels of sex hormones were compared between groups and the relationship between sex hormone levels and the degree of coronary artery stenosis was analyzed. Results The levels of T, DHEA and DHEAS in CHD group were significantly lower than those in the control group (T (18.6 ± 8.6) nmol / L vs (29.7 ± 11.5) nmol / L and (22.9 ± 15.3) nmol / L vs 57.9 ± 27.1 nmol / L, DHEAS (5.5 ± 1.3) μmol / Lvs (6.4 ± 2.4) μmol / L (P <0.05); E2, P and E2 / T were not significantly different between the two groups and the different groups of count lesions. The more the lesion count, the lower the T and DHEA levels (P <0.05 or <0.01). The multiple regression equations of DHEA and DHEAS with the Gensini integral as the dependent variable had the standard regression coefficients of -0.229 and -0.230, respectively. Conclusion Male patients with coronary heart disease have low levels of androgen, and male androgen levels may affect the degree of coronary artery stenosis.