脂蛋白测定可作为多发性硬化临床观察指标

Lipoproteins Are of Clinical Use in Monitoring the Disease Course in Multiple Sclerosis

目的 :探讨高密度脂蛋白 (HDL)、低密度脂蛋白 (LDL)浓度的变化是否与多发性硬化病情程度以及病程发展有关。方法 :观察 30例多发性硬化患者 (2 1例为缓解复发型 ,9例为原发进展型 )HDL、LDL以及血白细胞计数以及分类变化情况 ,以同期住院 30例非免疫相关性疾病患者作为对照组。并将患者EDSS评分、血白细胞计数以及分类与HDL、LDL浓度进行相关性分析。入组患者及对照组均除外 :急性感染、肿瘤、急性组织损伤、肾病综合征、肝功能异常、甲状腺疾病、糖尿病、以及抽血 6个月前服用降脂药物。结果 :多发性硬化原发进展组HDL浓度为 1.0 6± 0 .34mmol/L ,较对照组 1.5 4± 0 .33mmol/L明显下降(P <0 .0 0 1) ,复发缓解组HDL浓度 1.33± 0 .4 3mmol/L ,较对照组有所下降 ,但无显著差异。原发进展组、复发缓解组甘油三酯、LDL浓度均较对照组增高 ,无显著差异。三组间血白细胞计数及分类均无明显差异。相关性分析发现 ,多发性硬化患者LDL浓度与EDSS评分正相关 (r=0 .4 16 ,P =0 .0 2 2 )。HDL浓度与血单核细胞计数呈负相关 (r =- 0 .2 76 ,P =0 .0 4 8)。原发进展组与复发缓解组HDL与LDL比值分别为 0 .5 5、0 .6 6 ,均较对照组 (0 .82 )降低 ,但无显著差异。结论 :血脂蛋白与多发性硬化患者病情的严重程度以及?

Objective: To elucidate the relationship between the concentration of lipoproteins (HDL,LDL) and progression of disability in multiple sclerosis (MS). Methods: We compared the concentration of lipoproteins and blood WBC count in 30 MS patients (21 relapsing-remitting, 9 primary progressive) with 30 control subjects. The relationship between lipoprotein concentrations and EDSS score, WBC count and classification was studied using Spearman correlation coefficients. All the patients and control subjects were excluded: acute infection, tumor, acute injures, thyroidism disease, abnormal in liver function, renal diseases, diabetes and had taken antihyperlipidaemic agents 6 month ago. Results: HDL concentration was significantly lower (P<0.001) in patients with primary progressive pattern (1.06±0.34 mmol/L) compared with control subjects (1.54±0.33 mmol/L). It also dropped in patients with relapsing-remitting pattern (1.33±0. 43 mmol/L) but with no significant difference. Triglycerides and LDL concentration were higher in both patterns than control subjects, but had no significant difference. WBC count and classification has no significant difference among three groups. EDSS scores of MS patients were correlated positively with LDL concentrating (r=0.416, P=0.022). HDL concentration was negative correlated with WBC count (r = -0.276, P=0.048). The ratio of HDL to LDL in primary pattern and relapsing-remitting pattern was 0.55, 0.66 respectively, was lower compared with control subjects (0.82), but with no significant difference. Conclusion:Our results suggest that blood lipoprotein maybe associated with progression of disability in MS. Low HDL concentration, high LDL concentration indicate the possibility of aggressive of progress in MS, which results disability.