氧化型低密度脂蛋白及其受体SR-PSOX在类风湿关节炎患者中的表达  

The expression of oxidized low density lipoprotein and scavenger receptor that binds phospha- tidylserine and oxidized lipoprotein in patients with rheumatoid arthritis

作　　者：建磊磊 于若寒 孙琳[1] 赵金霞[1] 刘湘源[1] 李常虹[1] 

机构地区：[1]北京大学第三医院风湿免疫科,100191

出　　处：《中华风湿病学杂志》2018年第2期76-81,共6页Chinese Journal of Rheumatology

基　　金：国家自然科学基金（81471599,81501387）;中华医学会风湿病学分会燎原计划基金（LYJH-92）

摘　　要：目的分析氧化型低密度脂蛋白（ox-LDL）及其清道夫受体SR-PSOX在RA患者中的表达水平，探讨ox-LDL与疾病活动度之间的关系。 方法采用ESLIA法检测RA患者和健康体检者血清以及RA、OA、炎性关节炎（IA）患者关节滑液ox-LDL表达水平，同时采用蛋白质印迹法检测RA及IA患者关节滑液来源的混合细胞中SR-PSOX表达情况。RA患者临床资料分析采用非参数检验，t检验分析RA及对照组血清中的ox-LDL表达水平的差异，Pearson相关分析RA患者ox-LDL与CRP、ESR等炎性指标及疾病活动度之间的相关性。 结果RA患者血清ox-LDL表达水平[（3 076±131）mU/ml]高于健康对照组[（2 334±84）mU/ml]（t=4.242，P〈0.01）。RA滑液ox-LDL表达水平[（4 963±254）mU/ml]高于OA组[（3 956±347）mU/ml]（t=2.372，P〈0.05）。RA滑液混合细胞SR-PSOX表达水平高于IA组[（4.92±0.18）和（0.24±0.04），t=33.53，P〈0.01]。RA血清ox-LDL表达水平与ESR、CRP及整体疾病活动度DAS28评分呈负相关（分别为r=-0.42，P=0.009；r=-0.35，P=0.029 7；r=-0.42，P=0.008 4）。中度疾病活动度患者血清ox-LDL表达水平高于高度疾病活动度患者，且差异有统计学意义[（3 302±138）mU/ml和（2 464±228）mU/ml，t=3.335，P〈0.01]，而低疾病活动度和病情缓解的RA患者ox-LDL表达水平较高疾病活动度患者虽有上升趋势但差异无统计学意义。经DMARDs治疗后，RA患者ox-LDL整体有轻微上升趋势，但差异无统计学意义。ox-LDL/LDL-C或ox-LDL/HDL-C与DAS28无相关性。 结论RA患者血清及滑液高表达ox-LDL，滑液高表达其受体SR-PSOX，血清ox-LDL水平与ESR、CRP、DAS28呈负相关，与疾病活动度有关，提示ox-LDL及其受体SR-PSOX可能在RA致病中发挥着一定作用，仍需进一步深入探讨。ObjectiveTo investigate the expression level of oxidized low density lipoprotein （ox-LDL） and its scavenger receptor scavenger receptor that binds phosphatidylserine and oxidized lipoprotein （SR-PSOX） in patients with rheumatoid arthritis （RA）, and to explore the relationship between ox-LDL and disease activity. MethodsThe serum ox-LDL in RA patients and healthy control group were detected by enzyme-linked immunosorbent assay （ELISA）, as well as the fluidox-LDL in RA, osteoarthritis （OA） and inflammatory arthritis（IA）. The expression of SR-PSOX in mixed cells of RA and IApatients was detected by western blot. The expression of serum ox-LDL between RA groupand the control group was analyzed by t-test and non-parametric test. The correlation of serum ox-LDL expression levels in RA patients with C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR） and other inflammatory factors and disease activitywas analyzed by Pearson linear regression. ResultsThe expression of ox-LDL in the serum of RA patients was significantly higher than that of normal control group [（3 076±131） mU/ml, （2 334±84） mU/ml, t=4.242, P〈0.01]. The expression of ox-LDL in synovial fluid of RA patients was significantly higher than that of the OA group[（4 963±354） mU/ml],（3 956±347） mU/ml, t=2.372, P〈0.05）. The expression of SR-PSOX in synovial fluid mixed cells of RA patients was higher than that of the IA group [（4.92±0.18） vs （0.24±0.04）, t=33.53, P〈0.01]. The expression of ox-LDL in serum of RA patients was negatively correlated with ESR, CRP and overall disease activity DAS28 （r=-0.42, P=0.009; r=-0.35, P=0.029 7; r=0.42, P=0.008 4）. The expression of ox-LDL in the serum of RA patients with moderate disease activity was significantly higher than those patients with high disease activity [（3 302±138） mU/ml vs （2 464±228） mU/ml, t=3.335, P〈0.01], however, those with low disease activity and disease remission had higher serum ox-LDL expression but

关 键 词：脂蛋白类 LDL 关节炎 类风湿 血沉 氧化型低密度脂蛋白 SR-PSOX 

分 类 号：R593.22[医药卫生—内科学]