Hepatic And Renal Deficiency Type Of Rheumatoid Arthritis Of Laboratory Index To Analyze The Clinical Features

Objective: To investigate the correlation between cortisol,Adrenocorticotropic Hormone(ACTH)and sex hormone levels and clinical and inflammation-related indicators in patients with hepatorenal deficiency rheumatoid arthritis,and to provide a new theoretical basis for the treatment of patients with liver and renal insufficiency of RA.Methods: A total of 60 patients with hepatorenal deficiency type RA who visited the inpatient department of rheumatology at the Affiliated Hospital of Jiangxi University of Chinese Medicine during December2021-December 2022 were selected.The enrolled cases were divided into male and female groups according to gender and sex hormone levels;they were classified into four grades(1,2,3,4)according to joint function classification;clinical data and ACTH,cortisol,estradiol(E2),progesterone(P),testosterone(T),prolactin(PRL),luteinizing hormone(LH),follicle stimulating hormone(FSH),Rheumatoid factor(RF),Anticyclic citrulline peptide antibodies(anti-CCP antibodies),blood sedimentation,and C-reactive protein(CRP)were recorded in all patients.The correlation between ACTH,cortisol and sex hormone levels in rheumatoid arthritis and the clinical symptoms and inflammation-related indicators of liver and kidney deficiency was studied.Results:(1)There were 60 patients with hepatorenal deficiency RA,including 24 males and 36 females.The differences between the two groups were statistically significant in E2,P,T,FSH,and LH(P < 0.05),and there were no differences in ACTH,cortisol,RF,anti-CCP antibody,CRP,blood sedimentation,and PRL(P > 0.05).(2)There was a negative correlation between RF and T in male patients with hepatorenal deficiency RA(r=-0.411,P<0.05);there was no correlation between RF and T in female patients(P>0.05);there was no correlation between RF and ACTH,cortisol,E2,P,FSH,LH and PRL(P>0.05).(3)There was a positive correlation between anti-CCP antibodies and E2 in female patients with hepatorenal deficiency RA(r=0.450,P<0.01);there was no correlation between anti-CCP antibodies and E2 in male patients(P>0.05);there was a positive correlation between anti-CCP antibodies and FSH in male patients(r=0.355,P<0.05)and a negative correlation with T(r=-0.388 There was no correlation between anti-CCP antibodies and FSH and T in female patients(P>0.05);there was no correlation between anti-CCP antibodies and ACTH,cortisol,P,LH and PRL(P>0.05).(4)There was a negative correlation between liver and kidney deficiency type RA blood sedimentation and cortisol(r=-0.224,P<0.05);a negative correlation between female RA patients’ sedimentation and FSH(r=-0.377,P<0.05);no correlation between male RA patients’ blood sedimentation and FSH(P>0.05);no correlation between RA patients’ blood sedimentation and ACTH,E2,P,PRL,LH and T(P>0.05).(P>0.05).(5)There was a negative correlation between CRP and ACTH in RA patients with liver and kidney deficiency(r=-0.220,P<0.05);a negative correlation between CRP and E2 and P in male patients(r=-0.419,P<0.05;r=-0.394,P<0.05),and a positive correlation with FSH(r=0.402,P<0.05);a positive correlation between CRP and E2,P and FSH in female patients(r=0.402,P<0.05).There was no correlation between CRP and E2,P and FSH in female patients(P>0.05);there was no correlation between CRP and cortisol,PRL,LH and T(P>0.05).(6)There was a negative correlation between joint function classification and cortisol(r=-0.286,P<0.05)and positive correlation between age,disease duration,RF,anti-CCP antibody,blood sedimentation and CRP(r=0.437,P<0.01;r=0.403,P<0.01;r=0.287,P<0.05;r=0.380,P<0.01;r=0.318,P<0.01;r=0.298,P<0.05);there was a positive correlation between joint function classification and FSH in male RA patients(r=0.386,P<0.05);there was no correlation between joint function classification and FSH in female RA patients(P>0.05);there was no correlation between joint function classification and ACTH,E2,P,PRL,LH,T were not correlated(P > 0.05).Conclusions:1.There was a negative correlation between ACTH and CRP and between cortisol and blood sedimentation in RA patients with hepatorenal insufficiency type.It is suggested that the level of ACTH and cortisol can not only reflect the inflammation of the disease,but also be correlated with the classification of hepatorenal deficiency in RA.2.E2 and anti-CCP antibodies were positively correlated and FSH and blood sedimentation were negatively correlated in female patients with hepatorenal deficiency RA;E2,P and CRP were negatively correlated,FSH was positively correlated with CRP,anti-CCP antibodies and joint function classification,and T was negatively correlated with RF and anti-CCP antibodies in male patients with hepatorenal deficiency RA;suggesting that sex hormones are related to hepatorenal deficiency RA patients The correlation between sex hormones and immune abnormal response and inflammatory response in RA patients with liver and kidney deficiency can be considered as a reference index for the identification of liver and kidney deficiency in Traditional Chinese Medicine while the correlation between sex hormones and inflammation-related indexes in different sexes needs to be further explored.3.There was a positive correlation between joint function classification and age,disease duration,blood sedimentation,CRP,RF and anti-CCP antibodies,and a negative correlation with cortisol in RA patients with liver and kidney deficiency.This indicates that the age,disease duration and inflammation-related indexes of RA patients can affect the joint activity function,and the joint function grade decreases with the increase of cortisol level.4.The correlation between ACTH,cortisol,sex hormone levels and inflammation-related indexes in RA patients with liver and kidney deficiency can provide new ideas for the treatment of this disease in Chinese medicine and improve the clinical treatment effect of patients.