炎症性肠病患者血脂水平与疾病活动的相关性分析

Correlation of serum lipid profile and disease activity in patients with inflammatory bowel disease

研究炎症性肠病(IBD)患者血脂代谢指标水平与疾病活动的相关性。纳入2014年1月至2018年11月南京医科大学第一附属医院307例克罗恩病(CD)患者、232例溃疡性结肠炎(UC)患者及165名健康对照。收集患者临床资料和实验室检查指标,包括总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和脂蛋白a[Lp(a)]。采用克罗恩病活动指数(CDAI)和Mayo评分分别评估CD及UC疾病活动度,并分析其与TC、TG、HDL-C、LDL-C和Lp(a)水平的关系。结果显示,CD及UC患者TC、TG、HDL-C及LDL-C的水平低于健康对照组(P<0.05)。CDAI与TC、HDL-C、LDL-C水平呈负相关(r分别为-0.218、-0.210、-0.176,P值均<0.05),与TG不相关。Mayo评分与TC、HDL-C、LDL-C及TG均不相关。另外,CD患者Lp(a)水平高于健康对照组及UC患者(P值均<0.05),且活动期CD患者Lp(a)水平高于缓解期CD患者(P<0.05),而健康对照组与UC组相比Lp(a)水平差异无统计学意义。CD患者Lp(a)水平与CDAI评分呈正相关(r=0.151,P<0.05),UC患者Lp(a)水平与Mayo评分无明显相关。提示IBD患者存在血脂代谢异常,CD患者血脂水平与疾病活动相关。

To analyze the correlation between lipid profile and disease activity in patients with inflammatory bowel disease(IBD).A total of 307 Crohn′s disease(CD)patients,232 ulcerative colitis(UC)patients and 165 healthy subjects from the same geographic region were included.Total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and lipoprotein(a)[Lp(a)]were retrieved from their medical records.Crohn disease activity index(CDAI)and Mayo scores were calculated as measurement of disease severity for CD and UC separately.Patients with CD and UC had lower TC,TG,HDL-C and LDL-C levels than those in control group(P<0.05).Additionally,CDAI was negatively associated with TC,HDL-C and LDL-C levels(r=-0.218,-0.210,-0.176,P<0.05),while TG level was not associated with CDAI.Mayo scores was not significantly associated with TC,HDL-C,LDL-C and TG.Patients with CD had higher Lp(a)levels than those in UC and control group(P<0.05).Furthermore,patients with active CD had higher Lp(a)levels than those with inactive disease(P<0.05).The Lp(a)levels in CD patients were positively associated with CDAI(r=0.151,P<0.05),while Lp(a)level in UC group was nor assocriated with Mayo score.Patients with IBD have dyslipidemia and lipid profile is associated with disease activity in CD patients.