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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<0.05);RA组黄体期泌乳素(PRL)的浓度明显高于正常对照组(P<0.05);RA组孕酮(PROG)浓度明显低于正常对照组(P<0.05);RA组滤泡期PRL明显高于正常对照组(P<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>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。
Objective To investigate the changes of sex hormones in female patients with rheumatoid arthritis (RA) and its relationship with inflammatory markers. Methods From January 2008 to December 2009, 45 female patients (16 in the menopause group, 14 in the luteal phase group and 15 in the follicular phase group) and 40 in the control group (14 in the menopausal group , Luteal phase group and follicular phase group (n = 13 each)). Serum levels of SR, CRP, RF, anti-cyclic citrullinated peptide (anti-CCP) Antibody levels. Results The concentration of estradiol (E2) in postmenopausal women with RA was significantly higher than that in normal controls (P <0.05). The concentration of prolactin (PRL) in RA group was significantly higher than that in normal controls (P <0.05) The concentration of PROG was significantly lower than that of the normal control group (P <0.05). The PRL of follicular phase in RA group was significantly higher than that of the normal control group (P <0.05). There was a positive correlation between PRL and PROG in RA group (r = 0.754, P = 0.031), E2 in menopause, PRL and PROG in luteal phase and PRL in follicular phase with SR, CRP, RF and anti-CCP P> 0.05). Conclusion Female RA patients have different changes of sex hormones in different stages of the menstrual cycle, estrogen is significantly increased in menopausal women, and progesterone is obviously changed in luteal phase and follicular phase. There was a positive correlation between PRL and PROG in luteal phase. There was no correlation between sex hormones and inflammation in female RA patients.