类风湿关节炎患者丙二醛修饰型低密度脂蛋白及低密度脂蛋白循环免疫复合物水平分析

目的分析类风湿关节炎患者丙二醛修饰型低密度脂蛋白、低密度脂蛋白循环免疫复合物及血脂水平,探讨其与心血管病高发生率的关系。方法选择类风湿关节炎患者55例,其中合并心血管疾病患者(并发症组)13例,单纯类风湿关节炎患者(单纯组)42例;正常对照组60例。采用酶联免疫吸附试验分别测定血浆丙二醛修饰型低密度脂蛋白和低密度脂蛋白循环免疫复合物水平,同时对受检者血脂和炎症指标进行检测。结果两组类风湿关节炎患者除载脂蛋白B高于对照组外(P<0.05),其它脂质和载脂蛋白水平无明显改变;并发症组与单纯组间脂质和载脂蛋白水平相似。并发症和单纯组血浆丙二醛修饰型低密度脂蛋白(分别为187.81±90.89和102.01±57.73mg/L)和低密度脂蛋白循环免疫复合物水平(分别为2.58±1.69和1.87±0.74AU)均明显高于对照组(分别为32.65±27.00mg/L和1.21±0.38AU,P<0.01),且并发症组高于单纯组(P<0.01或0.05)。低密度脂蛋白循环免疫复合物与C反应蛋白正相关(r=0.301,P=0.026),丙二醛修饰型低密度脂蛋白与血沉趋于相关(r=0.263,P=0.057)。结论类风湿关节炎患者丙二醛修饰型低密度脂蛋白和低密度脂蛋白循环免疫复合物水平显著升高,参与动脉粥样硬化的发生、发展过程。

Analyzing the Level of Malondialdehyde-Modified Low-Density Lipoproteins and Its Immune Complexes in Patients with Rheumatoid Arthritis

Aim To investigate malondialdehyde-modified (MDA) low-density lipoprotein (LDL), its immune complexes (LDL-IC) and blood lipid levels in patients with rheumatoid arthritis (RA), and to explore the mechanism of high incidence from cardiovascular disease in patients with RA. Methods 55 patients with RA, 13 of which had cardiovascular disease (CAD), 42 of which had simply RA, and 60 healthy controls were randomly chosen. Plasma MDA-LDL and its immune complexes (LDL-IC) levels were determined by enzyme linked immunosorbent assay (ELISA). Blood lipid levels and inflammatory markers were also studied. All data was subjected to statistical analysis. Results Compared with the control, plasma lipids and apolipoproteins levels in patients with RA remained unchanged, except that apolipoprotein B levels increased in RA patients (P<0.05); meanwhile no difference was found in plasma lipids and apolipoproteins concentrations between simple RA patients and RA patients with CAD. MDA-LDL level in RA with CAD, simple RA and control were 187.81±90.89 mg/L, 102.01±57.73 mg/L and 32.65±27.00 mg/L, respectively. LDL-IC level in the three groups were 2.58±1.69 AU, 1.87±0.74 AU and 1.21±0.38 AU, respectively. Compared with the control, MDA-LDL and LDL-IC levels increased in simple RA patients and RA patients with CAD (P<0.01), furthermore, MDA-LDL and LDL-IC levels in RA patients with CAD were both found significantly higher than those in simple RA (P<0.01 or 0.05). LDL-IC level was found related with C-reactive protein (r=0.301, P=0.026), and MDA-LDL level tended to be related with erythrocyte sedimentation rate (r=0.263, P=0.057). Conclusions MDA-LDL and LDL-IC were both increased in RA patients, and may play an important role in atherocslerosis.