本文選題：絕經(jīng)后女性 + 雌二醇　； 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的： 檢測腦絕經(jīng)后女性腦梗死患者血漿雌二醇（E2）水平，探討其與腦梗死及頸動(dòng)脈粥樣硬化的關(guān)系，分析E2與相關(guān)代謝指標(biāo)及炎性指標(biāo)、頸動(dòng)脈內(nèi)膜厚度的相關(guān)性，為探討絕經(jīng)后女性E2對腦梗死和頸動(dòng)脈粥樣硬化的影響提供依據(jù)。 方法： 收集我院神經(jīng)內(nèi)科住院的90例絕經(jīng)后女性腦梗死急性期患者（腦梗死組）和40例同期絕經(jīng)后女性健康體檢者（對照組），檢測血漿E2水平，分析與腦梗死的關(guān)系，通過相關(guān)性分析，研究E2與代謝和炎性指標(biāo)的關(guān)系。采用多普勒超聲檢測頸動(dòng)脈，，計(jì)算雙側(cè)頸總動(dòng)脈平均內(nèi)-中膜厚度（IMT)并依據(jù)頸動(dòng)脈是否存在斑塊及其性質(zhì)分亞組（無斑塊組，穩(wěn)定斑塊組和不穩(wěn)定斑塊組），通過Logistic回歸分析E2水平與腦梗死及斑塊性質(zhì)之間的關(guān)系。 結(jié)果： （1）絕經(jīng)后女性急性腦梗死組與正常對照組相比，E2水平明顯降低,有顯著性差異（P0.01）。 Logistic回歸分析顯示在考慮了腦梗死其他的獨(dú)立危險(xiǎn)因素后，雌激素水平降低并不能使腦梗的發(fā)病風(fēng)險(xiǎn)增加（OR:1.173;95%CI:0.743-1.875:;P=0.479）。 （2）相關(guān)分析發(fā)現(xiàn)，腦梗死組患者中E2水平與高密度脂蛋白膽固醇膽固醇（HDL-C）、ISI呈正相關(guān)。與低密度脂蛋白膽固醇膽固醇（LDL-C）、hs-CRP、FINS水平呈負(fù)相關(guān)。均有統(tǒng)計(jì)學(xué)意義（P0.01）。與空腹血糖、BMI、血壓無相關(guān)。 （3）絕經(jīng)后女性腦梗死組頸動(dòng)脈IMT1.32±0.27mm，對照組頸動(dòng)脈內(nèi)膜厚度IMT（1.0±0.32）mm，兩組間差異具有統(tǒng)計(jì)學(xué)意義（P0.05）。腦梗死患者中的血漿E2水平與頸動(dòng)脈平均IMT呈負(fù)相關(guān)(r=-0.163; P=0.035)； (4)絕經(jīng)后女性腦梗死患者中頸動(dòng)脈粥樣硬化發(fā)生率為87.7%，與對照組動(dòng)脈粥樣硬化發(fā)生率42.5%相比，差異具有顯著性（P0.01）；絕經(jīng)后女性腦梗死患者不穩(wěn)定斑塊檢出率53.3%,顯著高于對照組的15%，差異具有顯著性（P0.01）；絕經(jīng)后女性腦梗死組患者穩(wěn)定斑塊檢出率較對照組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 （5）腦梗死患者中非不穩(wěn)定斑塊患者E2水平高于不穩(wěn)定斑塊組，Logistic回歸分析在考慮了hs-CRP、低密度脂蛋白膽固醇膽固醇水平后，E2水平下降并不能使不穩(wěn)定斑塊的風(fēng)險(xiǎn)增加（OR:1.035;95%CI:0.826-1.054；P=0.612)。 結(jié)論： （1）絕經(jīng)后女性腦梗死患者E2水平較對照組E2水平明顯下降。絕經(jīng)后女性E2水平的下降不是腦梗死發(fā)病的獨(dú)立危險(xiǎn)因素。 （2）絕經(jīng)后女性腦梗死患者E2水平與代謝及炎性指標(biāo)相關(guān)，血漿E2水平與HDL-C、ISI水平呈正相關(guān)，與FINS、LDL-C、hs-CRP水平呈負(fù)相關(guān)。E2可能通過影響血糖、血脂及炎癥因子的水平增加腦梗死的發(fā)生。 （3）絕經(jīng)后女性腦梗死患者血漿E2水平與頸動(dòng)脈平均IMT呈負(fù)相關(guān)，頸動(dòng)脈具有不穩(wěn)定斑塊的腦梗死患者較頸動(dòng)脈具有穩(wěn)定斑塊的腦梗死患者E2水平明顯下降，絕經(jīng)后女性腦梗死患者E2水平可以預(yù)測動(dòng)脈粥樣硬化的嚴(yán)重程度。
[Abstract]:Objective: The plasma estradiol E _ 2 (E _ 2) levels in postmenopausal female patients with cerebral infarction were determined to explore the relationship between E _ 2 and cerebral infarction and carotid atherosclerosis, and to analyze the correlation between E _ 2 and related metabolic and inflammatory indexes, carotid intima thickness. To study the effect of E _ 2 on cerebral infarction and carotid atherosclerosis in postmenopausal women. Methods: A total of 90 postmenopausal female patients with acute cerebral infarction (cerebral infarction group) and 40 postmenopausal women healthy persons (control group) were collected from neurology department of our hospital. The plasma E 2 level was measured and the relationship between E 2 levels and cerebral infarction was analyzed. The relationship between E2 and metabolic and inflammatory indexes was studied by correlation analysis. Carotid artery was detected by Doppler ultrasound, the mean IMT of bilateral common carotid artery was calculated, and the carotid artery was divided into subgroup (no plaque group) according to whether there were plaques in the carotid artery or not. The relationship between E _ 2 level and cerebral infarction and plaque character was analyzed by Logistic regression