注射用重组人Ⅱ型肿瘤坏死因子受体―抗体融合蛋白对绝经后女性类风湿关节炎血清性激素水平影响.docVIP

注射用重组人Ⅱ型肿瘤坏死因子受体―抗体融合蛋白对绝经后女性类风湿关节炎血清性激素水平影响 　　【摘 要】目的：了解注射用重?M人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白（以下简称益赛普）对绝经后女性类风湿关节炎（RA）患者血清性激素水平的影响，探讨性激素在绝经后女性RA中的临床意义。方法：选取绝经后女性RA患者65例作为RA组，健康体检者65例作为健康对照组。采用微粒子化学发光法测定2组血清睾酮（T）、雌二醇（E2）水平，计算E2/T比值，评估其与红细胞沉降率（ESR）、C-反应蛋白（CRP）、DAS28评分、健康评估问卷（HAQ）等指标的相关性。RA组给予皮下注射益赛普，每次25 mg，每周2次，1个疗程12周。比较治疗前后E2、T水平，E2/T比值及临床指标的变化。结果：RA组血清E2水平及E2/T比值显著高于健康对照组（P 0.05）。治疗前，RA患者E2水平、E2/T分别与ESR（r = 0.688，P = 0.000；r = 0.722，P = 0.000）、CRP（r = 0.499，P = 0.000；r = 0.505，P = 0.000）、DAS28（r = 0.756，P = 0.000；r = 0.413，P = 0.001）、HAQ（r = 0.603，P = 0.000；r = 0.416，P = 0.001）呈正相关性。RA组经益赛普治疗后，血清E2水平、E2/T比值显著低于治疗前（P 0.05）。结论：血清性激素水平变化及雌雄激素比值失调可能参与了绝经后女性RA的发病，可能作为评估RA活动的指标。益赛普治疗可促进绝经后女性RA患者性激素水平及雌雄激素比值的恢复。 　　【关键词】 关节炎，类风湿；雌雄激素比值；重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白；疾病活动 　　【ABSTRACT】Objective：To investigate the effect of Recombinant Human Tumor Necrosis Factor-α Receptor Ⅱ：Igg Fc Fusion Protein for Injection（Yi Sai Pu）on serum sex hormone levels in postmenopausal women with rheumatoid arthritis（RA）and to explore its clinical significance.Methods：The RA group was established by 65 cases of postmenopausal women with RA and the control group was composed of 65 healthy volunteers.The levels of estradiol（E2）and testosterone（T）in serum were measured by microparticle chemiluminescence，and the ratio of E2/T was calculated，whose correlation with ESR，CRP，DAS28 scores and HAQ indexes was evaluated.The RA group was given subcutaneous injection of 25 mg of Yi Sai Pu twice a week for 12 weeks.The changes of T and E2 levels，E2/T ratios and clinical indicators were compared before and after treatment.Results：The serum level of E2 and the ratio of E2/T in the RA group were significantly higher than those in the control group（P 0.05）.Before treatment，E2 and E2/T were positively correlated with ESR（r = 0.688，P = 0.000；r = 0.722，P = 0.000），CRP（r = 0.499，P = 0.000；r = 0.505，P = 0.000），DAS28（r = 0.756，P = 0.000；r = 0.413，P = 0.001），HAQ（r = 0.603，P = 0.000；r = 0.416，P = 0.001）of the RA patients.After treatmen