类风湿性关节炎患者的血清脂蛋白a水平与炎症指标相关性分析

目的 通过对类风湿性关节炎(RA)患者组与对照组(正常健康者)脂蛋白a(Lp-a)与脂代谢水平的比较,分析RA患者血清中的Lp-a水平与系统性炎症进展的风险相关性.方法 选取30例RA患者(血清类风湿因子阳性)与30例正常健康者,年龄为25～80岁,性别分布相同,采集血样并检测其脂代谢水平(Lp-a、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和极低密度脂蛋白胆固醇(VLDL-C))与炎症反应指标(肿瘤坏死因子α(TN F-α)、白细胞介素6(IL-6)和C反应蛋白(CRP)),对数据进行统计学分析.结果 与对照组比较,RA患者组的血清Lp-a水平显著增高(P＜0.001),HDL-C水平显著降低(P＜0.05),而TC、TG、LDL-C与VLDL-C水平则无明显变化,差异均无统计学意义(P＞0.05).同时,RA患者组的TNF-α、IL-6及CRP水平较对照组均显著增高(P＜0.05),且TNF-α与Lp-a水平的升高有相关性(r=0.753,P＜0.001).结论 RA患者常伴有高水平的Lp-a,且Lp-a水平的升高与RA患者的全身性炎症反应增强具有相关性,Lp-a水平可作为RA患者的风险评价指标.

Correlation between lipoprotein(a) and inflammation markers in rheumatoid arthritis patients

Objective To compare the lipoprotein(a) (Lp-a) and lipid metabolism level in rheumatoid arthritis(RA) patients and control group (healthy subjects),and evaluate the correlation between Lp-a levels and systemic inflammation in patients with RA.Methods Blood samples from 30 RA patients with positive rheumatoid factor and 30 healthy controls were collected,with same distribution of gender and age in both groups.Lipid metabolism level such as Lp-a,triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),very low-density lipoprotein cholesterol (VLDL-C) and inflammation markers such as tumor necrosis factor α (TNF-α),interleukin 6 (IL-6) and C reactive protein (CRP) were detected and analyzed statistically.Results LP-a levels were higher in RA patients than that of control group(P＜0.001),HDL-C levels were lower in RA group (P＜0.05),while TC,TG,LDL-C and VLDL-C levels showed no difference (P＞0.05).The TNF-α、IL-6 and CRP levels of RA patients were higher than that of control group(P＜0.05),and the association between higher Lp-a level and TNF-α were confirmed (r=0.753,P＜0.001).Conclusions High levels of Lp-a are often observed in RA patients,and a rising Lp-a level are associated with systematic inflammation reaction.Lp-a may be a risk factor for RA progress.