类风湿关节炎患者脂质水平异常特征  

Abnormal characteristics of plasma lipid levels in patients with rheumatoid arthritis

作　　者：胡兵[1] 汪俊军[2] 姚茹冰[1] 蔡辉[1] 张春妮[2] 

机构地区：[1]南京军区南京总医院中西医结合科,江苏南京210002 [2]南京军区南京总医院解放军临床检验医学研究所,江苏南京210002

出　　处：《医学研究生学报》2007年第10期1041-1043,1046,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金资助项目(批准号:30471649);江苏省自然科学基金青年科技创新人才项目(批准号:BK2006529);南京军区医药卫生科研基金课题(批准号:06MA119)

摘　　要：目的:分析类风湿关节炎(RA)患者脂质和氧化修饰低密度脂蛋白(Ox-LDL)水平,探讨RA患者心脑血管病高发生率的机制。方法:选择RA患者55例,其中活动型24例,非活动型31例;对照组60例。同时对受检者血脂、Ox-LDL水平进行检测。结果:活动型RA患者总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和载脂蛋白B(apoB)水平较对照组显著升高;非活动型RA患者TC、三酰甘油(TG)、LDL-C、apoAⅠ、apoB和Ox-LDL水平均较对照组显著升高;而活动型RA患者血脂和Ox-LDL水平较非活动型RA患者水平均有下降趋势,但仅apoAⅠ有统计学意义。血沉(ESR)分别与TC、LDL-C、高密度脂蛋白胆固醇(HDL-C)和apoAⅠ负相关;C反应蛋白(CRP)分别与HDL-C和apoAⅠ负相关。结论:RA患者脂质和Ox-LDL水平发生显著变化,炎症反应对脂代谢具调节作用,参与动脉粥样硬化的发生、发展。Objective： To explore the mechanism of high incidence of cardiovascular diseases and the levels of plasma lipids and oxidized low-density lipoprotein （Ox-LDL） in patients with rheumatoid arthritis （RA）. Methods： Fifty-five patients with RA （24 case of active type, 31 non-active ） and 60 healthy controls were randomly chosen. Plasma lipids and Ox-LDL levels were studied. All the data were subjected to statistical analysis. Results： Compared with the control, total cholesterol （TC）, LDL cholesterol （LDL-C） and apolipoprotein B （apoB） levels were increased in patients with active RA, while TC, triglyceride （TG）, LDL-C, apoA I , B and Ox-LDL levels were elevated in those with non-active RA. Furthermore, plasma lipids and Ox-LDL level decreased in the active patients as compared with the non-active ones, while only the change of apoA Ⅰ had statistical significance. The erythrocyte sedimentation rate was found negatively related with TC, LDL-C, high-density lipoprotein cholesterol （HDL-C） and apoA Ⅰ , while C-reacting protein was found negatively related with LDL-C and HDL-C. Conclusion ： Ox-LDL and plasma lipid levels were changed in RA patients. Inflammation may induce changes of lipoprotein and play an important role in atherosclerosis.

关 键 词：低密度脂蛋白 氧化修饰 免疫复合物 类风湿关节炎 动脉粥样硬化 

分 类 号：R392.6[医药卫生—免疫学]