小剂量糖皮质激素对类风湿关节炎患者血脂水平影响.doc

小剂量糖皮质激素对类风湿关节炎患者血脂水平影响[摘要] 目的 探讨联合短期小剂量糖皮质激素疗法对类风湿关节炎患者血脂水平的影响。方法 74例活动期类风湿关节炎患者随机分为糖皮质激素(GC)组和非GC组,所有患者在基线和治疗6个月时计算DAS28评分及测定血沉、C反应蛋白、血脂水平,比较两组的差异。结果 系统治疗6个月后,两组患者DAS28评分均有下降;HDL-C水平较基线时升高。但GC组和非GC组之间治疗后的血脂水平无统计学差异。结论 联合应用短期、小剂量GC治疗RA,对患者的血脂水平亦并无不利影响。小剂量GC有利于患者系统炎症的控制,从减轻系统慢性炎症的角度降低患者动脉粥样硬化的风险,从而有利于减少患者的心血管并发症。 [关键词] 类风湿关节炎; 糖皮质激素; 血脂; 高密度脂蛋白胆固醇 [中图分类号] R593.22 [文献标识码] A [文章编号] 1673-9701(2010)07-11-03 Influence of Low Doses of Glucocorticoid on BloodLipid Level in Rheumatoid Arthritis LIN Xiaojun LI Weinian HE Zhixiang TANG Chun YE Jinghua Department of Rheumatology,Guangzhou No.1 People’s Hospital,Guangzhou 510180,China [Abstract] ObjectiveTo explore the effect of low-doses of joint short-term glucocorticoid therapy on lipid levels in patients with rheumatoid arthritis. MethodsWe divided 74 patients with active rheumatoid arthritis randomly into glucocorticoids(GC) group and non-GC group,determined the DAS28 score,erythrocyte sedimentation rate,C-reactive protein,and blood lipid levels in all the patients at baseline and at the end of 6-month treatment and compared the difference between the two groups. ResultsAfter 6-month systemic therapy,the DAS28 scores were decreased and the HDL-C levels were higher than those at the baseline in the two groups. There was no difference in the blood lipid levels between the two groups after therapy. ConclusionLow-doses of joint short-term glucocorticoid therapy may have no adverse effects on the lipid levels in the patients with rheumatoid arthritis. Low doses of glucocorticoid therapy may contribute to controlling inflammation in rheumatoid arthritis patients,thus leading to the reduction of cardiovascular complications in the patients. [Key words]Rheumatoid arthritis; Glucocorticoid; Blood lipid levels; HDL-cholesterol 目前普遍认为小剂量糖皮质激素(Glucocorticoids,Gc)有助于控制类风湿关节炎(rheumatoid arthritis,RA)患者的炎症及改善临床功能,是RA的重要治疗药物之一。但GC本身亦会引起血脂升高,诱发动脉粥样硬化。本研究旨在探讨短期小剂量应用糖皮质激素疗法对RA患者血脂水平的影响。 1 资料与方法 1.1 对象和方法 2003