活动期类风湿关节炎患者血脂水平与疾病活动及骨侵蚀相关性研究

The correlation between blood lipids and disease activity and bone erosion in patients with rheumatoid arthritis

目的观察活动期类风湿关节炎(rheumatoid arthritis,RA)患者血脂水平与疾病活动性及骨侵蚀的相关性。方法选取活动期RA患者80例,另外选取40例健康体检者作为对照组,对RA组患者进行血清总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白(High density lipoprotein,HDLC)、低密度脂蛋白(Low density lipoprotein,LDLC)及血沉(erythrocyte sedimentation rate,ESR)、C-反应蛋白(C-reactive protein,CRP)检测,并计算RA患者的疾病活动性评分(DAS28)、简化的疾病活动指数(SDAI)、临床疾病活动指数(CDAI)、双手X线Sharp评分;对健康对照组进行TC、TG、HDLC、LDLC检测。结果与正常对照组相比,活动期RA患者血清HDLC水平显著降低(P<0.01),TC、TG、LDLC在两组中差异无统计学意义;HDLC与DAS28(ESR)、DAS28(CRP)、SDAI、CDAI、ESR、CRP呈负相关(P<0.05或P<0.01);TC、TG、LDLC与DAS28(ESR)、DAS28(CRP)、SDAI、CDAI、ESR、CRP无明显相关;TC、TG、HDLC、LDLC与Sharp评分无明显相关性。结论活动期RA患者体内血脂水平发生异常,HDLC可作为评价RA疾病活动性的指标,RA患者血脂水平与骨侵蚀无关。

Objective To study the correlation between blood lipids and disease activity and bone erosion in patients with active rheumatoid arthritis（RA）.Methods 80 patients with active RA and 40 healthy controls were included.Serum total cholesterol（TC）,triglyceride（TG）,High density lipoprotein（HDLC）,Low density lipoprotein（LDLC）,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,the Disease Activity Score 28（DAS28）,the Simplified Disease Activity Index（SDAI）,Clinical Disease Activity Index（CDAI）and Sharp score were assessed in patients with active RA.TC,TG,HDLC,LDLC were assessed in healthy controls.Results The level of HDLC in active RA was significantly lower than in healthy controls（P〈0.01）,while TC,TG,LDLC had no statistical significance.HDLC in patients with active RA correlated negatively with DAS28（ESR）,DAS28（CRP）,SDAI,CDAI,ESR,CRP（P〈0.05 or P〈0.01）,TC、TG、LDLC had no obvious correlation with disease activity marker.TC,TG,HDLC,LDLC did not correlate with Sharp score in patients with RA.Conclusion The levels of blood lipids are abnormal in patients with active RA.HDLC can be used to evaluate disease activity in patients with RA.The levels of blood lipids have no correlation with bone erosion in patients with RA.