摘要
目的研究抗风湿治疗对改善幼年特发性关节炎(JIA)血脂紊乱的影响。方法采用前瞻性研究,选择2017年10月至2018年10月在浙江大学医学院附属儿童医院风湿免疫过敏科住院的新近确诊JIA患儿28例,未接受皮质类固醇激素或改变病情抗风湿药物治疗。检测并比较他们在治疗前和治疗后3个月的外周血血脂水平,包括甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)与低密度脂蛋白胆固醇(lowdensity lipoprotein cholesterol,LDL-C);以及炎症细胞因子白介素-2(IL-2)、白介素-4(IL-4)、白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)与γ干扰素(INF-γ)水平,评估并记录患儿疾病活动度(JADAS27评分)。检测患儿治疗前和治疗后3个月后炎症控制指标超敏C反应蛋白(hypersensitive C-reactive protein,hsCRP)与红细胞沉降率(erythrocyte sedimentation rate,ESR)。比较治疗前和治疗后3个月血脂的变化水平,以及炎症控制情况各指标的差异。结果治疗前28例JIA患儿中21例(75%)存在血脂紊乱,治疗3月后仅7例(25%)存在血脂紊乱,明显改善(P<0.001)。其中,与治疗前组相比,治疗后组甘油三酯(TG,t=3.092,P<0.01)和低密度脂蛋白胆固醇(LDL-C,t=3.476,P<0.01)明显下降,高密度脂蛋白胆固醇(HDL-C,t=-6.06,P<0.01)明显升高,总胆固醇(TC)变化无统计学意义。同时与治疗前相比,治疗后外周血超敏C反应蛋白(hsCRP)、红细胞沉降率(ESR)、JADAS27、IL-6均明显降低(P均<0.01)。结论 JIA患儿经有效的抗风湿治疗后,随着炎症控制和疾病活动度改善,血脂紊乱情况亦得到改善。
To investigate the effect of anti-rheumatic drugs on dyslipidemia in children with juvenile idiopathic arthritis(JIA),total of 28 children patients diagnosed as JIA and never been treated with corticosteroids and DMARDs were selected,and then blood lipid level(TG,TC,HDL-C,and LDL-C),inflammatory markers of blood sedimentation(hsCRP and ESR),inflammatory cytokines(IL-1,IL-4,IL-6,IL-10,TNF-α,and INF-γ)in peripheral blood was detected and compared before and 3 months after treatment.The disease activity was measured by using JADAS27.Data showed that the rate of children patients with dyslipidemia was significantly decreased,the levels of TG and LDL-C were significantly decreased,the level of HDL-C was significantly increased,but the levelof TC showed no significant differences after treatment.Furthermore,the levels of hsCRP,ESR,JADAS27,IL-6 were all significantly decreased,while the levels of IL-10,TNF-αand INF-γshowed no significantdifferences.Taken together,anti-rheumatic drugs could improve dyslipidemia in children with JIA,thereby reducing the risk of cardiovascular disease.
作者
莫妙军
卢美萍
徐益萍
邹丽霞
郑琪
MO Miaojun;LU Meiping;XU Yiping;ZOU Lixia;ZHENG Qi(Department of Rheumatology,Immunology&Allergy,Children's Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Pediatrics,Wenling Maternal and Child Health Care Hospital,Wenling 317500,China)
出处
《免疫学杂志》
CAS
CSCD
北大核心
2019年第5期422-427,共6页
Immunological Journal
基金
温岭市科技计划(2018C312025)
