网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
绝经女性的潮热症状与冠心病的相关性研究
作者:沙翔1  陈政祺2  陈梦珠3  乔勇4  王如珠1 
单位:1. 南京医科大学附属泰州人民医院 心血管内科, 江苏 泰州 225300;
2. 柳州市妇幼保健院 妇科, 广西 柳州 545000;
3. 东南大学附属中大医院 妇产科, 江苏 南京 210009;
4. 东南大学附属中大医院 心内科, 江苏 南京 210009
关键词:绝经 潮热 Kupperman评分 冠心病 
分类号:R541.4
出版年·卷·期(页码):2024·52·第五期(681-687)
摘要:

目的:研究绝经女性的潮热症状与冠心病的相关性。方法:纳入2020年6月至2021年3月于东南大学附属中大医院心内科住院并行冠状动脉造影术(CAG)的40~60岁的绝经女性患者218例,根据CAG结果分为冠心病组(106例)和对照组(112例)。采用更年期症状评分(改良Kupperman评分量表)对更年期症状严重程度进行评估。采用Gensini评分系统评价冠脉病变严重程度。结果:冠心病组的平均改良Kupperman评分显著高于对照组,潮热的发生率也高于对照组,差异均有统计学意义(均P<0.001)。与对照组相比,冠心病组的潮热频率和持续时间的差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,改良Kupperman评分与诊断冠心病的比例呈正相关(OR=1.12,95%CI 1.07~1.17)。每日潮热频率3~9次和≥10次的患者诊断冠心病的比例是无潮热者的4.60和6.03倍,潮热持续1~3年和>3年的患者诊断冠心病的比例是无潮热者的4.43和7.55倍,均有统计学意义(均P<0.05)。线性回归分析结果显示,在冠心病组中,有潮热症状者Gensini评分比无症状者平均高出11.17分(95%CI 2.74~19.60)。结论:绝经期女性的潮热、潮热频发和持续性潮热与冠心病的发生及病变程度具有一定的相关性。

Objective: To investigate the correlation between hot flushes and coronary heart disease in menopausal women. Methods: A total of 218 menopausal female patients aged 40-60 who were admitted to the Department of Cardiology,Zhongda Hospital, Southeast University from June 2020 to March 2021 and underwent coronary angiography(CAG) were enrolled. According to the CAG results, patients were divided into coronary heart disease group(106 cases) and control group(112 cases). The severity of menopausal symptoms was assessed with the modified Kupperman menopausal score. Coronary lesion severity was evaluated by Gensini score. Results: The mean modified Kupperman score in the coronary heart disease group was significantly higher than that in control group, and the incidence of hot flushes was also higher than that in the control group, among which the differences were statistically significant(all P<0.001). There were significant differences in frequency and duration of hot flushes between the coronary heart disease group and the control group(P<0.05). Multivariate Logistic regression analysis showed that the modified Kupperman score was positively correlated with the proportion of coronary heart disease diagnosed(OR=1.12, 95%CI 1.07-1.17). The proportion of patients with 3-9 times and ≥10 times hot flushes per day diagnosed with coronary heart disease was 4.60 and 6.03 times that of patients without hot flashes, the proportion of patients with hot flashes lasting 1-3 years and >3 years who were diagnosed with coronary heart disease was 4.43 and 7.55 times that of patients without hot flashes, all of which were statistically significant(all P<0.05). Linear regression analysis showed that in the coronary heart disease group, the Gensini score of patients with hot flashes was 11.17 points higher than that of asymptomatic patients(95%CI 2.74-19.60). Conclusion: Hot flushes, frequent and persistent hot flushes in menopausal women are correlated with the occurrence and severity of coronary heart diease.

