膝骨性关节炎患者血清脂质、载脂蛋白、高密度脂蛋白亚类的测定  

Detecting the level of lipid,apoprotein,HDL-subclasses in serum with knee osteoarthritis

作　　者：王平[1,2] 李群芳[3] 廖瑛[1] 

机构地区：[1]南华大学附属第一医院骨外科,湖南衡阳421001 [2]衡阳市第三人民医院骨外科,湖南衡阳421001 [3]湖南环境生物职业技术学院护理系,湖南衡阳421001

出　　处：《临床骨科杂志》2009年第1期81-85,共5页Journal of Clinical Orthopaedics

基　　金：衡阳市科技计划项目(编号:2008KS09)

摘　　要：目的探讨血清中脂质、载脂蛋白、高密度脂蛋白(HDL)及其亚类的含量水平是否可以作为膝骨性关节炎辅助诊断以及患病严重程度诊断的指标,为膝骨性关节炎的早期预防、诊断与治疗提供理论依据。方法按X线、临床、病理等不同分级方法、不同级别对50例膝骨性关节炎患者和54例正常人分别进行血清检查,血清甘油三酯(TG)、总胆固醇(TC)、HDLC含量采用酶法试剂盒测定,低密度脂蛋白(LDLC)按公式LDLC=TC-HDLC-TG/2.19计算。血清载脂蛋白均采用单向免疫扩散试剂盒测定。HDL及其亚类通过琼脂糖凝胶电泳、梯度聚丙烯酰胺凝胶电泳、免疫印迹实验等方法测试。结果膝骨性关节炎患者血清中TG、APOC2、APOC3、APOE、pre-β1、HDL3b、HDL3a含量高于正常对照组(P<0.05),尤其是pre-β1、HDL3a、HDL3b(P<0.001);血清中APOA1、HDLC、HDL3c、HDL2a、HDL2b的含量低于正常对照组(P<0.05),尤其是HDL2a、HDL2b(P<0.001);同一分级标准的不同级别pre-β1、HDL3a、HDL3b、HDL2a、HDL2b含量差异有显著性,随着级别升高,HDL3a、HDL3b、pre-β1含量明显上升,而HDL2a、HDL2b含量明显降低。结论正常人与膝骨性关节炎患者血清中部分脂质、载脂蛋白、HDL亚类的含量比较差异有显著性。pre-β1、HDL3a、HDL3b、HDL2a、HDL2b含量变化与骨性关节炎病变存在相关性;pre-β1、HDL3a、HDL3b、HDL2a、HDL2b的含量可能成为骨性关节炎早期临床辅助诊断的候选指标,也可以为膝骨性关节炎患者患病的严重程度提供参考。Objective To investigate whether high density lipoprotein （HDL） and HDL-subclasses levels could be use as an assistant diagnostic index and severe degree index of knee osteoarthritis （OA） in order to provide theoretical foundation for early prevention, diagnosis and therapy. Methods 54 healthy people and fifty knee OA patients in various stages according to X-ray, clinics, pathology were enrolled. Triglyeride （TG）, total cholesterol （TC） , HDL-C in serum were detected by ELISA. Apoprotein in serum was detected by single IDK. LDLC was calculated by ＂LDLC = TC- HDLC-TG/2. 19＂. HDL and HDL-subclasses were detected by AGE, GPGE, IB. Results Compared with controls, the levels of TG, APOC2, APOC3, APOE, pre-β1, HDL3a and HDL3b in serum with OA patients obviously increased （P 〈 0. 05 ） , especially pre-β1 , HDL3a, and HDL3b （ P 〈 0. 001 ）. Compared with controls, the levels of APOA1, HDLC, HDL3c, HDL2a and HDL2b in serum with OA patients obviously decreased （ P 〈 0. 05 ）, especially HDL2a and HDL2b （P 〈 0. 001 ）. The levels of pre-β1, HDL3a, HDL3b, HDL2a and HDL2b were significant different among different stages according to the same standard. In general, the levels of HDL3a, HDL3b, and pre-β1 significantly increased and the levels of HDL2a, and HDL2b decreased as stages were advanced. Conclusions The levels of some lipid, apoprotein, HDL-subelasses are significant different between the OA patients and controls. The changes of levels of pre-β1 , HDL3a, HDL3b, HDL2a and HDL2b have con＇elation with OA and the detection of levels of pre-β1 , HDL3a, HDL3b, HDL2a and HDL2b could be used as early assistant diagnostic index and even could provide refference for the severity of OA patients.

关 键 词：骨关节炎 膝 载脂蛋白类 高密度脂蛋白及其亚类 

分 类 号：R684.3[医药卫生—骨科学] R341[医药卫生—外科学]