类风湿性关节炎患者血清胆红素与血脂水平的相关性研究  

Correlation between Serum Bilirubin and Serum Lipids in Patients with Rheumatoid Arthritis

作　　者：王杨[1] 王倩[1] 孙丽莎[1] 胡志东[1] WANG Yang;WANG Qian;SUN Li-sha(Department of Clinical Laboratory Medicine,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院医学检验科

出　　处：《中国实验诊断学》2019年第11期1906-1910,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨类风湿性关节炎患者(RA)血清胆红素和血脂水平的变化及其相关性。方法检测115例RA患者(活动期64例和缓解期51例)及62例健康体检者的血清胆红素和血脂水平。多组间样本均数比较用单因素方差分析,有差别用SHKq检验进一步两两比较。变量间相关性,符合正态分布的计量资料采用Pearson相关性分析,偏态分布的计量资料采用Spearman相关性分析。结果RA活动期组和RA缓解期组血清总胆红素(TBIL)和直接胆红素(DBIL)水平均显著低于对照组(P<0.01),但RA两组血清胆红素水平差异无统计学意义(P>0.05)。RA活动期组血清总胆固醇(TC)和高密度脂蛋白胆固醇(HDL-C)水平均显著低于对照组(P<0.01),并且RA活动期组血清HDL-C水平与RA缓解期组相比也显著降低(P<0.01)。RA活动期组血清甘油三酯(TG)水平显著高于对照组和RA缓解期组(P<0.01)。RA缓解期组血清TC和HDL-C水平显著低于对照组(P<0.05和P<0.01)。进一步计算得出RA活动期组动脉粥样硬化指数(TC/HDL-C)显著高于对照组和RA缓解期组(P<0.01)。变量间相关性分析显示,RA患者血清TBIL和DBIL水平均与HDL-C水平呈正相关(r=0.203、0.232,均P<0.05),血清DBIL水平与动脉粥样硬化指数(TC/HDL-C)呈负相关(r=-0.237,P<0.05)。结论RA患者血清TBIL和DBIL水平明显降低,血清HDL-C水平的明显降低是RA患者血脂异常最突出的表现,并且其降低程度与疾病活动性有关,RA患者胆红素水平的降低与其血脂水平相关。Objective To investigate the changes and correlation of serum bilirubin and lipid levels in patients with rheumatoid arthritis(RA).Methods Serum bilirubin and lipid levels were measured in 115RA patients(64active and 51remission)and 62healthy controls.Single factor analysis of variance(ANOVA)was used to compare the mean number of samples between groups and further pairwise comparison was made by SHKq test.The correlation between variables was analyzed by pearson correlation analysis for normal distribution data and spearman correlation analysis was used for skewed distribution data.Results The levels of serum TBIL and DBIL in RA active group and RA remission group were significantly lower than those in control group(P<0.01).However,there was no significant difference in serum bilirubin levels between the two groups in RA(P>0.05).The levels of serum TC and HDL-C in RA active group were significantly lower than those in control group(P<0.01),and serum HDL-C levels in RA active group were significantly lower than those in RA remission group(P<0.01).The serum TG levels in RA active group were significantly higher than those in control group and RA remission group(P<0.01).The levels of serum TC and HDL-C in RA remission group were significantly lower than those in control group(P<0.05and P<0.01).Further calculations showed that the atherosclerosis index(TC/HDL-C)in RA active group was significantly higher than that in control group and RA remission group(P<0.01).The correlation analysis between variables showed that the levels of serum TBIL(r=0.203,P<0.05)and DBIL(r=0.232,P<0.05)in RA patients were positively correlated with serum HDL-C levels,and serum levels of DBIL in RA patients were negatively correlated with atherosclerosis index(TC/HDL-C)(r=-0.237,P<0.05).Conclusion Serum TBIL and DBIL levels were significantly lower in patients with RA.The decrease of serum HDL-C level was the most prominent manifestation of dyslipidemia in RA patients,and the degree of decrease was related to disease activity.The decrease of

关 键 词：类风湿性关节炎 胆红素 血脂 氧化应激 炎症 

分 类 号：R593.2[医药卫生—内科学]