系统性红斑狼疮血清中抗卵巢细胞抗体与性激素水平及月经异常关系的研究

Relationship between anti-ovary antibodies and serum levels of hormone profile and menstrual dis- turbances in patients with systemic lupus erythematosus

目的探讨女性系统性红斑狼疮（SLE）血清中抗卵巢细胞抗体与性激素水平及月经异常的关系。方法对本院SLE患者（78例）及对照组（40例）的临床资料进行分析，并测定性激素E2、T、P水平，同时采用酶联免疫吸附试验（ELISA）法测定血清中抗核抗体（ANA）等自身抗体及抗卵巢细胞抗体，分析系统性红斑狼疮（SLE）血清中抗卵巢细胞抗体与性激素水平及月经异常的相关因素。结果SLE组患者抗卵巢细胞抗体阳性率高于健康对照组（34．6％vs2．5％，P〈0．01）。SLE组患者性激素E2、T、P均明显低于健康对照组[E2：（80．96±36．2）ng／L vs（118．53±42．4）ng／L；T：（3．85±1．18）nmol／Lvs（6．43±2．28）nmol／L；P：（1．374-0．59）μg/L vs（3．92±1．23）恤g／L，P〈0．01或P〈0．05]，而FSH、LH及PRL水平显著高于健康对照组[FSH：（19．17±9．26）IU／Lvs（10．18±7．27）IU／L；LH：（21．19±12．44）IU／Lvs（13．79±8．27）IU／L；PRL：（6．18±2．27）μg／Lvs（2．37±0．63）μg/L，P〈0．05或P〈0．01]。SLE组患者月经异常率显著高于健康对照组（59％vs22％，P〈0．05）。SLE组患者血清抗卵巢细胞抗体阳性者SLEDAI积分及月经异常率显著高于抗体阴性者（6．3±2．8vs3．5±1．7，81％vs47％，P〈0．05或P〈0．01），而E2水平明显低于抗体阴性者[（64．13±26．36）ng／L vs（82．83±28．71）ng／L，P〈0．05]。结论SLE患者中抗卵巢细胞抗体的阳性率为34．6％，并可能与患者的性激素水平异常及月经异常相关。

Objective To verify the presence of anti-ovary antibodies in systemic lupus erythematosus （SLE） and its possible correlations with serum levels of hormone profile and menstrual disturbances in patients with SLE. Methods Clinical data of 78 consecutive patients who fulfilled 4 or more of the ACR 1997 revised criteria for SLE were studied and compared with 40 age-matched healthy controls, including anti-ovary antibodies. Results 27 （34. 6% ） patients with SLE, and 1 （2. 5% ） of the healthy controls tested positive of anti-ovary antibodies. The levels of E2 and T and P decreased [ E2 ： （ 80. 96 ± 36. 2） ng/L vs （118.53 ± 42.4） ng/L;T： （3.85 ± 1.18） nmol/L vs（6. 43 ± 2. 28） nmol/L;P： （1.37 ±0.59） μg/L vs （3.92± 1.23 ）μg/L], and the levels of FSH and LH and PRL increased in SLE patients when compared with healthy controls [ FSH ： （ 19. 17 ± 9. 26） IU/L vs （ 10. 18 ± 7.27 ） IU/L; LH ： （ 21.19 ± 12. 44） IU/L vs （13.79 ±8.27）IU/L;PRL：（6. 18 ±2.27）μg/L vs （2.37 ±0.63）μg/L, P 〈0.05 orP 〈0.01]. The higher SLEDAI score, higher rate of menstrual disturbances （6. 3 ±2. 8 vs 3.5 ± 1.7,81% vs 47%, P 〈0. 05 orP 〈0. 01 ） and decreased serum level of Ez[ （64. 13±26. 36）ng/L vs （82. 83 ±28.71）ng/L, P 〈0. 05]were found in SLE patients with anti-ovary antibodies positive than in SLE patients with anti-ovary antibodies negative. Conclusions The presence of anti-ovary antibodies was 34. 6% in SLE, and may correlate to decreased serum level of E2 and menstrual disturbance.