纤维肌痛患者血清中三种促激素释放激素含量的改变  

Alterations of serum levels of three kinds of promote hormone releasing hormones in patients with fibromyalgia

作　　者：虞金霞[1] 陈贵海[1] 

机构地区：[1]安徽医科大学第一附属医院神经内科,合肥230022

出　　处：《中华神经科杂志》2011年第9期619-622,共4页Chinese Journal of Neurology

摘　　要：目的探讨纤维肌痛患者血清中促肾上腺皮质激素释放激素（CRH）、促甲状腺激素释放激素（TRH）和促性腺激素释放激素（GnRH）含量变化及其临床意义。方法选取2009年6月至2010年10月在安徽医科大学附属第一医院神经内科就诊的纤维肌痛患者26例及同期健康体检者29名，分别作为患者组及对照组，用汉密尔顿抑郁量表-17评估患者的抑郁状况。采取ELISA方法检测两组血清中CRH、TRH和GnRH含量，所得数据分别采用独立样本t检验（正态分布）与Mann—Whitney Test检验（非正态分布），同时用受试者工作特征（ROC）曲线分析3种激素对纤维肌痛诊断的特异度和敏感度，并采取Spearman相关性分析探讨3种激素含量与患者年龄、性别、压痛点个数、疼痛程度及抑郁程度的相关性。结果与对照组[70．0（48．7，78．0）ng／L]相比，纤维肌痛患者血清中CRH含量明显升高[271．9（210．9，326．5）ng／L，x2=6．408，P〈0．01]，TRH[分别为（82．7±6．9）、（87．2±6．8）ng／L，t=2．560，P〈0．05]及GnRH[分别为（18．2±0．9）、（19．9±1．6）ng／L，t=5．324，P〈0．01]含量也显著性升高。三者均与疼痛程度和压痛点个数正相关，CRH和GnRH含量还与患者抑郁程度正相关。血清中3种激素含量的诊断敏感度和特异度ROC曲线下面积分别为1．000、0．684与0．854。结论纤维肌痛患者CRH、TRH和GnRH分泌增多，其中CRH的值可能可以作为诊断纤维肌痛的参考指标。Objective To explore alterations of serum levels and clinical significance of corticotropin releasing hormone （CRH）, thyrotropin releasing hormone （TRH） and gonadotropin releasing hormone （GnRH） in patients with fibromyalgia （FM）. Methods A total of 55 subjects participated in this study： 29 healthy volunteers and 26 patients with FM recruited from Department of Neurology, the First Affiliated Hospital of Anhui Medical University from June 2009 to October 2010. The depression rate was assessed by Hamilton Depression Rating Scale-17. ELISA was used for the detection of the serum levels of CRH, TRH and GnRH. Normal distribution quantitative data were described by the x ± s and tested by independent sample t-test. Non-normal quantitative data were described by interquartile range and tested by independent Mann-Whitney. The diagnostic specificity and sensitivity of 3 kinds of hormones test were analyzed by receiver operator characteristic （ROC） curve, and the Spearman correlation was used for analysis of hormone levels and age, gender, tenderness, pain degree and depression severity. Results Compared with the control （ 70. 0 （48.7,78.0） ng/L）, the fibromyalgia patients had obviously increased CRH （271.9 （210. 9,326. 5） ng/L, X2 = 6. 408, P 〈 0. 01 ） , and significantly higher TRH （ （82. 7 ± 6.9） ng/Lvs（87.2±6.8）ng/L,t=2.560, P〈0.05, respectively） and GnRH （（18.2 ±0.9） ng/Lvs （ 19.9± 1.6） ng/L,t = 5. 324, P 〈 0.01, respectively）. The serum concentrations of the CRH, TRH and GnRH were positively correlated with pain intensity and numbers of tenderness respectively, and those of the CRH and GnRH were positively correlated with depressive degree either. The areas under the ROC curve in the CRH, TRH and GnRH, evaluating the sensitivity and specificity for diagnosis of fibromyalgia, were respectively 1. 000, 0. 684 and 0. 854. Conclusions The FM patients had an increased secretion of CRH, TRH and GnRH. CRH might serve as the adjunctive criteria for th

关 键 词：纤维肌痛 促肾上腺皮质素释放激素 促甲状腺素释放激素 促性腺素释放激素 

分 类 号：R685[医药卫生—骨科学]