初发SLE病人CRP变化与动脉粥样硬化形成关系

RELATIONSHIP BETWEEN THE CHANGES OF LEVELS OF C-REACTIVE PROTEIN IN INCIPIENT PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND THE PATHOGENESIS OF ATHEROSCLEROSIS

目的探讨初发系统性红斑狼疮（SLE）病人C-反应蛋白（CRP）水平与病情活动性及动脉粥样硬化形成的关系。方法选取58例初发、未经治疗的SLE病人,以同期58例年龄、性别与之相匹配的健康人作对照。根据SLE病人的疾病活动指数（SLEDAI）将SLE病人分为活动组30例,非活动组28例。以常规方法检测SLE病人和对照组血清CRP、纤维蛋白原（Fg）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）的浓度,以高频超声测量颈总动脉内膜中层厚度（IMT）,分析CRP变化与SLE动脉粥样硬化形成的关系。结果SLE病人活动组CRP、Fg水平及IMT高于非活动组及对照组,差异有显著性（F=34.262~177.932,q=8.631~25.944,P〈0.01）;SLE病人活动组LDL-C水平明显高于非活动组和对照组,HDL-C水平低于非活动组及对照组,且非活动组与对照组比较差异也有显著性（F=24.828、23.335,q=2.834~9.653,P〈0.05、0.01）。活动组CRP水平与SLEDAI及IMT呈正相关（r=0.76、0.85,P〈0.01）。结论SLE病人存在明显的炎症反应,CRP可作为SLE病人病情活动性的一个较好预测指标,CRP水平与SLE病人动脉粥样硬化的发生有明显的相关性。

Objective To investigate the relationship between the changes of levels of C-reactive protein（CRP） incipient patients with systemic lupus erythematosus（SLE） and the pathogenesis of atherosclerosis. Methods Fifty-eight incipient and untreated SLE patients and 58 healthy subjects matching for age and sex served as controls were enrolled in this study.Based on the systemic lupus erythematosus disease activity index（SLEDAI）,30 patients were divided into active group and 28 into inactive group.Serum levels of CRP,fibrinogen（Fg）,high density lipoprotein-cholesterol（HDL-C）,and low density lipoprotein-cholesterol（LDL-C） were measured by routine methods in the patients and the controls.The intima medial thickness（IMT） of common carotid artery was detected by high-frequency ultrasound.The association of CRP with SLE atherosclerosis was analyzed. Results The levels of CRP,Fg and IMT of SLE patients in active group were higher than those in inactive and control group（F=34.262-177.932,q=8.631-25.944,P0.01）.The level of LDL-C of the SLE patients in active group was also higher than those in inactive and control group,while the level of HDL-C was lower.The difference of that between inactive group and the control was also significant（F=24.828,23.335;q=2.834-9.653;P0.05,0.01）.A positive correlation between the levels of CRP and IMT,SLEDAI was noted in the active SLE patients（r=0.76,0.85;P0.01）. Conclusion Obvious inflammation exists in SLE patients.CRP can be regarded as a good marker for inflammation activity and is evidently associated with the pathogenesis of atherosclerosis.