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The Level of Testosterone in Acute Coronary Syndrome and Short-term Prognosis

Author: YuWenHui
Tutor: HuJian
School: China Medical University
Course: Internal Medicine
Keywords: Acute coronary syndrome Testosterone Prognosis
CLC: R541.4
Type: Master's thesis
Year: 2003
Downloads: 47
Quote: 0
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Abstract


Introduction acute coronary syndrome (ACS) including unstable angina pectoris (UAP), acute myocardial infarction (AMI) and coronary heart disease sudden death, is a common clinical Intensive. Epidemiological survey at home and abroad, the incidence of coronary heart disease is increasing year by year, excluding hypertension, diabetes, dyslipidemia, smoking and other risk factors for CHD, male gender is still an independent risk factor for coronary heart disease, may be associated with male androgen-dependent. In recent years, many studies have found that the main component of the male hormone testosterone have anti-coronary heart disease. Testosterone on the cardiovascular role of domestic and foreign literature reports inconsistent and inconclusive. This paper mainly detected in patients with ACS plasma testosterone levels to understand the relationship between testosterone with ACS. Subjects and methods. ACS group: Participants select male ACS patients in our hospital from March 2002 to December 2002 a total of 31 cases, except for diabetes, high blood pressure and severe liver, kidney, lung, brain and other organic diseases, age between 50-59 years old, the average age to 55.4 ± 2.6 years old, which UAP18 cases, cases QMI7, NQMI6 cases. 2. The control group of 30 patients, selected from the same period in outpatient healthy subjects, aged between 51-58 years old, the average age was 54.0 ± 3.2 years old, asked in detail about the history, physical examination, 12-lead ECG, blood glucose were normal. 3. Refrigerator at minus 20 ° C in all subjects after fasting for 10 hours mining the median cubital vein blood 5ml, 3ml Enter the Hitachi 7150 automatic biochemical analyzer lipids, remaining 2ml isolated the serum stored testosterone detected by radioimmunoassay kit Roche kit from the United States. Results 1. ACS and control groups testosterone levels were 46.84 ± 7.17un / L and 59.15 Guests 5.68Ug / L, the two groups through the test, a statistically significant difference, p <0.05; ACS group control of the group, TG, HOL-C, LDL-C were 4.97 ± O. 53--1/L2.06 ± 0.38 mmol / L, 1.72 soil 0.27 mmol / L, 3.31 disabilities 0.31mmol / L and 4. % ± O. 391 / L, 2.12 ± 0. Needle 1 / L, I. Four Persons O. 321 / L. The 3.16 ± 0.42InlnOI / L, two sets of parameter group comparison of the on test, p> 0.05, not statistically significant. 2. Hospital treatment and hospital follow-up of 2.131 cases of ACS patients, the UAP18 cases, QMI7 cases, NQMI6 cases. Five patients hospitalized during the onset of ischemic chest pain, ECG formation of non-Q wave myocardial enzymes were normal. The length of stay is 10-14 days. 2.2 ACS patients discharged after a three-month follow-up observation of cardiac events, including acute Q-wave myocardial infarction and screwed dead. 31 patients, 3 were lost. The remaining 28 patients, cardiac events occurred in 8 cases, 6 cases of acute Q-wave myocardial infarction, sudden death cases. 2.3 cardiac events in patients with retrospective analysis of these patients for the first time in our hospital during the detection plasma military ketone levels lower than 40fig / L, the average value of the 36.95 ± 1.70fig children, without. O dirty incident plasma Tsui ketone levels in 40fig / L or more, with an average of 50.27 soil 4.6lllg / L, the two sets of data t-test, p tight corner. 05, there are significant differences; cardiac events in patients with ACS compared with the control group plasma Army ketone level, t-test, P tight corner. 05, there is a significant difference. · Discuss the male population of cardiovascular disease incidence was significantly higher than women, and this gender differences suggest that male hormones and cardiovascular disease may have a certain relationship. Foreign reports, the crown. 0 patients plasma testosterone levels than normal was significantly lower, male testosterone cattle rational can promote the formation of atherosclerosis. The results of this study suggest that ACS patients with plasma Army ketone level is low, compared with the control group significant difference b. 05), suggesting that plasma testosterone levels may be associated with ACS. Its mechanisms consider the following: 1. Cold ketone affect lipid metabolism, may be associated with the following factors, Q) to increase LDL {receptor activity. u) to increase the activity of lipoprotein and hepatic lipase activity. Promote the free fatty acids into the three slope acid cyclic oxidation 2 O) on the impact of three winnow acid cycle. Research has shown that the palm ketone direct expansion of the coronary artery, increase coronary blood flow. 3. Army ketone coagulation and fibrinolysis function. The military one with tissue plasminogen activator was positively correlated with the fast A human fibrinogen and plasminogen activator inhibitor, D-dimer was negatively correlated. 4. Cold ketone impact on endothelial function. The relationship between the military one with coronary heart disease reported in the literature are inconsistent, but most scholars believe that low testosterone levels susceptible to coronary heart disease, and crown. 0 disease was negative. In recent years, many of angina and myocardial infarction, and confirmed by coronary angiography crown. 0 disease endpoint events epidemiological study showed that male crown. O patients with plasma testosterone levels are significantly lower than normal. Long-term intervention treatment and disposable intravenous injection of testosterone short-term intervention can reduce the incidence of exercise-induced angina, ECG exercise test positive rate and ST-segment depression to Inun time to extend the exercise test. The results suggest that ACS patients with plasma testosterone level is low, the low degree of influence on the prognosis, especially of less than 40fig / L by a worse prognosis, consistent with the results of the above scholars. But there are dissidents, such as fees Epworth testosterone levels and coronary heart disease independent of DHEA was negatively correlated with coronary heart disease. It is yet to be a long-term follow-up study of a large sample. In summary, the military one in the incidence of coronary heart disease in the male plays an important role, it may · 3 · through a variety of passers-tree coronary artery have a beneficial impact, prevent thrombosis. Male hormone replacement therapy in the international multi-center clinical trials are in progress, the result is not yet reached. Sri Lanka attached letter B in this area have access to useful research results and clinical application, will improve the quality of life of older men male hormone deficiency in patients with ACS. Conclusions 1. In all 31 cases

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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