高级氧化蛋白产物在系统性红斑狼疮早发动脉粥样硬化中的临床意义  

The clinical significance of advanced oxidation protein products in patients with systemic lupus erythematosus complicated with atherosclerosis praecox

作　　者：王贞[1] 薛原[1] 林珺芳[1] 陈翠林[2] 黄亚婷[3] 

机构地区：[1]福建医科大学附属第一医院风湿科,福州350005 [2]福建医科大学附属第一医院B超室,福州350005 [3]福建医科大学附属第一医院心电图室,福州350005

出　　处：《中华风湿病学杂志》2010年第6期404-407,共4页Chinese Journal of Rheumatology

摘　　要：目的 研究系统性红斑狼疮（SLE）氧化应激状态及早发动脉粥样硬化的情况,并重点探讨高级氧化蛋白产物（AOPPs）在SLE早发动脉粥样硬化中的意义.方法 采用酶联免疫吸附试验（ELISA）法、分光光度法检测44例未绝经女性SLE患者和31名健康对照组血清中AOPPs、同型半胱氨酸（Hey）、丙二醛（MDA）的浓度以及超氧化物歧化酶（SOD）活性,并检测臂踝脉搏波速度（baPWV）以及颈动脉内膜中层厚度（CIMT）,进行比较.并进一步将SLE组分为病程≥5年与〈5年组、活动组与非活动组,记录SLE患者的总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）等指标.采用t检验.t＇检验以及Pearson榆验.结果 SLE组AOPPs、Hey、MDA浓度显著高于健康对照组（P〈0.05）,SOD浓度显著低于健康对照组（P〈0.05）,并且病程≥5年与〈5年组、活动组与非活动组间差异亦有统计学意义（P〈0.05）;CIMT检查SLE组中有2例存在颈动脉斑块（CAP）（病程均〉5年）,而31名健康对照组均无CAP形成,且SLE组CIMT、baPWV较对照组明显增高（P〈0.05）,病程是否≥5年组中比较差异亦有统计学意义（P〈0.05）;氧化应激指标（AOPPs、Hcy、MDA、SOD）与baPWV、CIMT有显著相关性（P〈0.01）;AOPPs浓度与Hcy、TC、TG、LDL呈显著正相关（P〈0.01～0.05）.结论 SLE患者体内存在显著的氧化应激,较对照组有明显的动脉粥样硬化倾向;疾病病程、氧化应激是动脉粥样硬化的重要危险因素;AOPPs与SLE早发动脉粥样硬化相关,可作为一项SLE早发动脉粥样硬化的预测因子.Objective To estimate the degree of oxidative stress and atherosclerosis praecox in patients with systemic lupus erythematosus （SLE）, and emphasize on exploring AOPPs＇ clinical significance in premature atherosclerosis in SLE. Methods The levels of AOPPs, Hey, MDA, SOD, baPMV and CIMT were detected by ELISA and spectropholometry in 44 non-menopausal female SLE patients and 31 healthy middle-aged women respectively, and baPWV. The results were compared with AOPPs of the two groups. Then each group was stratified based on disease duration （≥5 years or 〈5 years） and the disease activity（active and inactive） in SLE patients. The patients＇ TC, TG, LDL were analyzed. T test, t＇ test and Pearson correla-tion were selected. Results The levels of AOPPs, Hcy, MDA in SLE patients were significantly higher than those of the healthy controls （P〈0.05）. The activities of SOD were lower than controls （P〈0.05）. The levels of AOPPs, Hcy, MDA, SOD had statistical significance between SLE patients disease duration ≥5 years or 〈5 years, active or inactive groups. There were two cases with CAP in patients with SLE （more than 5 years disease duration）,while there wasnone in healthy controls. The levels of baPWV and CIMT in patients with SLE were higher than healthy controls （P〈0.05）, and had statistical significance in SLE patients disease duration more than or less than 5 years （P〈0.05）. The oxidative stress targets （AOPPs, Hey, MDA, SOD） had significant correlation with the level of baPWV and CIMT （P〈0.01）. The level of serum AOPPs had significant positive correlation with the levels of Hcy, TC, TG and LDL （P〈0.01～0.05）. Conclusion SLE patients have increased oxidative stress , and significantly higher prevalence of atherosclerosis than healthy controls. The disease duration and oxidative stress play important roles in the duration of atherosclerosis. AOPPs probably involves in the accelerated atherosclerosis of SLE patients. It may be a predictor for SLE complic

关 键 词：红斑狼疮 系统性 氧化应激 动脉粥样硬化 高级氧化蛋白产物 

分 类 号：R593.241[医药卫生—内科学]