类风湿关节炎患者血清中高密度脂蛋白的水平检测与意义

Detection of high density lipoprotein-cholesterol levels and its clinical significance in rheumatoid arthritis

目的分析类风湿关节炎(Rheumatoid Arthritis,RA)患者体内高密度脂蛋白(HDL-C)的水平与疾病活动度的关系。方法选取RA患者158例,化学沉淀法检测患者血清中HDL-C水平,同时收集患者的其它临床指标,包括C反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)及抗环瓜氨酸肽(CCP)抗体。通过查体评估患者的压痛关节数(Tender joint count,TJC),肿胀关节数(Swollen joint count,SJC),视觉疼痛评分(Visual analogue scale,VAS),并通过标准公式根据ESR来评价患者的28个关节疾病活动度(Disease activity score in 28 jointsusing ESR,DAS28-ESR)水平。结果在总体RA患者中,其HDL-C水平与其CRP,ESR水平呈负相关,女性患者HDLC水平较男性患者高,复治患者HDL-C水平较初治患者高。对于初治患者,HDL-C与患者的炎症水平呈负相关,血清学阳性的患者HDL-C水平较血清学阴性的患者高,对于女性血清学阳性的患者而言,HDL-C水平与疾病活动度呈负相关。结论HDL-C水平对于RA疾病具有保护作用。

Objective To Analyze the correlation between high density lipoprotein-cholesterol(HDL-C)and disease activity of rheumatoid arthritis(RA).Methods The levels of HDL-C were tested by chemical precipitation method in 158RA patients,and other clinical parameters were recorded,including C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),rheumatoid factor(RF)andanti-cyclic citrullinated peptide(anti-CCP).The tender joints counts(TJC),swollen joints counts(SJC)and visual analogue scale(VAS)were assessed by physical examination,the disease activity score in 28 joints were calculated using ESR(DAS28-ESR)by standard formula.Results There were negative correlations between HDL-C levels and CRP,ESR levels in RA patients,with higher HDL-C levels in female than in male,higher in repeat-treatment patients than in the first-treatment patients.For first-treatment patients,there were negative correlations between HDL-C and inflammatory index,with higher HDL-C levels in sero-positive RA patients than in sero-negative patients.As for sero-positive female patients,HDL-C was also negative connected with disease activities.Conclusion HDL-C has protective effect for RA.【】