类风湿性关节炎患者血清HDL2-c、HDL3-c水平及其临床意义  

Serum levels of HDL2-c and HDL3-c in patients with rheumatoid arthritis and their clinical significance

作　　者：向玉林 韵雪雪 Yu-lin Xiang;Xue-xue Yun(Department of Laboratory Medicine,Chengdu Women's and Children's Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu,Sichuan 611731,China)

机构地区：[1]电子科技大学医学院附属成都市妇女儿童中心医院检验科,四川成都611731

出　　处：《中国现代医学杂志》2021年第20期81-85,共5页China Journal of Modern Medicine

摘　　要：目的探讨类风湿性关节炎(RA)患者和健康群众高密度脂蛋白亚组份2(HDL2-c)和高密度脂蛋白亚组份3(HDL3-c)水平,并分析HDL2-c、HDL3-c水平与RA疾病活动的关系。方法选取2018年1月—2018年12月于电子科技大学医学院附属成都市妇女儿童中心医院收治的45例RA患者作为RA组。并选取同期该院健康体检群众45例作为对照组。从两组体内采集空腹血液样本。患者均无心血管疾病或糖尿病病史,也未服用任何降血脂药物。采用超速离心法提取HDL2-c和HDL3-c浓聚物。比较两组间高密度脂蛋白亚组份水平,分析疾病活性度对HDL2-c和HDL3-c的影响。使用独立样本t检验分析两组间HDL2-c、HDL3-c及其他脂蛋白水平(TC、TG、LDL-c、HDL、ApoA-I和ApoB)的差异。采用方差分析年龄和性别对HDL2-c和HDL3-c水平的影响。结果RA组TG、ApoB较对照组高(P<0.05),HDL、HDL2-c、HDL3-c、HDL2/HDL3和Apo A-1较对照组低(P<0.05)。对照组女性HDL2-c、HDL3-c水平较男性高(P<0.05)。DAS28分值为RA患者HDL2-c水平的影响因素(P<0.05)。校正年龄、性别、病程和糖皮质激素使用后,DAS28分值每增加1分,HDL2-c水平降低0.061 mmol/L。长病程组HDL2-c、HDL3-c水平较短病程组高(P<0.05)。结论RA患者体内HDL2-c、HDL3-c水平下降。HDL亚组份水平降低,尤其是HDL2-c水平降低,可能导致女性RA患者心血管疾病发病风险增加。Objective To investigate the differences in the serum levels of high-density lipoprotein2 cholesterol(HDL2-c)and high-density lipoprotein3 cholesterol(HDL3-c)in patients with rheumatoid arthritis(RA)and healthy controls,and to analyze the relationship between the levels of HDL2-c and HDL3-c and RA disease activity.Methods A total of 45 RA patients admitted to our hospital from January 2018 to December 2018 were selected as the RA group,and another 45 healthy individuals undergoing physical examination during the same period were enrolled as the control group.Fasting blood samples were collected from all the participants,and none of them had a history of cardiovascular diseases or diabetes mellitus and did not take any lipid-lowering drugs.The concentrated HDL2-c and HDL3-c were extracted by ultracentrifugation.The levels of HDL subcomponents between RA patients and healthy controls were compared to analyze the effects of disease activity on HDL2-c and HDL3-c.The differences in levels of HDL2-c,HDL3-c and other lipoproteins(TC,TG,LDL-c,HDL,ApoA-I and ApoB)between RA patients and healthy controls were analyzed using independent samples t test.The analysis of variance was performed to identify the effects of age and gender on HDL2-c and HDL3-c levels.Results Compared with the control group,the levels of TG and ApoB were higher,while the levels of HDL,HDL2-c,HDL3-c,and ApoA-I as well as HDL2/HDL3 ratio were lower in RA patients(P<0.05).Among the healthy individuals,the levels of HDL2-c and HDL3-c in the female were higher than those in the male(P<0.05).The DAS28 score affected the levels of HDL2-c in RA patients(P<0.05).After adjusting for age,gender,disease duration,and glucocorticoid use,the concentration of HDL2-c decreased by 0.061 mmol/L when DSA28 score increased by 1(P<0.05).The levels of HDL2-c and HDL3-c were higher in RA patients with longer disease duration(P<0.05).Conclusions The levels of HDL2-c and HDL3-c are decreased in RA patients,and the reduced concentration of HDL subcomponents,especially that of

关 键 词：类风湿性关节炎 脂蛋白类 HDL 心血管疾病 

分 类 号：R446.11[医药卫生—诊断学]