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目的探讨脂代谢紊乱与系统性红斑狼疮(systemic lupus erythematosus,SLE)的相关性。方法 41例SLE患者为狼疮组,其中脂代谢紊乱组26例,无脂代谢紊乱组15例,同期体检健康者36例为对照组,比较狼疮组和对照组血脂水平,比较脂代谢紊乱组与无脂代谢紊乱组蝶形红斑、盘状红斑、肾病、抗双链DNA抗体滴度升高、血沉增高、C反应蛋白水平升高、补体C3降低、补体C4降低的发生率。结果狼疮组血清总胆固醇[(4.88±1.31)mmol/L]、三酰甘油[(1.64±0.72)mmol/L]高于对照组[(3.74±0.93)、(0.85±0.33)mmol/L](P<0.05),高密度脂蛋白胆固醇[(1.00±0.28)mmol/L]明显低于对照组[(1.36±0.31)mmol/L](P<0.05),低密度脂蛋白胆固醇[(2.06±0.84)mmol/L]与对照组[(1.93±0.64)mmol/L]比较差异无统计学意义(P>0.05);脂代谢紊乱组肾病(88.5%)、抗双链DNA抗体滴度增高(73.1%)、血沉增高(73.1%)、补体C3降低(65.4%)、补体C4降低(73.1%)发生率均明显高于无脂代谢紊乱组(46.7%、40.0%、33.3%、33.3%、40.0%)(P<0.05),蝶形红斑(42.3%)、盘状红斑(73.1%)、C反应蛋白水平升高(53.8%)发生率与无脂代谢紊乱组(46.7%、66.7%、40.0%)比较差异无统计学意义(P>0.05)。结论 SLE患者常见脂代谢紊乱,伴脂代谢紊乱患者易出现肾病、抗双链DNA抗体滴度上升、血沉增高及补体C3、C4降低等,脂代谢紊乱可能参与SLE的发生、发展过程。
Objective To investigate the relationship between lipid metabolism disorders and systemic lupus erythematosus (SLE). Methods Twenty-one patients with SLE were treated with lupus. Among them, 26 were lipid disorders, 15 were non-lipid metabolism disorders, and 36 were healthy subjects at the same period. The levels of serum lipids were compared between lupus patients and control subjects. In the non-lipid metabolic disorder group, the incidence of butterfly erythema, discoid erythema, nephropathy, anti-double-stranded DNA antibody titer, elevated erythrocyte sedimentation rate, elevated C-reactive protein, reduced C3, and decreased C4. Results The levels of total cholesterol ([4.88 ± 1.31] mmol / L] and triglyceride (1.64 ± 0.72 mmol / L) in lupus group were significantly higher than those in control group [(3.74 ± 0.93) and (0.85 ± 0.33) mmol / (1.36 ± 0.31) mmol / L] (P <0.05), low density lipoprotein cholesterol [(2.06 ± 0.84) mmol / L] had no significant difference with the control group [(1.93 ± 0.64) mmol / L] (P> 0.05); nephropathy (88.5%) and anti-dsDNA antibody titer (73.1%), elevated erythrocyte sedimentation rate (73.1%), decreased C3 (65.4%) and decreased C4 (73.1%) were significantly higher than those in the non-lipid metabolic disorder group (46.7%, 40.0%, 33.3% , 40.0% (P <0.05). The incidences of butterfly erythema (42.3%), disk erythema (73.1%) and elevated C-reactive protein level (53.8% , 40.0%) was no significant difference (P> 0.05). CONCLUSIONS: Lipid metabolism disorders are common in patients with SLE. Nephropathy is prone to appear in patients with lipid metabolism disorders. Titers of anti-double-stranded DNA antibodies are increased, erythrocyte sedimentation rate is increased, complement C3 and C4 are decreased, and disturbance of lipid metabolism may be involved in the pathogenesis and development of SLE.