类风湿性关节炎患者心血管并发症与脂蛋白a的相关性研究进展

类风湿性关节炎(RA)是成人常见的系统性炎症反应性疾病,其常见致命并发症为心血管病变,与脂代谢异常有关,其中脂蛋白a(Lp-a)近来发现是一种独立的心血管疾病危险因素,也有大量实验证实Lp-a水平在RA患者中异常升高。Lp-a不仅与心血管病变具有直接关系,也与RA患者的全身性炎症反应进程息息相关。Lp-a的基因编码具有丰富的多态性,影响着Lp-a的不同亚型的产生与表达,并进一步影响了Lp-a的生理功能。另一方面,尽管Lp-a的基因型特征与表现型特征差异明显,但其水平一般具有稳定性,不易受饮食、药物或代谢水平影响。但近几年发现,在系统性炎症疾病如RA发生时,Lp-a水平会异常增高,从而影响RA患者的炎症反应进程与心血管并发症的发生,对RA患者来说,Lp-a是一项值得长期关注的CVD并发症评估因素。

Research Progress on the Association between Cardiovascular Complications and Lipoprotein(a) in Rheumatoid Arthritis Patients

ABSTRACT: Rheumatoid arthritis is a common systematic inflammation disease in adults. The increasing mortality rate of RA patients was mainly caused by cardiovascular diseases(CVD). Possible mechanisms involved in RA progress could be lipid metabolism disorders, and elevated lipoprotein(a), called as Lp-a, was identified as an independent risk factor for CVD. Many papers have reported that Lp-a was related with CVD complications and the inflammation reaction in RA patients. Lp-a gene shows a highly polymorphism and relates with Lp-a synthesis, subtypes and function. Besides, Lp-a levels in serum remain fairly stable, not related with the different gene types in individuals. Alos Lp-a are not influenced by diet or treatment for lipid metabolisms. In recent years, the relationship be- tween Lp-a and CVD was reported in chronic inflammatory diseases, such as RA, and an elevated Lp-a level might be correlated with CVD development and systemic inflammation. So Lp-a could be useful for evaluating CVD risk in RA patients.