【摘要】 目的 探讨女性类风湿关节炎（rheumatoid arthritis，RA）患者性激素的变化及其与炎症指标的关系。 方法 2008年1月-2009年12月检测RA组45例女性患者（绝经期组16例、黄体期组14例和滤泡期组15例）和正常对照组40例女性（绝经期组14例、黄体期组、滤泡期组各13例）血清性激素水平，同时检测RA组血沉（SR）、C反应蛋白（CRP）、类风湿因子（RF）、抗环瓜氨酸肽（抗CCP） 抗体的水平。 结果 RA患者绝经期雌二醇（E2）浓度明显高于正常对照组（P lt;0.05）；RA组黄体期泌乳素（PRL）的浓度明显高于正常对照组（P lt;0.05）；RA组孕酮（PROG）浓度明显低于正常对照组（P lt;0.05）；RA组滤泡期PRL明显高于正常对照组（P lt;0.05）。RA组黄体期PRL与其孕酮（PROG）呈正相关（r=0.754，P=0.031），绝经期E2，黄体期PRL和PROG以及滤泡期PRL与SR、CRP、RF、抗CCP无相关性（P gt;0.05）。 结论 女性RA患者月经周期的不同阶段，性激素水平的改变不同，绝经期以雌激素升高明显，黄体期和滤泡期则以孕激素改变明显。黄体期PRL与其PROG呈正相关；女性RA患者性激素的变化与其炎症指标无相关性。
【Abstract】 Objective To explore the change of sex hormone levels in female patients with rheumatoid arthritis (RA) and its relationship with inflammatory markers. Methods The serum sex hormones of 45 female patients with RA (RA group, including menopausal group of 16 patients, luteal phase group of 14 patients and follicular phase group of 15 patients) and 40 females (control group: including menopausal group of 14 females, luteal phase group of 13 females and follicular phase group of 13 females) in the control group between January 2008 and December 2009 were detected. The inflammatory makers of erythrocyte sedimentation rate (SR), C-reactive protein (CRP), rheumatoid factor (RF), and anti-cyclic citrullinated peptide antibodies (anti-CCP) of patients in the RA group were also detected. Results The menopausal estradiol (E2) level and the concentration of prolactin (PRL) of patients with RA were significantly higher than that of patients in the normal control group (P lt;0.05), while the progesterone (PROG) level was significantly lower than that of patients in the control group (P lt;0.05). The PRL level of follicular phase group was significantly higher than that of the normal control group (P lt;0.05). PRL level in the luteal phase was positively correlated with its PROG level (r=0.754, P=0.031). The menopausal E2, the luteal PRL and PROG as well as the follicular phase PRL had no correlation with SR, C-reactive protein, RF, or anti-CCP antibodies (P gt;0.05). Conclusions At different stages of the menstrual cycle in women with RA, the changes of sex hormone levels were different. The concentration of estrogen has increased significantly in menopause, while the progesterone has changed markedly in luteal and follicular phases. PRL in luteal phase is positively correlated with PROG. The changes of sex hormones in female patients with RA show no correlation with inflammatory markers.
Citation： LIU Defang,GUO Mingyang,LIU Taihua,YUN Mingdong,GUO Linglin. Clinical Study of the Change of Sex Hormone Levels in Female Patients with Rheumatoid Arthritis and Its Relationship with Inflammatory Markers. West China Medical Journal, 2011, 26(3): 341-343. doi: Copy