摘要目的 探讨SLE患者脂代谢与疾病活动性及其他临床表现的关系.方法 分别检测96例未经治疗的SLE患者及50例正常体检者血清总胆固醇、三酰甘油、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇,比较两组间血清脂质水平的差异及与SLE患者临床表现和病情活动的关系.结果 SLE患者组血清三酰甘油水平明显高于正常对照组,高密度脂蛋白胆固醇水平明显低于对照组.SLE血脂异常组中肾炎、肾病综合征、抗dsDNA抗体、抗RNP抗体、抗核糖体P蛋白抗体、核周型抗中性粒细胞胞质抗体阳性率明显高于SLE血脂正常组,补体C3、C4水平明显低于血脂正常组;稳定期SLE高密度脂蛋白胆固醇水平明显高于活动期.结论 未经治疗的SLE患者即已存在血脂异常,主要表现为三酰甘油增高和高密度脂蛋白胆固醇降低.其异常主要与肾损害有关,且与病情活动有一定的相关性.

abstractsObjective To assess the relationship of blood lipid profile to disease activity and clinical manifestations of patients with systemic lupus erythematosus(SLE).Methods Fasting blood samples taken from 96 patients with SLE and 50 healthy human controls were subjected to the measurement of total cholesterol(TC), triglyceride(TG), high-density lipoprotein-cholesterol(HDL-C)and low-density lipoproteincholesterol(LDL-C).The relationship of blood lipid profile to disease activity and clinical manifestations was assessed.Results The serum level of triglyceride was significantly increased together with a decrease in the level of HDL-C in patients with SLE compared with the normal controls.In patients with SLE, dyslipidemia was associated with an increase in the incidence of nephritis and nephrotie syndrome as well as positivity rates of anti-dsDNA antibodies, anti-RNP antibodies, anti-ribosomal P protein antibodies and perinuclear anti-neutrophil cytoplasmic antibodies(p-ANCA), and with a reduction in the levels of complement C3 and C4.The serum level of HDL-C was elevated in patients with stable SLE in comparison with those with inactive SLE (1.07 ± 0.24 mmol/L vs 0.95± 0.33 mmol/L, t = 2.22, P ＜ 0.05).Conclusions These findings suggest that untreated patients with SLE have an abnormal blood lipid profile, which is mainly characterized by elevated level of triglyceride and reduced level of HDL-C.Furthermore, the dyshpidemia is associated mainly with renal damage, and somewhat with disease activity of SLE.