中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2011年
9期
619-622
,共4页
纤维肌痛%促肾上腺皮质素释放激素%促甲状腺素释放激素%促性腺素释放激素
纖維肌痛%促腎上腺皮質素釋放激素%促甲狀腺素釋放激素%促性腺素釋放激素
섬유기통%촉신상선피질소석방격소%촉갑상선소석방격소%촉성선소석방격소
Fibromyalgia%Corticotropin-releasing hormone%Thyrotropin-releasing hormone%Gonadotropin-releasing hormone
目的 探讨纤维肌痛患者血清中促肾上腺皮质激素释放激素(CRH)、促甲状腺激素释放激素(TRH)和促性腺激素释放激素(GnRH)含量变化及其临床意义。方法 选取2009年6月至2010年10月在安徽医科大学附属第一医院神经内科就诊的纤维肌痛患者26例及同期健康体检者29名，分别作为患者组及对照组，用汉密尔顿抑郁量表-17评估患者的抑郁状况。采取ELISA方法检测两组血清中CRH、TRH和GnRH含量，所得数据分别采用独立样本t检验(正态分布)与MannWhitney Test检验(非正态分布)，同时用受试者工作特征(ROC)曲线分析3种激素对纤维肌痛诊断的特异度和敏感度，并采取Spearman相关性分析探讨3种激素含量与患者年龄、性别、压痛点个数、疼痛程度及抑郁程度的相关性。结果 与对照组[70.0(48.7，78.0) ng/L]相比，纤维肌痛患者血清中CRH含量明显升高[271.9(210.9，326.5)ng/L，x2=6.408，P＜0.01]，TRH[分别为(82.7±6.9)、(87.2±6.8)ng/L，t =2.560，P＜0.05]及GnRH[分别为(18.2±0.9)、(19.9±1.6) ng/L，t=5.324，P＜0.01]含量也显著性升高。三者均与疼痛程度和压痛点个数正相关，CRH和GnRH含量还与患者抑郁程度正相关。血清中3种激素含量的诊断敏感度和特异度ROC曲线下面积分别为1.000、0.684与0.854。结论 纤维肌痛患者CRH、TRH和GnRH分泌增多，其中CRH的值可能可以作为诊断纤维肌痛的参考指标。
目的 探討纖維肌痛患者血清中促腎上腺皮質激素釋放激素(CRH)、促甲狀腺激素釋放激素(TRH)和促性腺激素釋放激素(GnRH)含量變化及其臨床意義。方法 選取2009年6月至2010年10月在安徽醫科大學附屬第一醫院神經內科就診的纖維肌痛患者26例及同期健康體檢者29名，分彆作為患者組及對照組，用漢密爾頓抑鬱量錶-17評估患者的抑鬱狀況。採取ELISA方法檢測兩組血清中CRH、TRH和GnRH含量，所得數據分彆採用獨立樣本t檢驗(正態分佈)與MannWhitney Test檢驗(非正態分佈)，同時用受試者工作特徵(ROC)麯線分析3種激素對纖維肌痛診斷的特異度和敏感度，併採取Spearman相關性分析探討3種激素含量與患者年齡、性彆、壓痛點箇數、疼痛程度及抑鬱程度的相關性。結果 與對照組[70.0(48.7，78.0) ng/L]相比，纖維肌痛患者血清中CRH含量明顯升高[271.9(210.9，326.5)ng/L，x2=6.408，P＜0.01]，TRH[分彆為(82.7±6.9)、(87.2±6.8)ng/L，t =2.560，P＜0.05]及GnRH[分彆為(18.2±0.9)、(19.9±1.6) ng/L，t=5.324，P＜0.01]含量也顯著性升高。三者均與疼痛程度和壓痛點箇數正相關，CRH和GnRH含量還與患者抑鬱程度正相關。血清中3種激素含量的診斷敏感度和特異度ROC麯線下麵積分彆為1.000、0.684與0.854。結論 纖維肌痛患者CRH、TRH和GnRH分泌增多，其中CRH的值可能可以作為診斷纖維肌痛的參攷指標。
목적 탐토섬유기통환자혈청중촉신상선피질격소석방격소(CRH)、촉갑상선격소석방격소(TRH)화촉성선격소석방격소(GnRH)함량변화급기림상의의。방법 선취2009년6월지2010년10월재안휘의과대학부속제일의원신경내과취진적섬유기통환자26례급동기건강체검자29명，분별작위환자조급대조조，용한밀이돈억욱량표-17평고환자적억욱상황。채취ELISA방법검측량조혈청중CRH、TRH화GnRH함량，소득수거분별채용독립양본t검험(정태분포)여MannWhitney Test검험(비정태분포)，동시용수시자공작특정(ROC)곡선분석3충격소대섬유기통진단적특이도화민감도，병채취Spearman상관성분석탐토3충격소함량여환자년령、성별、압통점개수、동통정도급억욱정도적상관성。결과 여대조조[70.0(48.7，78.0) ng/L]상비，섬유기통환자혈청중CRH함량명현승고[271.9(210.9，326.5)ng/L，x2=6.408，P＜0.01]，TRH[분별위(82.7±6.9)、(87.2±6.8)ng/L，t =2.560，P＜0.05]급GnRH[분별위(18.2±0.9)、(19.9±1.6) ng/L，t=5.324，P＜0.01]함량야현저성승고。삼자균여동통정도화압통점개수정상관，CRH화GnRH함량환여환자억욱정도정상관。혈청중3충격소함량적진단민감도화특이도ROC곡선하면적분별위1.000、0.684여0.854。결론 섬유기통환자CRH、TRH화GnRH분비증다，기중CRH적치가능가이작위진단섬유기통적삼고지표。
