月经及性腺功能在成年女性系统性红斑狼疮中的变化

Menstrual and gonadal functional alterations in systemic lupus erythematosus in adult females

目的探讨月经及性腺功能在成年女性系统性红斑狼疮(SLE)中的变化。方法对先后在本院就诊的SLE患者及在本院进行健康体验的正常对照者进行临床资料收集,详细记录入选研究对象的月经及生育情况,检测研究对象血中性激素水平。结果在入选的192例成年女性SLE患者中,78例(41%)患者出现月经异常,并且患者月经异常的情况表现为多种模式。在100例健康对照者中,仅19例(19%)患者出现月经异常。和健康对照者相比,SLE患者组的性激素E2、P、T明显下降,FSH、LH及PRL的水平均明显升高(P<0.05)。与无月经异常表现的SLE患者相比,有月经异常表现的SLE患者的起病年龄相对较小、SLEDAI积分相对较高、使用过烷化剂的比例相对较高、服用激素的平均剂量相对较大,两组的性腺功能差异无统计学意义(P>0.05)。结论 SLE患者中出现月经异常的比例显著高于健康对照者,有月经异常的SLE患者临床表现具有一定的特点,虽然SLE患者的性腺功能存在异常,但未见其与SLE的月经异常相关。

Objective To investigate menstrual and gonadal functional alterations in systemic lupus erythematosus（SLE） in adult females.Methods The clinical data of 192 consecutive patients who fulfilled four or more of the ACR 1997 revised criteria for SLE（the SLE patients） were studied and compared with 100 age-matched healthy controls,including menstrual function,gonadal function,ad serum Sex Hormone Levels.Results 78（41%） SLE patients and 19（19%） healthy individuals presented menstrual abnormalities.The level of E2,P,T significantly decreased and the level of FSH,LH,PRL significantly increased in SLE patients,compared with that if the healthy controls（P0.05）.Younger disease-onset age,higher SLEDAI score,higher use of alkylating agent,and higher dose of glucosteroid therapy were found in patients with menstrual abnormalities than in patients without menstrual abnormalities.Conclusion The incidence of menstrual abnormalities were significantly higher in SLE patients than in healthy controls.SLE patients with menstrual abnormalities were characterized by younger disease-onset age,higher SLEDAI score,higher use of alkylating and higher dose of glucosteroid therapy,but not correlated with gonadal function.