自身免疫性肺泡蛋白沉积症血清脂代谢特点  

Characteristics of Serum Lipid Metabolism in Patients with Autoimmune Pulmonary Alveolar Proteinosis

作　　者：李妍[1] 田欣伦[1] 桂耀松[1] 马爱平[1] 李雪[1] 曾妮[1] 张芃[1] 詹永忠[1] 李果珍[1] 徐凯峰[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院呼吸科,北京100730

出　　处：《中国医学科学院学报》2014年第6期645-649,共5页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨血脂在自身免疫性肺泡蛋白沉积症(APAP)诊断与监测中的意义。方法连续收集APAP患者血清脂代谢资料,分析32例非糖尿病APAP患者及100例健康体检者血脂水平。用ELISA法测定APAP患者血清抗粒细胞巨噬细胞集落刺激因子(GM-CSF)抗体水平。分析血脂与乳酸脱氢酶、癌胚抗原、抗GM-CSF抗体、肺功能及血气指标的相关性。结果 APAP组血清总胆固醇及低密度脂蛋白-胆固醇水平分别为(5.54±0.99)及(3.73±0.83)mmol/L,显著高于健康对照组的(5.05±0.97)及(3.17±0.89)mmol/L(P均<0.05);高密度脂蛋白-胆固醇显著低于健康对照组[(1.10±0.18)比1.22(1.05-1.41)mmol/L,P均<0.05]。APAP组的低密度脂蛋白/高密度脂蛋白及总胆固醇/高密度脂蛋白比值分别为3.47±0.90及5.14±1.12,显著高于健康对照组的2.63±0.87及4.18±1.12(P均<0.05)。APAP组的甘油三酯水平与健康对照组的差异无统计学意义(P>0.05)。高密度脂蛋白-胆固醇与肺泡动脉氧分压差呈负相关(r=-0.436,P<0.05),与动脉血氧饱和度呈正相关(r=0.459,P<0.05)。血脂指标与抗GM-CSF抗体无线性相关关系(P均>0.05)。结论APAP患者存在血脂代谢异常,血脂异常与疾病严重程度有一定相关性,在APAP患者的评估与治疗过程中需关注血脂异常。Objective To study the serum lipid panels in consecutive autoimmune pulmonary alveolar proteinosis （APAP） patients and analyze their relationship with anti-granulocyte macrophage-colony stimulating factor （GM-CSF） antibody and other markers.Methods Thirty-two non-diabetic APAP patients were enrolled in the study.Serum lipids of these patients and 100 healthy volunteers were tested after an overnight fasting.Anti-GM-CSF antibody levels were measured with enzyme-linked immunosorbent assay.The correlation of serum lipids with lactate dehydrogenase,carcinoembryonic antigen,pulmonary function,and artery blood gas parameters were analyzed.Results Total cholesterol and low-density lipoprotein cholesterol levels [（5.54 ± 0.99） and （3.73 ± 0.83） mmoL/L respectively] were significantly higher in APAP patients than in healthy volunteers [（5.05 ± 0.97） and （3.17 ± 0.89） mmol/L respectively] （all P 〈 0.05）.High-density lipoprotein cholesterol （HDL-C） level of the APAP group [（1.10 ± 0.18） mmol/L] was significantly lower than that of the healthy group （P 〈 0.05）.Low-density lipoprotein/HDL and total cholesterol/HDL ratios in the APAP group （3.47 ±0.90 and 5.14 ± 1.12 respectively） were significantly higher than those in the healthy group [（2.63 ± 0.87） and （4.18 ± 1.12）] （all P 〈0.05）.There was no significant difference in triglyceride level between the two groups （P 〉 0.05）.HDL-C level was negatively correlated with alveolar-arterial oxygen pressure difference （r =-0.436,P 〈 0.05） and positively correlated with arterial oxygen saturation （r =0.459,P 〈 0.05）.None of the lipid markers correlated with serum anti-GM-CSF antibody levels （all P 〉 0.05）.Conclusions APAP patients were likely to suffer from disturbed lipid metabolism,which was correlated with disease severity to some degree.Lipid markers deserved more attention in the management of APAP patients.

关 键 词：肺泡蛋白沉积症 脂代谢 抗粒细胞巨噬细胞集落刺激因子抗体 乳酸脱氢酶 癌胚抗原 

分 类 号：R563[医药卫生—呼吸系统]