摘要
目的探讨儿童SLE血脂特点及其危险因素。方法收集225例未经治疗SLE患儿的临床资料,根据LDL-C、极低密度脂蛋白胆固醇(VLDL-C)、HDL-C、TG、TC的值,分组为LDL-C正常组与升高组,VLDL-C正常组与升高组,HDL-C正常组与降低组,TG正常组与升高组,TC升高组与正常组,采用χ^2验、二元Logistic回归及t检验等,分析各血脂组与临床症状、实验室检查、疾病活动度、激素及并发症的关系。 结果185例(82.2%)儿童SLE出现血脂紊乱,主要表现为LDL-C、VLDL-C、TG、TC升高及HDL-C降低。尿素氮与TG呈正相关(r=0.257,P<0.01),与LDL-C呈正相关(r=0.129,P<0.05),与VLDL-C呈正相关(r=0.225,P<0.01)。白蛋白与TG(r=-0.464,P<0.01)、TC(r=-0.246,P<0.01)、LDL-C(r=-0.138,P<0.05)、VLDL-C(r=-0.426,P<0.05)均呈负相关。尿蛋白定量(24 h)与TG呈正相关(r=0.257,P<0.01)。SLEDAI与TG呈正相关(r=0.597,P<0.01),与VLDL-C呈正相关(r=0.565,P<0.01),与HDL-C呈负相关(r=-0.324,P<0.01)。补体C3呈与TG呈负相关(r=-0.284,P<0.01)。抗dsDNA抗体阳性比例[TG升高组(58/89)高于TG正常组(70/136)(χ^24.116,P=0.042);TC正常组(112/186)高于TC升高组(16/39)(χ^24.841,P=0.028);LDL-C升高组(7/21)高于LDL-C正常组(121/204)(χ^25.240,P=0.022)]。TG升高组(25/89)冠状动脉受累事件比例高于TG正常组(17/136)(χ^28.612,P=0.003)。LN比例[TG升高组(54/89)高于TG正常组(34/136)(χ^228.75,P<0.01);TC升高组(23/39)高于TC正常组(65/186)(χ^27.816,P=0.005);LDL-C升高组(14/21)高于LDL-C正常组(74/204)(χ^27.385,P=0.007)];VLDL-C升高组(12/17)高于VLDL-C正常组(76/208)(χ^27.651,P=0.006)]。结论早期儿童SLE已存在明显血脂异常。多种因素参与儿童SLE血脂紊乱过程。血脂异常可引起SLE患儿多脏器受损。
ObjectiveTo explore the characteristics of lipid profile in children with systemic lupus erythematosus (SLE) and its risk factors. MethodsA total of 225 untreated children with SLE were enrolled in this study. According to the values of low-density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), high-density lipoprotein cholesterol (HDL-C), total glycerin (TG) and trigly-ceride (TG), they were grouped into LDL-C normal group and elevated group, VLDL-C normal group and elevated group, HDL-C normal group and lower group, TG normal group and elevated group, TC normal group and elevated group. We used χ^2test, binary logistic regression and t- test to analyze the relationship between various lipid groups and clinical symptoms, laboratory tests, disease activity, hormones and complications.Results Οne hundred and eighty-five cases (82.22%) of children with SLE developed dyslipidemia, mainly manifested as increased LDL-C, VLDL-C, TG, TC levelsand decreased HDL-C level. There was a positive correlation between urea nitrogen and TG (r=0.257, P<0.01), positive correlation with LDL-C (r=0.129, P<0.05) and positive correlation with VLDL-C (r=0.225, P<0.01). Albumin and TG (r=-0.464, Ρ<0.01), TC (r=-0.246, P<0.01), LDL-C (r=-0.138, P<0.05), VLDL-C (r=-0.426, P<0.05) were negatively correlated. Urine protein level(2 h) was positively correlated with TG (r=0.257, P<0.01). Systemic lupus erythematosus disease activity index (SLEDAI) was positively correlated with TG (r=0.597, P<0.01), positively correlated with VLDL-C (r=0.565, P<0.01) and negatively correlated with HDL-C (r=-0.324, P<0.01). Complement C3 was negatively correlated with TG (r=-0.284, P<0.01). The positive proportion of anti-dsDNA antibody [TG-increased group (58/89) was higher than TG normal group (70/136) (χ^24.116, P=0.042);TC normal group (112/186) was higher than TC-increased group (16/39) (χ^24.841, P=0.028);LDL-C elevated group (7/21) was higher than LDL-C normal group (121/204) (χ^25.240, P=0.022)]. The proportion
作者
袁娇
李彩凤
Yuan Jiao;Li Caifeng(Department of Rheumatology and Immunology,Beijing Children's Hospital, Capital Medical University,Beijing 100045,China)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2018年第12期802-808,共7页
Chinese Journal of Rheumatology
