系统性硬化病血脂异常与炎症的相关性分析  

Altered lipid in systemic sclerosis is associated with inflammation

作　　者：汪汉[1] 葛鹏[2] 蔡盈盈[3] 胡迎春[3] 刘汉雄[1] 王引利[1] 曹溢[1] 袁龙会[1] 蔡琳[1] 

机构地区：[1]重庆医科大学附属成都第二临床医学院成都市第三人民医院成都市心血管病研究所心内科,成都610031 [2]湖北医药学院附属人民医院心内科 [3]四川大学华西医院老年心血管科

出　　处：《中华风湿病学杂志》2013年第7期453-457,共5页Chinese Journal of Rheumatology

摘　　要：目的探讨系统性硬化病（SSc）的血脂及与炎症的关系。方法采用病例对照研究，纳入67例SSc患者及67名年龄、性别配对的健康体检者。检测所有纳入患者的甘油三酯、总胆固醇、低密度脂蛋白胆固醇（LDL-c）、高密度脂蛋白胆固醇（HDL-c）、C反应蛋白（ERP）及红细胞沉降率（ESR），Mann-Whitney U及Kruskal-Wallis法用于检验各组之间的差异，血脂与炎症指标的关系采用Spearman相关分析。结果23例（34％）SSc患者甘油三酯升高，而65例（97％）患者的HDL-c下降。与对照组相比，SSc患者总胆固醇（舟0．004）、LDL-c（P=0．014）及HDL-c（P=0．000）偏低，甘油三酯（P=0．023）、极低密度脂蛋白胆固醇（VLDL-c）（P=-O．023）、VLDL-c／LDL-c（P=0．000）及TC／HDL-c比值（肚0．026）偏高。Spearman分析显示HDL-c水平与CRP（r=-0．259，P=-0．036）及ESR（r=-0．256，P=O．038）呈负相关。结论SSc患者血脂异常相当普遍，常以甘油三酯升高，HDL-c降低，并伴总胆固醇、LDL-c降低为主，该现象可能与炎症部分相关。这种血脂异常的“剩余风险”可能提示高风险的动脉粥样硬化的发生。Objective Altered lipid levels may occur in autoimmune diseases, such as systemic lupus erythematosus （SLE） and rheumatoid arthritis. However, serum lipid profiles in patients with systemic sclerosis （SSc） have rarely been reported. Our aim was to identify lipid profiles in untreated SSc patients, and to assess the relationship between the inflammatory condition of SSc with lipid profiles. Methods This work was conducted as a case-control study. Sixty-seven SSc patients and 67 age-and gender-matched healthy con- trois were included. None of the patients had received corticosteroids or disease-modifying antirheumatic drugs prior to the study. Triglyceride （TG）, total cholesterol （TC）, low-density lipoprotein-cholesterol （LDL-c） and high-density lipoprotein-cholesterol （HDL-c）, C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） were assessed using standard techniques. Comparison of lipid profiles and CRP/ESR between groups was analyzed by Mann-Whitney U or Kruskal-Wallis test. Corrections between variables were analyzed using Spearman＇ s correlation test. Results Twenty-three patients （34%） had an increased level of TG, and 65 patients （97%） had a decreased level of HDL-C. The levels of HDL-c （P=0.000）, TC （P=0.004） and LDL-c （P=-0.014） in SSc were significantly lower than in controls. The levels of TG （P=0.023）, VLDL-c （P=0.023）, VLDL-c/LDL-c （P=0.000）, and TC/HDL-c ratio （P=0.026） were significantly higher than in controls. Spear- man＇s correlation test demonstrated that HDL-c levels correlated negatively with serum CRP （r=-0.259, P= 0.036） and ESR （r=-0.256, P=0.038）, and LDL-c/HDL-c （r=0.263, P=0.033） and TC/HDL-c ratio （r=0.262, P=0.034） correlated positively with ESR in SSc （P〈0.05）. Conclusion Dyslipoproteinemia is a common feature in patients with SSc that is characterized by an increase in TG and a decrease in HDL-c, sug-gesting a high risk of atheroosclerosis. Inflammation might partly account for

关 键 词：硬化病 系统性 高脂血症 脂蛋白类 炎症 

分 类 号：R744.51[医药卫生—神经病学与精神病学]