【作者】 张新； 郝志华； 宋光耀； 冯志山； 张明明； 刘娜；

【Author】 Zhang Xin;Hao Zhi-hua;Song Guang-yao;Hebei General Hospital;

【机构】 河北省人民医院；

【摘要】 目的:通过对不同类型血脂异常患者血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏C反应蛋白(Hs-CRP)的检测,探索不同血脂成份对炎症因子的影响。方法:选取血脂异常病例522人,均来自2007年1月-2007年12月我院体检中心,按照2007年"中国成人血脂异常防治指南"临床分型标准,分为四组:(1)高胆固醇血症组121例;其中男60例,女61例;平均年龄为(48.2±13.2)岁;(2)高甘油三酯血症组144例;其中男73例,女71例;平均年龄为(45.4±10.2)岁;(3)混合型高脂血症组226例;其中男112例,女114例;平均年龄为(46.6±1 0.9)岁;(4)低高密度脂蛋白血症组31例;其中男1 5例,女16例;平均年龄为(46.8±12.1)岁,同时选取体检正常人群120例作为对照组;其中男60例,女60例;平均年龄为(44.2±11.1)岁,所有研究对象经检查除外冠心病,肾功能障碍。所有受检者测量身高、体重、收缩压、舒张压、腰围,并留取静脉血。检测TC,TG,HDL-C、FPG、FINS、TNF-α、IL-6、Hs-CRP;并采用稳态模型计算胰岛素抵抗指数(HOMA-IR)=(FPG×FINS)/22.5。结果:1、在522例血脂异常人群中,高胆固醇组占23.1%,高甘油三酯组占27.5%,混合型高脂血症组占43.4%,低高密度脂蛋白血症组较少占6.0%。高甘油三酯组与高胆固醇组相比腰围、BMI升高明显,差异有统计学意义(P<0.05)。低HDL-C血症组与其它各组相比SBP升高明显,差异均有统计学意义(P<0.05)。2、各血脂异常组空腹血糖均高于对照组(均P<0.05),以高甘油三酯组最明显。高甘油三酯组和混合型高脂血症组与对照组相比胰岛素水平及HOMA-IR升高,差异有统计学意义(P<0.05)。3、高胆固醇组与高甘油三酯组与正常组比较TNF-α、IL-6及Hs-CRP均明显升高,差异均有统计学意义(P<0.01)。TNF-α、IL-6在高胆固醇组(分别为3.39±2.60 pg/ml、1.91±0.47pg/ml)升高比高甘油三酯组(分别为2.91±2.27 pg/ml、0.83±0.60 pg/ml)更加明显,差异有统计学意义(P<0.05)。混合型高脂血症组Hs-CRP(1.94±1.75 mg/L)水平最高,说明TG和TC有协同作用使Hs-CRP升高。结论:TNF-α与IL-6、Hs-CRP的水平均与血TC、TG水平呈正相关,血清高胆固醇与高甘油三酯相比使TNF-α与IL-6升高更明显。更多还原

【Abstract】 Objective:To observe serum TNF-α,IL-6,Hs-CRP levels in different types of dyslipidemia patients and to explore the relationship between inflammation and dyslipidemia.Methods:522 subjects were accepted and divided into four groups.Meanwhile,120 subjects were collected as health control group.Total cholesterol,triglyceride,high density lipoprotein- cholesterol,serum TNF-α,IL-6 and Hs-CRP were measured.Results:1.In the study of 522 dyslipidemia patients,there were 23.1%of cases in hypercholesteremia group.27.5%of cases were hypertriglyceridemia patients.Combined hyperlipi- demia group composed with 43.4%of cases,and low high density lipoproteinemia was the least,only 6.0%.2.FPG in each dyslipidemia group was higher than that in health control group.and FPG increased most significantly(P<0.05) in hypertriglyceridemia group.Compared with health control group,FINS and HOMA-IR in hypertriglyceridemia group and combined hyperlipidemia group were higher and there was statistical significance(P<0.05) 3.The serum level of TNF-α,IL-6 and Hs-CRP in hypercholesteremia group and hypertriglyceridemia group were significantly higher than those in health control group,(P<0.01).Compared with hypertriglyceridemia group,TNF-α and IL-6significantly increased in hypercholesteremia group.The level of Hs-CRP was highest in combined hyperlipidemia group compared with other groups.Conclusion:The serum levels of TNF-α,IL-6 and Hs-CRP were in positive correlation with TC and TG.In high cholesterol state,TNF-α and IL-6 increased significantly higher than those in high triglyceride state.更多还原