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中华危重症医学杂志(电子版) ›› 2022, Vol. 15 ›› Issue (02) : 118 -121. doi: 10.3877/cma.j.issn.1674-6880.2022.02.005

论著

绝经后女性冠状动脉钙化患者的相关危险因素分析
吴聪聪1,†(), 李开军2, 徐剑3, 林莉3   
  1. 1. 323000　浙江丽水，丽水市中心医院妇产科
    2. 323000　浙江丽水，丽水市中心医院全科医学科
    3. 323000　浙江丽水，丽水市中心医院心血管内科
  • 收稿日期:2021-12-29 出版日期:2022-04-30
  • 通信作者: 吴聪聪
  • 基金资助:
    浙江省中医药科学研究基金项目(2020ZB301)

Risk factor analysis of coronary artery calcification in postmenopausal women

Congcong Wu1,†(), Kaijun Li2, Jian Xu3, Li Lin3   

  1. 1. Department of Obstetrics and Gynecology, the Central Hospital of Lishui City, Lishui 323000, China
    2. Department of General Medicine, the Central Hospital of Lishui City, Lishui 323000, China
    3. Department of Cardiovascular Medicine, the Central Hospital of Lishui City, Lishui 323000, China
  • Received:2021-12-29 Published:2022-04-30
  • Corresponding author: Congcong Wu
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吴聪聪, 李开军, 徐剑, 林莉. 绝经后女性冠状动脉钙化患者的相关危险因素分析[J]. 中华危重症医学杂志(电子版), 2022, 15(02): 118-121.

Congcong Wu, Kaijun Li, Jian Xu, Li Lin. Risk factor analysis of coronary artery calcification in postmenopausal women[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2022, 15(02): 118-121.

目的

探讨影响绝经后女性患者发生冠状动脉钙化的相关危险因素。

方法

选取2020年1月至2020年12月行冠状动脉CT血管造影术的121例绝经后女性患者。根据冠状动脉钙化评分（CACS）将所有患者分成钙化组（CACS>10分，57例）及非钙化组（CACS ≤ 10分，64例）。对两组患者的一般资料进行比较，并检测所有患者的雌二醇、促黄体生成素（LH）、卵泡刺激素（FSH）、载脂蛋白A1（APOA1）、载脂蛋白A2（APOA2）、脂蛋白A、胆固醇、高密度脂蛋白（HDL）及低密度脂蛋白（LDL）水平。同时，采用Logistic多因素回归分析影响绝经后女性冠状动脉钙化的危险因素。

结果

与非钙化组比较，钙化组患者的年龄[（54 ± 9）岁vs.（60 ± 11）岁，t = 3.031，P = 0.003]、胆固醇[（5.2 ± 0.5）mmol/L vs.（5.6 ± 0.9）mmol/L，t = 3.410，P = 0.001]及LDL[（2.5 ± 0.6）mmol/L vs.（3.0 ± 0.7）mmol/L，t = 3.790，P< 0.001]水平显著升高，雌二醇[（26 ± 19）ng/L vs.（17 ± 11）ng/L，t = 3.052，P = 0.003]及脂蛋白A[（232 ± 36）mg/L vs.（144 ± 21）mg/L，t = 2.047，P = 0.043]水平均显著降低。Logistic回归分析表明，年龄[比值比（OR）= 1.046，95%置信区间（CI）（1.001，1.094），P = 0.047]及胆固醇[OR = 2.040，95%CI（1.034，4.025），P = 0.040]为绝经后女性冠状动脉钙化的危险因素，雌二醇则为绝经后女性冠状动脉钙化的保护因素[OR = 0.993，95%CI（0.984，0.998），P = 0.049]。

结论

年龄及胆固醇水平为绝经后女性冠状动脉钙化的危险因素，雌二醇则为绝经后女性冠状动脉钙化的保护因素。

关键词: 女性, 绝经, 冠状动脉疾病, 危险因素
Objective

To analyze the risk factors of coronary artery calcification in postmenopausal women.

