女性肝硬化患者性激素水平变化的初步探讨

A preliminary study of the changes in sex hormone levels in female patients with liver cirrhosis

目的探讨女性肝硬化患者性激素水平的变化特点。方法选取2014年9月-2015年6月在首都医科大学附属北京地坛医院门诊或住院的女性肝硬化患者30例作为肝硬化组,无慢性肝病而因其他疾病就诊或体检的非肝硬化女性30例作为对照组。分别检测两组患者血清中雌二醇(E_2)、卵泡刺激素(FSH)、黄体生成素(LH)、催乳素(PRL)、孕酮(PRGE)、睾酮(T)水平。比较两组的绝经比例及性激素水平。计数资料组间比较采用χ~2检验;计量资料组间比较采用t检验。结果对照组绝经13例(43.33%),肝硬化组绝经23例(76.67%),肝硬化患者绝经的比例明显高于对照组,差异具有统计学意义(χ~2=6.944,P=0.008)。E2水平肝硬化组低于对照组,差异有统计学意义(t=4.489,P<0.01);FSH和T水平肝硬化组高于对照组,差异均有统计学意义(t值分别为-5.010、-4.082,P值均<0.01)。结论女性肝硬化患者的部分性激素水平与正常女性存在差异,与男性肝硬化患者的性激素水平变化规律相较也具有不同特点,可能与慢性肝病的发病和进展有关,提示肝硬化的性激素治疗需要进一步研究探讨。

Objective To investigate the characteristics of the changes in sex hormone levels in female patients with liver cirrhosis.Meth-ods A total of 30 female patients with liver cirrhosis who visited or were hospitalized in Beijing Ditan Hospital,Capital Medical University from September 2014 to June 2015 were enrolled as liver cirrhosis group,and 30 non -cirrhotic female patients who had no chronic liver dis-ease and visited the hospital due to other diseases or underwent physical examination were enrolled as the control group.The serum levels of estradiol （E2 ）,follicle -stimulating hormone （FSH）,luteinizing hormone （LH）,prolactin （PRL）,progesterone （PRGE）,and testoster-one （T）were measured in both groups,and the proportion of menopausal women and sex hormone levels were compared between the two groups.The chi -square test was used for comparison of categorical data between groups,and the t -test was used for comparison of contin-uous data between groups.Results There were 13 menopausal women （43.33%）in the control group and 23 （76.67% ）in the liver cir-rhosis group,and the liver cirrhosis group had a significantly higher proportion of menopausal women than the control group （χ2 =6.944, P =0.008）.Compared with the control group,the liver cirrhosis group had a significantly lower level of E2 （t =4.489,P 〈0.01）and sig-nificantly higher levels of FSH and T （t =-5.010 and -4.082,both P 〈0.01）.Conclusion There are differences in the levels of some sex hormones between female patients with liver cirrhosis and healthy women,and female patients with liver cirrhosis have different charac-teristics of the changes in sex hormone levels from male counterparts,which may be related to the development and progression of chronic liv-er diseases.This suggests that sex hormone therapy for patients with liver cirrhosis needs further investigation.