原发性干燥综合征与脂代谢紊乱关系初探

Dyslipidemia in primary Sjogren＇s syndrome

目的了解原发性干燥综合征（pSS）患者血脂水平情况，探讨脂代谢紊乱与pSS的相关因素及可能的机制。方法选取114例pSS患者和20名健康者对照，回顾性分析血脂水平变化及与临床和实验室指标之间的关系。结果pSS患者平均血清高密度脂蛋白胆固醇（HDL—c）与载脂蛋白A1（apoA1）水平低于正常（P〈0．05）。pSS中39．5％存在血脂异常，血脂异常组较健康对照组平均病程较长，腮腺肿大发生率高，红细胞沉降率（ESR）增快、唾液流率降低明显（P〈0．05）。Lgistic回归分析发现腮腺肿大与pSS患者出现血脂异常相关。经单独或联合调脂治疗，pSS症状可得到改善，而随着疾病活动性减轻，血清脂质也恢复正常。结论pSS患者存在血脂水平异常，且脂类代谢的紊乱与pSS的病情密切相关。控制血脂升高、改善有害脂质可能对pSS的治疗起到积极的作用。

Objective To investigate the lipid profiles of patients with primary Sjogren＇s syndrome （pSS） and to analyze the correlation between abnormal serum lipids and the inflammationsof SS. Methods One hundred and fourteen pSS patients and 20 gendermatched healthy controls were studied. Serum lipids were measured in both groups. Results There was statistically significant difference between SS and healthy controls, and the serum HDL-c and apoA1 concentrations were significantly lower in patients （P〈0.05）. The incidence of abnormal serum lipids was 39.5% in these patients. Patients with abnormal lipids had longer course of disease, higher ESR level, lower salivary flow rate and more frequent parotid gland enlargement than those without abnormal lipids（P〈0.05）. Logistic regression analysis revealed statistically significant association between serum lipids levels and occurrence of parotid gland enlargement. Conclusion Findings from this study suggest that patients with SS have altered lipid profiles and the decrease of apoA1 and HDL-c levels may be the correlated factors of SS. The inflammation of SS may cause changes in lipids metabolisms.