高脂血症患者脂代谢紊乱对补体表达及活化的影响

The Effect of Lipid Disorders on the Expression and Activation of Complement in Patients with Hyperlipemia

目的探讨脂代谢紊乱对补体表达及其活化的影响。方法选择高脂血症患者并根据合并症分为单纯高脂血症组和高脂血症合并心脑血管病变组,同期设立正常对照组,分别测定并分析各组血清补体成分C3、C4、P因子、可溶性终末补体复合物及炎症因子肿瘤坏死因子α和白细胞介素6水平。结果单纯高脂血症组及合并心脑血管病变组血清补体C3水平均显著高于对照组(1.57±0.41 g/L、1.60±0.40 g/L比1.30±0.27 g/L,P<0.05),单纯高脂血症组血清P因子水平较对照组显著升高(0.46±0.08 g/L比0.38±0.07 g/L,P<0.01);合并心脑血管病变组可溶性终末补体复合物水平显著高于单纯高脂血症组和对照组(298±110 mg/L比233±101 mg/L、228±84mg/L,P<0.05);合并心脑血管病变组肿瘤坏死因子α水平显著高于单纯高脂血症组和对照组(5.66±1.54 g/L比4.45±1.47 g/L、4.42±1.07 g/L,P<0.01),单纯高脂血症组、合并心脑血管病变组白细胞介素6水平较对照组升高(0.139±0.017 g/L、0.143±0.024 g/L比0.120±0.025 g/L,P<0.05,P<0.01)。相关分析显示,血清C3、C4、P因子与总胆固醇、甘油三酯、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇呈正相关(P因子与甘油三酯除外);可溶性终末补体复合物与收缩压、舒张压和肿瘤坏死因子α呈正相关,与血脂水平无相关;肿瘤坏死因子α、白细胞介素6与血脂水平无相关。结论高脂血症患者外周循环血中补体成分明显升高,其浓度与血脂水平呈正相关;可溶性终末补体复合物与血脂无相关,但与动脉病变有关。

Aim To explore the effect of lipid disorders on the expression and activation of complement 41 patients with dyslipidemia were distributed into hyperlipemic group （HLP） and hyperlipemia combined with vascular diseases group （HLPC） according to clinical complications. HLP included 17 subjects with dyslipidemia, HLPC included 24 subjects suffered from dyslipidemia combined with cardiovascular diseases, cerebral vascular or peripheral vascular diseases, 17 healthy subjects with similar age and gender served as controls. The serum complement components C3, C4, properdin, the plasma complement terminal complex （sCSb-9）and inflammatory markers tumor necrosis factor a（TNF-a）, interleukin 6（IL-6） were examined. Results The concentration of C3 was higher in HLP （1.57 ± 0.41 g/L）and HLPC （ 1.60 ± 0.40 g/L）than in the control group （ 1.30 ± 0.27 g/L） （both P 〈 0.05） ; the properdin level was increased in HLP compared with control group （0.46 ± 0.08 g/L vs 0.38 ±0.07 g/L） （P 〈 0.01）. The concentration of sC5b-9 in HLPC （298 ± 110 mg/L） was increased than in HLP （233 ± 101 mg/L）and control group （228 ± 84 mg/L）（both P 〈 0.05）. The concentration of TNF-a was also elevated in than in HLP and controls, there is a significant increase of IL-6 in HLP and HLP compared with controls. Univariate analysis showed serum C3, C4, Pf were positively correlated with TC, TG, LDLC, HDLC （except Pf with TG）, sCSb-9 was positively correlated with SBP, DBP and TNF-a, but no correlation was found between sCSb-9 and lipids. Conclusions The complement components were significantly increased in serum of patients with dyslipidemia, which were positively correlated with lipidemic indexes. No correlation was found between sCSb-9 and lipids, but sCSb-9 was increased in patients with cardiovascular diseases,