ObjectiveTo explore alterations of serum levels and clinical significance of corticotropin releasing hormone (CRH), thyrotropin releasing hormone (TRH) and gonadotropin releasing hormone (GnRH) in patients with fibromyalgia (FM). Methods A total of 55 subjects participated in this study: 29 healthy volunteers and 26 patients with FM recruited from Department of Neurology, the First Affiliated Hospital of Anhui Medical University from June 2009 to October 2010. The depression rate was assessed by Hamilton Depression Rating Scale-17. ELISA was used for the detection of the serum levels of CRH, TRH and GnRH. Normal distribution quantitative data were described by the (-x) ± s and tested by independent sample t-test. Non-normal quantitative data were described by interquartile range and tested by independent Mann-Whitney. The diagnostic specificity and sensitivity of 3 kinds of hormones test were analyzed by receiver operator characteristic ( ROC ) curve, and the Spearman correlation was used for analysis of hormone levels and age, gender, tenderness, pain degree and depression severity. Results Compared with the control (70. 0(48.7,78.0) ng/L), the fibromyalgia patients had obviously increased CRH (271.9 (210.9,326.5) rg/L, x2 =6.408, P＜0. 01) , and significantly higher TRH ((82.7 ±6. 9 ) ng/L vs ( 87. 2 ± 6. 8 ) ng/L, t = 2. 560, P ＜ 0. 05, respectively) and GnRH ( ( 18. 2 ± 0. 9 ) ng/L vs ( 19. 9 ± 1.6)ng/L,t =5. 324, P ＜0. 01, respectively). The serum concentrations of the CRH, TRH and GnRH were positively correlated with pain intensity and numbers of tenderness respectively, and those of the CRH and GnRH were positively correlated with depressive degree either. The areas under the ROC curve in the CRH, TRH and GnRH, evaluating the sensitivity and specificity for diagnosis of fibromyalgia, were respectively 1. 000, 0. 684 and 0. 854. Conclusions The FM patients had an increased secretion of CRH,TRH and GnRH. CRH might serve as the adjunctive criteria for the diagnosis of FM.