analysis in stable plaque group and unstable plaque group. Results: The level of E 2 in postmenopausal women with acute cerebral infarction was significantly lower than that in normal controls (P 0.01). Logistic regression analysis showed that after taking into account other independent risk factors of cerebral infarction, the decrease of estrogen level did not increase the risk of cerebral infarction. Correlation analysis showed that there was a positive correlation between E _ 2 level and HDL-CU ISI in patients with cerebral infarction. There was a negative correlation between low density lipoprotein cholesterol and low density lipoprotein cholesterol hs-CRPN fins. All of them had statistical significance (P 0.01). There was no correlation with fasting blood glucose BMIand blood pressure. 3) the carotid IMT1.32 鹵0.27 mm in postmenopausal female cerebral infarction group and IMT(1.0 鹵0.32 mm in control group. The difference between the two groups was statistically significant (P 0.05). There was a negative correlation between plasma E2 level and carotid mean IMT in patients with cerebral infarction. The incidence of carotid atherosclerosis in postmenopausal women with cerebral infarction was 87.7%, compared with 42.5% in the control group. The detection rate of unstable plaques in postmenopausal women with cerebral infarction was 53.3%, which was significantly higher than that in the control group (15%), and the difference was significant (P 0.01). There was no significant difference in the detection rate of stable plaque in postmenopausal women with cerebral infarction compared with the control group (P 0.05). 5) the level of E _ 2 in non-unstable plaque patients with cerebral infarction was higher than that in the unstable plaque group. After considering hs-CRP, the decrease of E _ 2 level after low density lipoprotein cholesterol level did not increase the risk of unstable plaque. Conclusion: The level of E 2 in postmenopausal women with cerebral infarction was significantly lower than that in control group. The decrease of E 2 level in postmenopausal women is not an independent risk factor for cerebral infarction. 2) in postmenopausal women with cerebral infarction, the level of E2 was correlated with metabolic and inflammatory indexes, the level of plasma E2 was positively correlated with the level of HDL-CISI, and negatively correlated with the level of LDL-Chs-CRP. E2 may increase the occurrence of cerebral infarction by affecting the levels of blood glucose, blood lipids and inflammatory factors. 3) the plasma E2 level in postmenopausal female patients with cerebral infarction was negatively correlated with the average IMT of carotid artery, and the level of E2 in patients with unstable carotid plaques was significantly lower than that in patients with stable plaques of carotid artery. E 2 levels in postmenopausal women with cerebral infarction can predict the severity of atherosclerosis.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R543.5;R743.33

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 趙智深;雌激素對女性心血管系統(tǒng)的保護(hù)作用[J];國外醫(yī)學(xué)(內(nèi)科學(xué)分冊);1998年09期

2 梁鴻寅;王U

本文編號(hào)：1973556