男性内源性性激素水平与冠心病范围及左心室射血分数的相关性

摘要 目的：探究男性内源性性激素水平与冠心病范围及左心室射血分数（LVEF）的相关性。方法：将2018年6月至2020年6月于我院接受治疗的96例经冠状动脉造影术（CAG）确诊为冠心病的96例患者纳入研究，按照临床分型将其区分为稳定型心绞痛（SAP，30例）、不稳定型心绞痛（UAP，30例）、急性心肌梗死（AMI，36例），另选同期CAG检测结果提示冠状动脉管腔直径狭窄率<50 %的50例个体为对照组，检测入组对象的睾酮（Ts）、雌二醇（E₂）水平，评估计算入组对象的Gensini积分以及LVEF，对比不同组别之间Ts、E₂、Gensini积分以及LVEF差异，Spearman相关分析探究Ts、E₂与Gensini积分、LVEF的相关性，最后将患者按照Genisini评分区分为狭窄轻型组与严重组，Logistic回归分析影响冠脉狭窄的危险因素。结果：（1）比较显示，冠心病各组间Ts、E₂、Gensini积分以及LVEF差异明显，以AMI组患者Ts、E₂和LVEF水平最低，Gensini积分最高（P<0.05）；（2）Spearman相关性分析显示，Ts、E₂均与Gensini积分呈负相关，与LVEF呈正相关（P<0.05）；（3）多因素Logistic回归分析显示Ts、E₂水平是影响冠脉狭窄程度的独立危险因素（P<0.05）。结论：男性内源性性激素水平同其冠心病范围和LVEF呈现密切相关性，是影响冠脉狭窄程度的独立危险因素，可以考虑将其应用于临床冠脉狭窄的诊断与鉴别中。

The Correlation of Endogenous Sex Hormone Levels with Coronary Heart Disease and Left Ventricular Ejection Fraction in Men

ABSTRACT Objective: To explore the correlation between endogenous sex hormone levels and the range of coronary heart disease and left ventricular ejection fraction (LVEF) in men. Methods: 96 patients with coronary heart disease diagnosed by coronary angiography (CAG) in our hospital from June 2018 to June 2020 were included in the study. According to the clinical classification, they were divided into stable angina pectoris (SAP, 30 cases) and unstable angina pectoris UAP (30 cases), acute myocardial infarction (AMI), Another 50 individuals whose CAG results showed that the stenosis rate of coronary artery lumen diameter was less than 50% were selected as the control group. The levels of testosterone (TS) and estradiol (E₂) were detected, the Gensini score and LVEF were evaluated and calculated, and the differences of T _S , E₂, Gensini score and LVEF between different groups were compared. Spearman correlation analysis was used to explore the relationship between ts, E₂ and Gensini score and LVEF. Results: (1) There were significant differences in T _S , E₂, Gensini score and LVEF among the groups, with the lowest level of T _S , E₂ and LVEF in AMI group and the highest Gensini score (P<0.05). (2) Spearman correlation score Analysis showed that T _S and E₂ levels were negatively correlated with Gensini score, and positively correlated with LVEF (P<0.05). (3) multivariate logistic regression analysis showed that T _S and E₂ levels were independent risk factors for the degree of coronary artery stenosis (P<0.05). Conclusion: The level of endogenous sex hormone in men is closely correlated with the range of coronary heart disease and LVEF, and is an independent risk factor for the degree of coronary artery stenosis. It can be used in the diagnosis and differential diagnosis of coronary artery stenosis.