活动期克罗恩病患者的血脂异常及临床意义
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摘要
目的:通过比较活动期克罗恩病(CD)患者的血脂水平,评估其临床意义。方法:收集2013年1月-2018年11月在本院住院的103例活动期CD患者(CD组)和103例本院健康体检者(对照组)为研究对象,检测分析两组的血浆甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、脂蛋白a、白蛋白水平差异,分析其与Best克罗恩病活动指数(CDAI)评分、hs-CRP、ESR的关系。结果:CD组的TG、TC、LDL-C、HDL-C和白蛋白均低于对照组,但脂蛋白a高于对照组,差异均有统计学意义(P<0.05)。重度CD患者的TC、LDL-C、HDL-C等胆固醇水平均低于轻度CD患者,差异均有统计学意义(P<0.05),且与CDAI评分、hs-CRP呈负相关,HDL-C、白蛋白与ESR呈负相关。结论:活动期CD患者的胆固醇水平随病情加重而下降,胆固醇水平可评价CD患者的病情严重程度。
Objective:To explore the correlations between active Crohn's disease(CD)and lipid profiles levels and evaluate its clinical significance.Method:103 cases of active CD patients(group CD)hospitalized in our hospital and 103 cases of healthy subjects(control group)from January 2013 to November 2018 were collected as research objects.The differences of plasma levels of triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),lipoprotein(a),albumin between the two groups were analyzed respectively.The relationship between lipids levels and Best crohn's disease activity index(CDAI),hs-CRP,ESR were analyzed.Result:Plasma levels of TG,TC,LDL-C,HDL-C and albumin were significantly lower in the CD group than those in the control group,but lipoprotein(a)was higher than that in the control group(P<0.05).Plasma levels of TC,LDL-C,HDL-C were significantly lower in the patients with severe CD than those in mild CD(P<0.05).TC,LDL-C,HDL-C values were negatively correlated with CDAI,hs-CRP levels in CD patients.And HDL-C,lipoprotein(a)values was negatively correlated with ESR levels in CD patient.Conclusion:Plasma cholesterol levels are significantly decreased in the patients with active CD patients,which could evalutae the severity of CD.
Objective:To explore the correlations between active Crohn's disease(CD)and lipid profiles levels and evaluate its clinical significance.Method:103 cases of active CD patients(group CD)hospitalized in our hospital and 103 cases of healthy subjects(control group)from January 2013 to November 2018 were collected as research objects.The differences of plasma levels of triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),lipoprotein(a),albumin between the two groups were analyzed respectively.The relationship between lipids levels and Best crohn's disease activity index(CDAI),hs-CRP,ESR were analyzed.Result:Plasma levels of TG,TC,LDL-C,HDL-C and albumin were significantly lower in the CD group than those in the control group,but lipoprotein(a)was higher than that in the control group(P<0.05).Plasma levels of TC,LDL-C,HDL-C were significantly lower in the patients with severe CD than those in mild CD(P<0.05).TC,LDL-C,HDL-C values were negatively correlated with CDAI,hs-CRP levels in CD patients.And HDL-C,lipoprotein(a)values was negatively correlated with ESR levels in CD patient.Conclusion:Plasma cholesterol levels are significantly decreased in the patients with active CD patients,which could evalutae the severity of CD.
引文
[1]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2018年,北京)[J].中华消化杂志,2018,38(5):292-311.
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[12]Borba E F,Carvalho J F,Bonfa E.Mechanisms of dyslipoproteinemias in systemic lupus erythematosus[J].Clin Dev Immunol,2006,13(2-4):203-208.
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[14]张俊清.探寻东西方2型糖尿病的差异-从现象到本质的思考[J].中国糖尿病杂志,2016,24(10):955-960.
[15]Zeng Z,Zhu Z,Yang Y,et al.Incidence and clinical characteristics of inflammatory bowel disease in a developed region of Guangdong Province,China:a prospective populationbased study[J].J Gastroenterol Hepatol,2013,28(7):1148-1153.
[16]Rungoe C,Basit S,Ranthe M F,et al.Risk of ischaemic heart disease in patients with inflammatory bowel disease:a nationwide Danish cohort study[J].Gut,2013,62(5):689-694.
[17]Singh S,Kullo I J,Pardi D S,et al.Epidemiology,risk factors and management of cardiovascular diseases in IBD[J].Nat Rev Gastroenterol Hepatol,2015,12(1):26-35.
[18]晏廷亮,张帆,崔道林,等.美沙拉嗪联合益生菌对炎症性肠病大鼠模型血清IL-6、TNF-α和IFN-γ含量的影响[J].中国医学创新,2014,11(20):13-14.
