| Objective: To investigate the relationship between estradiol level and coronary artery lesion characteristics,prognosis and risk factors of coronary heart disease in patients with coronary heart disease before and after menopause,and provide reference for clinical prevention and treatment.Methods: According to the current research method,the 300 female patients with coronary heart disease who were admitted to the hospital from January2015 to January2017 in Cangzhou City People's Hospital were collected.According to the patient's menopause,they were divided into premenopausal coronary heart disease group and postmenopausal coronary heart disease group.Analyze the relationship between estradiol levels and risk factors for coronary heart disease,coronary lesions and prognosis.Results: The general data of patients with coronary heart disease before and after menopause including hypertension history,diabetes history,history of hyperlipidemia,and family history of coronary heart disease were not statistically significant(P>0.05).The age of postmenopausal coronary heart disease group was higher than that of premenopausal group.The difference between the heart disease group(years,56.3±6.2 vs.44.0±5.6)there was statistically significant(P<0.001).The number of lesions in the postmenopausal coronary heart disease group was higher than that in the premenopausal coronary heart disease group.[single(%):21.9vs40.7,double(%): 23.1vs20.0,more Branch(%): 55.0 vs38.6] there is statistical difference(both P<0.05);The coronary Gensini score in the postmenopausal coronary heart disease group was significantly higher than that in the premenopausal coronary heart disease group.(66.7±9.4vs43.2±7.5),there was statistical difference(P<0.05);Coronary heart disease count and coronary Gensini score were negatively correlated with estradiol level in postmenopausal coronary heart disease group.The incidence of major cardiac adverse events in the postmenopausal coronary heart disease group was significantly higher than that in the premenopausal coronary heart disease group.(recurrent angina(%):23.8vs19.2,myocardial infarction(%):4.3vs1.4,cardiogenic death(%): 5vs0.7,revascularization(%):5.6vs2.1,total rate(%)38.8vs23.6),the difference was statistically significant(both P<0.05).Total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),von Willebrand Factor Antigen(vWF:Ag),Fibrinogen concentration(Fbg),Plasminogen activator inhibitor-1(PAI-1)and plasma ET-1level(ET-1)in patients with coronary heart disease in postmenopausal womenwere significantly higher than those in premenopausal coronary heart disease group [TC(mmoL/L):4.7±1.3vs4.2 ±1.0,LDL-C(mmoL/L):2.9±0.8 vs2.7±0.7,vWF: Ag(%): 89.2±9.2vs77.6±7.5,Fbg(g/L): 3.7±1.4vs2.5±1.1,PAI-1(AU/mL):0.7±0.2vs0.5±0.1,ET-1(ng/L):28.2±7.1vs 15.8±5.4],Tissue plasminogen activator(t-PA),the level of estradiol were significantly lower than those in premenop-ausal coronaryheart disease group [t-PA(IU/mL):0.4±0.1vs0.6±0.2,estradiol(pg/mL)37.6±7.9vs63.5±8.4],there was statistically significant(both P<0.05).C-reactive protein(CRP)levels in postmenopausal coronary heart disease group were higher than those in premenopausal coronary heart disease group(mg/L,6.8±0.9vs2.3±0.5),the difference was statistically significant(P<0.05);Pearson correlation analysis shows that in the postmenopausal coronary heart disease group,estradiol levels were correlated with TC?LDL-C,CRP,vWF: Ag,Fbg,PAI-1,ET-1,t-PA,there was statistically significant,(both P<0.05)Conclusions:1.The level of estradiol is related to the severity and prognosis of coronary artery disease in postmenopausal patients with coronary heart disease.2.Decreased estradiol level is a risk factor for postmenopausal patients with coronary heart disease,which may be related to the regulation of blood lipid levels,blood coagulation,fibrinolysis,inflammatory factors and vascular endothelial function. |
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