绝经后女性膝骨关节炎性激素水平及其与年龄和病变程度的关系

摘要

目的 观察绝经后女性膝关节骨关节炎性激素水平及其与年龄和病变程度的关系.方法 观察2016年1月至2016年12月我院骨关节外科确诊为膝关节骨关节炎,行膝关节置换术或保守治疗的50岁以上绝经后女性患者215例,按年龄分组,每10岁为一组,分为三组,测量身高、体重,计算体重指数,进行WOMAC量表评分、X线拍片、膝关节磁共振T2-mapping成像.空腹抽血检测卵泡刺激素、黄体生成素、雌二醇、空腹血糖、甘油三酯、总胆固醇.按照卵泡刺激素(follicle-stimulating hormone,FSH)的高低分两组,高FSH组(＞40 mIU/mL)、低FSH组(＜40mIU/mL),高FSH组50～60岁患者42例,61～70岁患者45例,大于70岁患者26例,低FSH组50～60岁患者37例,61～70岁患者40例,大于70岁患者25例,观察两组WOMAC评分和T2值.结果 绝经后女性膝关节骨关节炎(knee osteoarthritis,KOA)患者随着年龄增加,身高、体重、体重指数、血甘油三酯、胆固醇、血糖无显著变化,WOM-AC评分、平均T2值显著性增加.血清FSH水平在50～60岁组最高,之后随着年龄增加,血清FSH浓度显著下降,血清黄体生成素(1uteinizing hormone,LH)、雌二醇(estradiol,E2)在绝经后随年龄增加逐渐降低,LH下降有显著性,E2下降无显著性.与FSH＞40 mIU/mL组比较,FSH＜40 mIU/mL组的年龄差异无统计学意义,但WOMAC评分、T2值显著增加.结论 膝骨关节炎是增龄性疾病,绝经后女性雌激素水平显著下降,50～60岁卵泡刺激素达到分泌高峰,排除年龄、雌激素的影响,随着卵泡刺激素的下降,骨关节炎症状加重.%Objective To explore the relationship of serum gonadal hormone levels with age and lesion severity in postmenopausal women with knee osteoarthritis.Methods 215 cases of postmenopausal female patients above 50 years old with knee joint replacement surgery or conservative treatment diagnosed as knee osteoarthritis in Shandong Jining the 1st People's Hospital bone and joint surgery from January 2016 to December 2016 were enrolled.According to age,every 10 years as a group,the patients weredivided into three groups.We measured height,weight,calculate body mass index,WOMAC scale score,X-ray and magnetic resonance imaging of the knee T2-mapping.Fasting blood samples were used to detect FSH,LH,estradiol,fasting blood glucose,triglyceride,and total cholesterol.In accordance with the level of FSH was divided into two groups,high FSH group (＞40 mIU/mL) and low FSH group (＜40 mIU/mL).High FSH group had42 cases at the age of 50～60,45 cases at the age of 61～70,26 cases more than 70 years old.Low FSH group had37 cases of 50～60 years old and 40 casesof 61～70 years oldand 25 cases more than 70 years old.WOMAC score and T2 valueof thetwo groups wereobserved.Results The height,weight,body mass index,blood triglyceride,cholesterol and blood sugar of the postmenopausal women with KOA did not change significantly with the increase of age,and the WOMAC score and the average T2 value increased significantly.Serum FSH levels were the highest in the 50 ～ 60 year old group,and then decreased significantly with age,and serum LH and E2 gradually decreased.The decrease of LH was significant,and E2 was not significant.Compared with the high FSH group,there was no significant difference in age between the two groups,but the WOMAC score and T2 value increased significantly.Conclusion Knee osteoarthritis is age-related disease.With the decrease of follicle stimulating hormoneandestrogen,osteoarthritis syptomswillincreases.