[19]Aggarwal A,Atreja A,Kapadia S,et al.Conventional risk factors and cardiovascular outcomes of patients with inflammatory bowel disease with confirmed coronary artery disease[J].Inflamm Bowel Dis,2014,20(9):1593-1601.
[20]Kohan A B.Apolipoprotein C-Ⅲ:a potent modulator of hypertriglyceridemia and cardiovascular disease[J].Curr Opin Endocrinol Diabetes Obes,2015,22(2):119-125.
[2]Zeng Z,Zhu Z,Yang Y,et al.Incidence and clinical characteristics of inflammatory bowel disease in a developed region of Guangdong Province,China:a prospective population-based study[J].J Gastroenterol Hepatol,2013,28(7):1148-1153.
[3]Feng W,Chen G,Cai D,et al.Inflammatory Bowel Disease and Risk of Ischemic Heart Disease:An Updated Meta-Analysis of Cohort Studies[J].J Am Heart Assoc,2017,6(8):e005892.
[4]中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中华心血管病杂志,2016,44(10):833-853.
[5]Carroll M D,Kit B K,Lacher D A,et al.Trends in lipids and lipoproteins in US adults,1988-2010[J].JAMA,2012,308(15):1545-1554.
[6]Robertson J,Peters M J,McInnes I B,et al.Changes in lipid levels with inflammation and therapy in RA:a maturing paradigm[J].Nat Rev Rheumatol,2013,9(9):513-523.
[7]Sappati B R,Putka B S,Mullen K D.Dyslipidemia and lipoprotein profiles in patients with inflammatory bowel disease[J].J Clin Lipidol,2010,4(6):478-482.
[8]Romanato G,Scarpa M,Angriman I,et al.Plasma lipids and inflammation in active inflammatory bowel diseases[J].Aliment Pharmacol Ther,2009,29(3):298-307.
[9]Koutroumpakis E,Ramos-Rivers C,Regueiro M,et al.Association Between Long-Term Lipid Profiles and Disease Severity in a Large Cohort of Patients with Inflammatory Bowel Disease[J].Digestive Diseases and Sciences,2016,61(3):865-871.
[10]贾喻,王娟,刘醒醒,等.溃疡性结肠炎患者的血脂异常及其临床意义[J].江苏医药,2016,42(11):1241-1243.
[11]苏乐乐,董卫国.中度活动度溃疡性结肠炎合并贫血患者蛋白质和脂代谢的变化及其临床意义[J].临床消化病杂志,2018,30(3):165-170.
[12]Borba E F,Carvalho J F,Bonfa E.Mechanisms of dyslipoproteinemias in systemic lupus erythematosus[J].Clin Dev Immunol,2006,13(2-4):203-208.
[13]Becker S A,McClave S A.Lipid profiles in Crohn’s disease patients with and without ileal resection[J].Am J Gastroenterol,1996,91(11):2452.
[14]张俊清.探寻东西方2型糖尿病的差异-从现象到本质的思考[J].中国糖尿病杂志,2016,24(10):955-960.
[15]Zeng Z,Zhu Z,Yang Y,et al.Incidence and clinical characteristics of inflammatory bowel disease in a developed region of Guangdong Province,China:a prospective populationbased study[J].J Gastroenterol Hepatol,2013,28(7):1148-1153.
[16]Rungoe C,Basit S,Ranthe M F,et al.Risk of ischaemic heart disease in patients with inflammatory bowel disease:a nationwide Danish cohort study[J].Gut,2013,62(5):689-694.
[17]Singh S,Kullo I J,Pardi D S,et al.Epidemiology,risk factors and management of cardiovascular diseases in IBD[J].Nat Rev Gastroenterol Hepatol,2015,12(1):26-35.
[18]晏廷亮,张帆,崔道林,等.美沙拉嗪联合益生菌对炎症性肠病大鼠模型血清IL-6、TNF-α和IFN-γ含量的影响[J].中国医学创新,2014,11(20):13-14.
[19]Aggarwal A,Atreja A,Kapadia S,et al.Conventional risk factors and cardiovascular outcomes of patients with inflammatory bowel disease with confirmed coronary artery disease[J].Inflamm Bowel Dis,2014,20(9):1593-1601.
[20]Kohan A B.Apolipoprotein C-Ⅲ:a potent modulator of hypertriglyceridemia and cardiovascular disease[J].Curr Opin Endocrinol Diabetes Obes,2015,22(2):119-125.