活动期类风湿关节炎患者血脂与疾病活动度的相关性分析

Lipid profile in active rheumatoid arthritis and disease activity correlation

目的观察活动期类风湿关节炎(RA)患者的血脂特征及动脉硬化指数(AI),分析血脂水平与疾病活动度之间的相关性。方法选择活动期RA患者51例,健康体检者52例为对照组,对血脂水平进行分析,包括血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C),并计算AI。记录其疾病活动性指标,包括血沉(ESR)、C反应蛋白(CRP)和28个关节疾病活动度评分(DAS 28)。对血脂水平与疾病活动度进行相关性分析。结果与对照组比较,活动期RA组TC、TG、LDL-C及AI升高,分别为(6.08±1.36)mmol/L vs(4.77±1.39)mmol/L、(2.41±1.28)mmol/L vs(1.42±0.83)mmol/L、(3.87±1.08)mmol/L vs(3.33±1.39)mmol/L及(5.12±1.78)vs(3.02±1.60);HDL-C水平降低,为(1.05±0.29)mmol/L vs(1.31±0.44)mmol/L(P<0.01或<0.05)。活动期RA患者DAS 28评分与TC(r=0.386,P<0.05)、LDL-C(r=0.444,P<0.01)和AI(r=0.793,P<0.01)呈正相关,与HDL-C呈负相关(r=-0.503,P<0.01),与TG无相关性。结论活动期RA患者血脂水平异常且与疾病活动度相关,对血脂进行干预可能改善RA患者的长期预后。

Objective To observe the characteristics of serum lipids and atherogenic index （AI） in patients with active rheumatoid arthritis （RA） and analyze the correlation between lipid profile and disease activity. Methods A total of 51 active RA patients were enrolled in this study and 52 healthy individuals were chosen as control group. The lipid profile including total cholesterol （TC）, triglyceride （TG）, high density lipoprotein-cholesterols （HDL-C） and low density lipoprotein-cholesterols （LDL-C） were retrospectively recorded, and AI was calculated. Erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP） and disease activity score of 28 joints （DAS 28） which could reflex the disease activity were also recorded. The correlation between lipid profile and disease activity was analyzed. Results Compared with control group, TC, TG, LDL-C and AI in active RA group were significantly higher; while HDL-C was significantly lower （TC 6.08±1.36 mmol/L vs 4.77±1.39 mmol/L, TG 2.41±1.28 mmol/L vs 1.42±0.83 retool/L, LDL-C 3.87±1.08 mmol/L vs 3.33± 1.39 mmol/L, AI 5.12± 1.78 vs 3.02± 1.60, HDL 1.05± 0.29 mmol/L vs 1.31±0.44 mmol/L, respectively （ P d0.01 or d0.05）. DAS 28 scores of active RA had positive correlation withTC （r=0.386, P〈0.05）, LDL-C （r =0.444, P〈0.01） and AI （r =0.793, P 〈0.01）, and negative correlation with HDL-C （r =-0. 503, P 〈0.01）. There was no correlation between DAS 28 and TG. Conclusion Dyslipidaemia existed in active RA patients and correlated with disease activity. Intervention on lipid profile may improve the long-term outcomes in RA.