绝经后女性雌激素水平对高血压伴心功能不全患者的影响

王楠; 宋继洋; 马慧元; 吕娜娜

doi:10.13201/j.issn.1001-1439.2015.08.008

绝经后女性雌激素水平对高血压伴心功能不全患者的影响

- 1. 甘肃省人民医院干三心内科(兰州, 730000);
- 2. 宁夏医科大学临床医学院
基金项目:
甘肃省自然科学研究基金计划（No：1208RJZA110）

详细信息

通讯作者: 宋继洋,E-mail:songjiyang620xyz@163.com

中图分类号: R544.1

收稿日期: 2014-11-14

修回日期: 2015-01-05

The impact of estrogen levels on postmenopausal women patients with hypertension and heart failure

- 1. Gansu Provincial Hospital, Lanzhou, 730000, China;
- 2. Ningxia Medical University

More Information

Corresponding author: SONG Jiyang, E-mail: songjiyang620xyz@163.com

Received Date: 14 November 2014

Revised Date: 05 January 2015

摘要

摘要: 目的：观察绝经后女性高血压、心功能不全患者雌激素水平变化；探讨女性绝经后雌激素水平和高血压、心功能不全的相关关系。方法：选取甘肃省人民医院心内科和体检科绝经女性患者107例，分为对照组（37例）、高血压组（40例）和高血压合并心功能不全组（30例），同时测定雌二醇（E2）、脂质过氧化物（LPO）、血清总抗氧化能力（TAS）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、左室射血分数（LVEF）、N末端脑利钠肽前体（NT-proBNP）、肌酐、尿酸、空腹血糖及BMI等指标，并进行统计分析。结果：①高血压组E2、HDL-C、TAS、LVEF显著低于对照组（P<0.05），LPO显著高于对照组（P<0.01）。高血压合并心功能不全组E2、TAS、HDL-C、LVEF显著低于对照组和高血压组（P<0.01），LPO、LDL-C、NT-proBNP显著高于对照组和高血压组（P<0.05）。②各组间在年龄、肌酐、尿酸、空腹血糖及BMI指数等方面无显著性差异（P>0.05）。③经Pearson相关分析，E2与LPO之间呈负相关（r=-0.707，P<0.01），E2与TAS之间呈正相关（r=0.847，P<0.01），E2与TC之间呈负相关（r=-0.304，P<0.01），E2与LDL-C之间呈负相关（r=-0.823，P<0.01），E2与HDL-C之间呈正相关（r=0.887，P<0.01），E2与LVEF之间呈正相关（r=0.725，P<0.01），E2与NT-proBNP之间呈负相关（r=-0.766，P<0.01）。结论：雌激素可通过多种途径改善血管内皮功能、抑制心肌细胞肥大、减少心肌细胞凋亡，是女性高血压和心功能不全的保护性因素；雌激素可能降低了TC、LPO及LDL-C水平，并增高了TAS、HDLC水平，二者具有相关性；氧化与抗氧化能力失衡可能参与了绝经后女性高血压和心功能不全的发生发展。
- 雌激素 /
- 脂质过氧化物 /
- 总抗氧化能力 /
- 血脂 /
- 高血压 /
- 心功能不全
Abstract: Objective: In order to observe the changes of estrogen level in the postmenopausal women with essential hypertension and heart failure.To investigate the association between estrogen, essential hypertension and heart failure in the postmenopausal women.Method: A total of 70 postmenopausal patients from Gansu Province People's Hospital were divided into essential hypertension group (40 cases) and heart failure group (30 cases), and another 37 cases of postmenopausal women from the physical examination center is the control group. Various medical tests were requested:estrogen (E2), lipid peroxide (LPO), total antioxidant status (TAS), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), left ventricular ejection fraction(LVEF)、NT-proBNP、creatinine, uric acid, fasting blood glucose and BMI.Result: ①Blood serum levels of E2, HDL-C, TAS and LVEF in hypertension group was significantly lower than the control group (P<0.05), and LPO was significantly higher than the control group (P<0.01). Blood serum levels of E2, TAS, HDL-C and LVEF in heart failure group was significantly lower than the control group and the hypertensive group (P<0.01), and the levels of LPO, LDL-C, NT-proBNP was significantly higher than the control group and hypertension group (P<0.05).②There was no significant difference between groups in age, creatinine, uric acid, fasting glucose and BMI(P>0.05). ③According to the Pearson correlation analysis, there is a negative correlation between E2 and LPO (r=-0.707, P<0.01), E2 and TC(r=-0.304, P<0.01), E2 and LDL-C(r=-0.823, P<0.01), E2 and NT-proBNP(r=-0.766, P<0.01). There is a positive correlation between E2 and TAS (r=0.847, P<0.01), E2 and HDL-C(r=0.887, P<0.01), E2 and LVEF(r=0.725, P<0.01).Conclusion: Estrogen may improve endothelial function, inhibit cardiomyocyte hypertrophy, and reduce myocardial apoptosis through a variety of channels.For women with hypertension and heart failure, estrogen, as a protective factor, can depress TC, LPO and LDL-C levels, and increase TAS, HDLC levels; oxidation and antioxidant capacity imbalance may be involved in the development of essential hypertension and heart failure in postmenopausal women.
- estrogen /
- lipid peroxides /
- total antioxidant status /
- lipids /
- hypertension /
- heart failure

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