吸烟对男性类风湿关节炎患者血脂水平和疾病活动度影响的病例对照研究

doi:10.13481/j.1671-587x.20170228

吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (02): 356-360.doi: 10.13481/j.1671-587x.20170228

吸烟对男性类风湿关节炎患者血脂水平和疾病活动度影响的病例对照研究

陈欢雪, 王晓非

中国医科大学附属盛京医院风湿免疫科, 辽宁沈阳 110022

收稿日期:2016-09-13 出版日期:2017-03-28 发布日期:2017-03-31
通讯作者: 王晓非,教授,主任医师,博士研究生导师(Tel:024-96615-27115,E-mail:wangxf@sj-hospital.org) E-mail:wangxf@sj-hospital.org
作者简介:陈欢雪(1987-),女,辽宁省沈阳市人,医师,医学硕士,主要从事风湿性疾病发病机制及临床治疗方面的研究。
基金资助:
辽宁省科技厅科学技术计划项目资助课题（2014225017）

Influence of smoking in levels of blood lipids and disease activity in male patients with rheumatoid arthritis:A case-control study

CHEN Huanxue, WANG Xiaofei

Department of Rheumatology and Immunology, Shengjing Hospital, China Medical University, Shenyang 110022, China

Received:2016-09-13 Online:2017-03-28 Published:2017-03-31

摘要/Abstract

摘要： 目的：观察吸烟对男性类风湿关节炎（RA）患者血脂水平及疾病活动度的影响，为RA患者提供经济有效的干预方式。方法：选取男性RA患者112例，全部患者于清晨空腹肘静脉采血，检测C-反应蛋白（CRP）、红细胞沉降率（ESR）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）等指标，收集患者吸烟情况（包括吸烟年限、每日吸烟支数）、压痛关节数（TJC）和肿胀关节数（SJC）等临床资料，并计算28个关节的疾病活动度评分（DAS28）。根据吸烟情况分为吸烟组87例和不吸烟组25例，并根据吸烟指数（SI）（吸烟年限×每日吸烟支数）分为A组（≤400支年）34例、B组（400支年800支年）16例。结果：吸烟组患者TC和TG水平明显高于不吸烟组（P<0.01），HDL-C水平明显低于不吸烟组（P<0.01），LDL-C水平组间比较差异无统计学意义（P>0.05）；随着SI的增大，患者TC和TG水平升高（P<0.05），HDL-C水平降低（P<0.05），LDL-C水平呈升高趋势但组间比较差异无统计学意义（P>0.05）。吸烟组患者CRP和ESR水平高于不吸烟组（P<0.05），TJC、SJC和DAS28明显高于不吸烟组（P<0.01）；随着SI的增大，患者的TJC和SJC增多且DAS28升高（P<0.05），CRP和ESR呈升高趋势。结论：吸烟可能导致RA患者血脂水平异常和疾病活动度增加，积极戒烟和控制吸烟量对改善RA患者血脂代谢和降低RA的发病风险可能有积极的影响。

关键词: 吸烟, 血脂, 疾病活动度, 类风湿关节炎

Abstract: Objective: To observe the influence of smoking in the levels of blood lipids and disease activity in the male patients with rheumatoid arthritis(RA), and to provide economical and effective intervention for the RA patients. Methods: A total of 112 male patients with RA were selected.The fasting blood samples from the ulnar vein of all patients were obtained in the morning. The level of C-reaction protein (CRP), erythrocyte sedimentation rate (ESR), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and other indicators were measured. The smoking status (including years of smoking, number of cigarettes smoked per day), tender joint count (TJC), swollen joint count (SJC) and other clinical data were collected and 28-joint disease activity score (DAS28) was calculated. The patients were divided into smoking group (87 cases) and non-smoking group (25 cases). According to the smoking index (SI)(years of smoking multiplied by number of cigarettes smoked per day), the patients were divided into group A (less than 400) (34 cases), group B (between 400 to 800) (37 cases) and group C (more than 800) (16 cases). Results: The levels of TC and TG of the patients in smoking group were significantly higher than those in non-smoking group(P<0.01), the HDL-C level was lower(P<0.01), and there was no significant difference in the LDL-C level between two groups(P>0.05). With the increase of SI, the levels of TC and TG were increased(P<0.05), and the HDL-C levels were decreased(P<0.05);the LDL-C levels were increased, but there was no significant difference between various groups(P>0.05). The levels of CRP and ESR in smoking group were higher than those in non-smoking group (P<0.05). The TJC, SJC, and DAS28 of the patients in smoking group were significantly higher than those in non-smoking group(P<0.01). With the increase of SI, the TJC, SJC, and DAS28 were increased(P<0.05), and the CRP and ESR levels showed an increasing trend. Conclusion: Smoking may cause the abnormal blood lipid levels in the patients with RA and the increased disease activity. To quit or reduce smoking may improve blood lipid metabolism in the patients with RA and has a positive effect on reducing the risk of RA.

Key words: blood lipid, rheumatoid arthritis, disease activity, smoking

中图分类号:

R593.22

陈欢雪, 王晓非. 吸烟对男性类风湿关节炎患者血脂水平和疾病活动度影响的病例对照研究[J]. 吉林大学学报(医学版), 2017, 43(02): 356-360.

CHEN Huanxue, WANG Xiaofei. Influence of smoking in levels of blood lipids and disease activity in male patients with rheumatoid arthritis:A case-control study[J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 356-360.

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吸烟对男性类风湿关节炎患者血脂水平和疾病活动度影响的病例对照研究

Influence of smoking in levels of blood lipids and disease activity in male patients with rheumatoid arthritis:A case-control study

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