Methods

A total of 121 postmenopausal women who underwent coronary CT angiography from January 2020 to December 2020 were selected in this study. According to the coronary artery calcification score (CACS), all patients were divided into a calcified group (CACS > 10, n = 57) and a non-calcified group (CACS ≤ 10, n = 64). The general data of the two groups were compared, and the estradiol, luteinizing hormone (LH), follicle stimulating hormone (FSH), apolipoprotein A1 (APOA1), apolipoprotein A2 (APOA2), lipoprotein A, cholesterol, high density lipoprotein (HDL) and low density lipoprotein (LDL) levels were detected in all patients. Meanwhile, the risk factors for coronary artery calcification in postmenopausal women were analyzed by multivariate Logistic regression.

Results

In the calcified group, the age [(60 ± 11) vs. (54 ± 9), t = 3.031, P = 0.003], levels of cholesterol [(5.6 ± 0.9) mmol/L vs. (5.2 ± 0.5) mmol/L, t = 3.410, P = 0.001] and LDL [(3.0 ± 0.7) mmol/L vs. (2.5 ± 0.6) mmol/L, t = 3.790, P< 0.001] were much higher than those in the non-calcified group, while the levels of estradiol [(17 ± 11) ng/L vs. (26 ± 19) ng/L, t = 3.052, P = 0.003] and lipoprotein A [(144 ± 21) mg/L vs. (232 ± 6) mg/L, t = 2.047, P = 0.043] were much lower. The Logistic regression analysis revealed that age [odds ratio (OR) = 1.046, 95% confidence interval (CI) (1.001, 1.094), P = 0.047] and cholesterol [OR = 2.040, 95%CI (1.034, 4.025), P = 0.040] were risk factors for coronary artery calcification in postmenopausal women, while estradiol was a protective factor [OR = 0.993, 95%CI (0.984, 0.998), P = 0.049].

Conclusion

Age and cholesterol are risk factors for coronary artery calcification in postmenopausal women, while estradiol is a protective factor.

Key words: Women, Postmenopause, Coronary artery disease, Risk factors
表1 两组绝经后女性患者一般资料的比较
组别 例数 年龄（岁，± s） BMI<24 kg/m2[例（%）] 糖尿病病史[例（%）] 高血压病史[例（%）] 饮酒史[例（%）]
非钙化组 64 54 ± 9 56（87.5） 30（46.9） 36（56.2） 6（9.4）
钙化组 57 60 ± 11 48（84.2） 32（56.1） 33（57.9） 4（7.0）
t/χ2值   3.031 0.270 1.036 0.033 0.221
P值   0.003 0.603 0.309 0.855 0.638
表2 两组绝经后女性患者相关实验室指标的比较（± s）
组别 例数 雌二醇（ng/L） LH（IU/L） FSH（U/L） APOA1（g/L） APOA2（g/L） 脂蛋白A（mg/L） 胆固醇（mmol/L） HDL（mmol/L） LDL（mmol/L）
非钙化组 64 26 ± 19 15.9 ± 1.6 37 ± 4 1.47 ± 0.31 1.02 ± 0.19 232 ± 36 5.2 ± 0.5 1.17 ± 0.33 2.5 ± 0.6
钙化组 57 17 ± 11 18.8 ± 1.7 44 ± 4 1.44 ± 0.24 1.07 ± 0.19 144 ± 21 5.6 ± 0.9 1.18 ± 0.27 3.0 ± 0.7
t值   3.052 1.237 1.214 0.669 1.163 2.047 3.410 0.240 3.790
P值   0.003 0.219 0.227 0.505 0.247 0.043 0.001 0.811 <0.001
表3 影响绝经后女性患者冠状动脉钙化的Logistic多因素回归分析
变量 回归系数 标准误 Wald值 P值 OR值 95%CI
年龄（岁） 0.045 0.023 3.955 0.047 1.046 1.001~1.094
雌二醇（ng/L） -0.002 0.001 3.898 0.049 0.993 0.984~0.998
脂蛋白A（mg/L） -0.024 0.016 2.127 0.145 0.977 0.946~1.008
胆固醇（mmol/L） 0.713 0.347 4.232 0.040 2.040 1.034~4.025
LDL（mmol/L） 0.726 0.371 3.805 0.051 2.067 0.998~4.280
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