参考文献:

[1] MAKARA-STUDZIŃŚKA M T,KRYŚ-NOSZCZYK K M,JAKIEL G.Epidemiology of the symptoms of menopause-an intercontinental review[J].Prz Menopauzalny,2014,13(3):203-211.
[2] TODOROVA L,BONASSI R,GUERRERO CARREÑO F J,et al.Prevalence and impact of vasomotor symptoms due to menopause among women in Brazil,Canada,Mexico,and Nordic Europe:a cross-sectional survey[J].Menopause,2023,30(12):1179-1189.
[3] EL KHOUDARY S R,AGGARWAL B,BECKIE T M,et al.Menopause transition and cardiovascular disease risk:implications for timing of early prevention:a scientific statement from the american heart association[J].Circulation,2020,142(25):e506-e532.
[4] THURSTON R C.Vasomotor symptoms and cardiovascular health:findings from the SWAN and the MsHeart/MsBrain studies[J].Climacteric,2024,27(1):75-80.
[5] BENJAMIN E J,MUNTNER P,ALONSO A,et al.Heart disease and stroke statistics-2019 update:a report from the American Heart Association[J].Circulation,2019,139(10):e56-e528.
[6] GENSINI G G.A more meaningful scoring system for determining the severity of coronary heart disease[J].Am J Cardiol,1983,51(3):606.
[7] 笪红英,李冬华,吴洁.围绝经期妇女相关问题的调查与分析[J].现代医学,2014,42(5):543-545.
[8] HUANG A J,SAWAYA G F,VITTINGHOFF E,et al.Hot flushes,coronary heart disease,and hormone therapy in postmenopausal women[J].Menopause,2018,25(11):1286-1290.
[9] NUDY M,JIANG X,ARAGAKI A K,et al.The severity of vasomotor symptoms and number of menopausal symptoms in postmenopausal women and select clinical health outcomes in the Women's Health Initiative Calcium and Vitamin D randomized clinical trial[J].Menopause,2020,27(11):1265-1273.
[10] DAM V,DOBSON A J,ONLAND-MORET N C,et al.Vasomotor menopausal symptoms and cardiovascular disease risk in midlife:a longitudinal study[J].Maturitas,2020,133:32-41.
[11] ARMENI A,ANAGNOSTIS P,ARMENI E,et al.Vasomotor symptoms and risk of cardiovascular disease in peri-and postmenopausal women:a systematic review and Meta-analysis[J].Maturitas,2023,171:13-20.
[12] HERBER-GAST G,BROWN W J,MISHRA G D.Hot flushes and night sweats are associated with coronary heart disease risk in midlife:a longitudinal study[J].BJOG,2015,122(11):1560-1567.
[13] 王红梅,闫雅更,董凤丽,等.不同绝经状态下血脂异常的可控风险因素分析[J].现代医学,2021,49(9):1048-1057.
[14] HERBER-GAST G C,MISHRA G D.Early severe vasomotor menopausal symptoms are associated with diabetes[J].Menopause,2014,21(8):855-860.
[15] THURSTON R C,SOWERS M R,CHANG Y,et al.Adiposity and reporting of vasomotor symptoms among midlife women:the study of women's health across the nation[J].Am J Epidemiol,2008,167(1):78-85.
[16] GERBER L M,SIEVERT L L,WARREN K,et al.Hot flashes are associated with increased ambulatory systolic blood pressure[J].Menopause,2007,14(2):308-315.
[17] THURSTON R C,CHRISTIE I C,MATTHEWS K A.Hot flashes and cardiac vagal control during women's daily lives[J].Menopause,2012,19(4):406-412.
[18] MALPAS S C.Sympathetic nervous system overactivity and its role in the development of cardiovascular disease[J].Physiol Rev,2010,90(2):513-557.
[19] GAST G C,POP V J,SAMSIOE G N,et al.Vasomotor menopausal symptoms are associated with increased risk of coronary heart disease[J].Menopause,2011,18(2):146-151.
[20] BECHLIOULIS A,KALANTARIDOU S N,NAKA K K,et al.Endothelial function,but not carotid intima-media thickness,is affected early in menopause and is associated with severity of hot flushes[J].J Clin Endocrinol Metab,2010,95(3):1199-1206.
[21] THURSTON R C,CHANG Y,BARINAS-MITCHELL E,et al.Physiologically assessed hot flashes and endothelial function among midlife women[J].Menopause,2018,25(11):1354-1361.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 790202 位访问者


 ©《现代医学》编辑部
联系电话:025-83272481;83272479
电子邮件: xdyx@pub.seu.edu.cn

苏ICP备09058541