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目的探讨血脂在自身免疫性肺泡蛋白沉积症(APAP)诊断与监测中的意义。方法连续收集APAP患者血清脂代谢资料,分析32例非糖尿病APAP患者及100例健康体检者血脂水平。用ELISA法测定APAP患者血清抗粒细胞巨噬细胞集落刺激因子(GM-CSF)抗体水平。分析血脂与乳酸脱氢酶、癌胚抗原、抗GM-CSF抗体、肺功能及血气指标的相关性。结果 APAP组血清总胆固醇及低密度脂蛋白-胆固醇水平分别为(5.54±0.99)及(3.73±0.83)mmol/L,显著高于健康对照组的(5.05±0.97)及(3.17±0.89)mmol/L(P均<0.05);高密度脂蛋白-胆固醇显著低于健康对照组[(1.10±0.18)比1.22(1.05-1.41)mmol/L,P均<0.05]。APAP组的低密度脂蛋白/高密度脂蛋白及总胆固醇/高密度脂蛋白比值分别为3.47±0.90及5.14±1.12,显著高于健康对照组的2.63±0.87及4.18±1.12(P均<0.05)。APAP组的甘油三酯水平与健康对照组的差异无统计学意义(P>0.05)。高密度脂蛋白-胆固醇与肺泡动脉氧分压差呈负相关(r=-0.436,P<0.05),与动脉血氧饱和度呈正相关(r=0.459,P<0.05)。血脂指标与抗GM-CSF抗体无线性相关关系(P均>0.05)。结论APAP患者存在血脂代谢异常,血脂异常与疾病严重程度有一定相关性,在APAP患者的评估与治疗过程中需关注血脂异常。
Objective To investigate the significance of serum lipids in the diagnosis and monitoring of autoimmune pulmonary alveolar proteinosis (APAP). Methods The serum lipids metabolism data of APAP patients were collected continuously, and the blood lipid levels of 32 non-diabetic APAP patients and 100 healthy volunteers were analyzed. Serum anti-granulocyte macrophage colony stimulating factor (GM-CSF) antibody levels in APAP patients were determined by ELISA. The correlation between lipids and lactate dehydrogenase, carcinoembryonic antigen, anti-GM-CSF antibody, pulmonary function and blood gas index was analyzed. Results The levels of serum total cholesterol and low density lipoprotein cholesterol in APAP group were (5.54 ± 0.99) and (3.73 ± 0.83) mmol / L, respectively, which were significantly higher than those in healthy control group (5.05 ± 0.97) and (3.17 ± 0.89) mmol / / L (all P <0.05); HDL-cholesterol was significantly lower than that of healthy controls [(1.10 ± 0.18) vs 1.22 (1.05-1.41) mmol / L, P <0.05; The ratios of low density lipoprotein / high density lipoprotein to total cholesterol / high density lipoprotein in APAP group were 3.47 ± 0.90 and 5.14 ± 1.12 respectively, which were significantly higher than those in healthy control group (2.63 ± 0.87 and 4.18 ± 1.12, P <0.05 respectively) ). There was no significant difference in triglyceride level between APAP group and healthy control group (P> 0.05). High - density lipoprotein - cholesterol was negatively correlated with the differential pressure of alveolar arterial oxygen (r = -0.436, P <0.05) and positively correlated with arterial oxygen saturation (r = 0.459, P <0.05). There was no linear relationship between serum lipid and anti-GM-CSF antibody (P> 0.05). Conclusion APAP patients have dyslipidemia, dyslipidemia and the severity of the disease have some relevance in the evaluation and treatment of APAP patients need to pay attention to dyslipidemia.