早期类风湿关节炎（RA）患者病情活动期血清脂质代谢异常发生率及其影响因素

目的探讨早期类风湿关节炎（RA）患者病情活动期血清脂质代谢紊乱发生率及其影响因素。方法 2011年1月—2012年12月收治的50例病情活动期未用激素以及免疫调节药物治疗的早期RA患者进行总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白Al（apoAI）、载脂蛋白B（aPoB）、脂蛋白（a）=LP（a）检测,观察RA患者活动期血清脂质代谢特点。结果①病情活动期未经治疗RA患者中发生血症代谢异常总例数是45例,占90%,异常的发生率分别是：高LP（a）血症为68%、低apoAI血症为40%、低HDL-C血症为30%、高TG血症为22%、高apoB血症为22%、高TC血症为16%、高LDL-C血症为16%。②早期RA病情活动期42例女性患者与8例男性患者于血脂差异无显著性;③早期RA病情活动期Tc、LDL-C、apoB与年龄、BMI呈正相关;TG与BMI呈正相关;HDL-C与CRP、DAS28呈负相关,apoAI与DAs28呈负相关。结论 RA患者血脂异常影响着AS的发生而发展,年龄、病程、BMI等因素影响着RA的预后,早期诊断、早期治疗是减轻RA危害的重要措施。

Early rheumatoid arthritis disease activity（RA） in patients with abnormal serum lipid metabolism and associated factors

Objective To investigate the early rheumatoid arthritis（RA） disease activity in patients with abnormal serum lipid metabolism and associated factors. Methods from January 2011 to December 2012 were treated 50 cases of active disease not use hormones and early RA patients treated with immunomodulatory drugs observation of serum lipids in patients with active RA qualitative metabolic characteristics. Results（1） disease activity of untreated abnormal metabolic acidosis total number of cases occurred in patients with RA in 45 cases, accounting for 90% incidence of abnormalities were： high LP（a） 68% hypertriglyceridemia, low blood apoAI disease was 40%, low HDL-C viremia was 30%, 22% high TG hyperlipidemia, hypertriglyceridemia high apoB was 22%, 16% higher TC hyperlipidemia, high LDL-C viremia was 16 %.（ 2） early RA disease activity of 42 cases of female patients and eight cases of male patients on lipid difference was not statistically significant;（ 3） early RA disease activity of Tc, LDL-C, apoB and age, BMI was positively correlated; TG and BMI was positively relevant; HDL-C and CRP, DAS28was negatively correlated, apoAI negatively correlated with DAs28. Conclusion RA patients with abnormal blood lipids affect the occurrence and development of AS, age, duration, BMI and other factors affecting the prognosis of RA, early diagnosis, early treatment is an important measure to reduce the RA hazards