Состояние репродуктивной функции и уровень репродуктивного маркера у женщин с системной красной волчанкой

Abstract

Для визначення стану репродуктивної системи та рівня антимюллерова гормону обстежено 30 жінок з СЧВ (середній вік – 31,1 1± 8,77 років) і 10 жінок без СЧВ (середній вік – 32,0 ± 4,15 років). Вимірювання рівня АМГ проводили в плазмі крові методом ІФА. Жінки з СЧВ мали обтяжену спадковість, особливо по захворюваннях сполучної тканини і серцево-судинної системи, високу частоту супутньої соматичної та гінекологічної патології, обтяжений акушерський анамнез. Рівень АМГ у пацієнток з СЧВ в 8,5 разів був нижче контрольного показника (р<0,001).; Х. И. Резюме. Для определения состояния репродуктивной системы и уровня антимюллерова гормона обследовано 30 женщин с СКВ (средний возраст 31,11 ± 8,77 лет) и 10 женщин без СКВ (средний возраст – 32,0±4,15 лет). Измерение уровня АМГ проводили в плазме крови методом ИФА. Женщины с СКВ имели отягощенную наследственность, особенно по заболеваниям соединительной ткани и сердечно-сосудистой системы, высокую частоту сопутствующей соматической и гинекологической патологии, отягощенный акушерский анамнез. Уровень АМГ у пациенток с СКВ в 8,5 раза было ниже контрольного показателя (р<0,001).; Determining the status of the reproductive system and the level antimullerian hormone (AMH) in women of reproductive age with SLE. Methods. We examined 30 women of reproductive age with SLE, whose average age amounted 31,11±8.77 years. The inclusion criteria in the study were: confirmed diagnosis of SLE; age limit 15-45 years; women with reproductive disorders, including amenorrhea and metrorrhagia, is not receiving treatment of SLE, and women with reproductive disorders, including amenorrhea and metrorrhagia receiving therapy for SLE; females of reproductive age with SLE activity index - SLEDAI (the Systemic Lupus Erythematosus Disease Activity Index) greater than 8. The control group consisted of 10 women of reproductive age without SLE, whose average age amounted to 32,0±4.15 years. Results. The average duration of SLE was 9.1±2.8 years (ranging from 1 to 20 years). The duration of the disease before 5 years, there have been 6.67% of cases, 5 to 10 years – at 40.0%, more than 10 years – in 53,3% of cases. Revealed that all surveyed women with SLE met moderate activity (activity II, 9-10, SLEDAI). Chronic disease was noted in 86.7 per cent, a sharp – 13.3% of women. Among organ lesions there were changes in the skin in the form of erythema, photosensitivity or lupus discoides – in 5 cases (16.7%) women, the mucous membranes – in 4 (13,3%), vascular changes 8 (26.7%), joint involvement (arthralgia, arthritis, syndrome Jacques) – in 7 (23,3%), kidneys (lupus nephritis, urinary syndrome) 8 (26.7%), lung in pleurisy in 3 (10,0%), heart in the form of pericarditis – in 2 (6,7%), damage to the nervous system – 1 (3,0%), alopecia in 1 (3.0 per cent) women. Therefore, prevailed diseases of vessels, joints and kidneys. Immunological and haematological changes occurred in all the women of the main group. History of connective tissue diseases in women with SLE was present in 13.3% of cases (p<0.05). Cardiovascular disease occurred in relatives 14 (46,7%) women with SLE, whereas in the control group only 1 (10,0%) (p<0.01). Differences in the number of relatives with diabetes and varicose veins, in women with SLE were statistically insignificant, as in the case of cancer. Thyroid disease in the family in women with SLE were found in 3.3% of cases of respiratory diseases – 6.7% of cases, diseases of the gastrointestinal tract and diseases of the skin – 3.3% respectively. Thus, among women with SLE often noted family history of connective tissue diseases and the cardiovascular system. In women with SLE revealed a high frequency of eye diseases (cataract, myopia) – 53,3% (control – 10,0%, p<0.01). Thyroid gland diseases (autoimmune thyroiditis, hypothyroidism, nodular goiter, etc.) in patients with SLE identified in 26.7% of cases (control – 10,0%, p<0.05). Conclusions. For women of reproductive age with SLE characterized by the fact that women with SLE had a family history, especially the connective tissue diseases and the cardiovascular system, the high frequency of concomitant somatic and gynecological pathology, as well as obstetric anamnesis.