围绝经期性激素与类风湿关节炎活动度及炎症因子的关系  

Relationship between perimenopausal sex hormones and activity and inflammatory factors in rheumatoid arthritis

作　　者：项捷[1] 危静[1] XIANG Jie;WEI Jing(Physical Examination Center,The Affiliated Hospital of Hangzhou Normal University,Zhejiang Hangzhou 310015,China)

机构地区：[1]杭州师范大学附属医院体检中心,浙江杭州310015

出　　处：《中国妇幼健康研究》2020年第6期762-767,共6页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨围绝经期妇女血清性激素水平与类风湿关节炎(RA)疾病活动度、炎症因子水平的关系。方法选取2018年1月至2019年6月于杭州师范大学附属医院就诊或体检的92例围绝经期RA患者为RA组,另选取同期92例围绝经期健康体检者为对照组,比较RA组与对照组血清性激素水平,比较RA患者中未停经组(54例)与停经组(38例)血清性激素、RA活动度(DAS28评分)、炎症因子水平,比较RA活动期组(41例)与缓解期组(51例)血清性激素、炎症因子水平,采用Pearson相关法分析性激素水平与RA活动度、炎症因子水平的相关性。结果 RA组患者血清雌二醇(E2)水平显著低于对照组(t=12.450,P<0.05),泌乳素(PRL)水平显著高于对照组(t=11.549,P<0.05);未停经组血清E2水平显著高于停经组(t=11.842,P<0.05),卵泡刺激素(FSH)、黄体生成素(LH)、C反应蛋白(CRP)、白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平及DAS28评分均显著低于停经组(t值分别为8.163、4.516、3.276、3.771、4.220、3.605、4.390,均P<0.05);活动期组患者血清E2水平显著低于缓解期组(t=18.477,P<0.05),PRL水平显著高于缓解期组(t=12.390,P<0.05),CRP、IL-1β、IL-6及TNF-α水平均显著高于缓解期组(t值分别为27.192、37.020、34.839、39.324,均P<0.05);经Pearson相关性分析显示,血清E2水平与DAS28评分及CRP、IL-1β、IL-6、TNF-α水平均呈负相关(r值分别为-0.517、-0.412、-0.482、-0.388、-0.357,均P<0.01),PRL水平与CRP、IL-6水平均呈正相关(r值分别为0.314、0.294,均P<0.05),且DAS28评分与血清CRP、IL-6、TNF-α水平均呈正相关(r值分别为0.412、0.501、0.473,均P<0.05)。结论围绝经期RA患者性激素较正常女性波动大,且不同阶段血清性激素水平、RA活动度、血清炎症因子水平不同,尤其是血清E2水平与疾病活动度、炎症因子水平关联密切。Objective To explore the relationship between serum sex hormones levels and rheumatoid arthritis(RA)disease activity and inflammatory factors levels in perimenopausal women.Methods A total of 92perimenopausal women with RA who were treated or had physical examination in The Affiliated Hospital of Hangzhou Normal University from January 2018to June 2019were selected as RA group.Another 92perimenopausal healthy women with physical examination at the same time period were selected as control group.The levels of serum sex hormones were compared between RA group and control group.And the levels of serum sex hormones,RA activity(DAS28score)and the levels of inflammatory factors were compared between non-menopause group(54cases)and menopause group(38cases)in RA patients.And the levels of serum sex hormones and inflammatory factors were compared between RA active phase group(41cases)and remission group(51cases).The correlations between sex hormones levels and RA activity and inflammatory factors levels were analyzed by Pearson correlation analysis.Results The serum estradiol(E2)level in RA group was significantly lower than that in control group(t=12.450,P<0.05),while the prolactin(PRL)level was significantly higher than that in control group(t=11.549,P<0.05).The E2level in non-menopause group was significantly higher than that in menopause group(t=11.842,P<0.05),while the levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),Creactive protein(CRP),interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)and score of DAS28were all significantly lower than those in menopause group(t=8.163,4.516,3.276,3.771,4.220,3.605and 4.390,respectively,all P<0.05).The serum E2level in active phase group was significantly lower than that in remission group(t=18.477,P<0.05),but the levels of PRL,CRP,IL-1β,IL-6and TNF-αwere significantly higher than those in remission group(t=12.390,27.192,37.020,34.839and 39.324,respectively,all P<0.05).Pearson correlation analysis showed that E2was negatively corre

关 键 词：类风湿关节炎 血清性激素水平 疾病活动度 炎症因子 相关性 

分 类 号：R711.75[医药卫生—妇产科学]