Tam L S, Gladman D D, Hallett D C, Rahman P, Urowitz M B
University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, University Health Network, Toronto Western Hospital, Ontario, Canada.
J Rheumatol. 2000 Sep;27(9):2142-5.
To ascertain the relative effect of antimalarial (AM) agents on fasting lipid fractions in patients with systemic lupus erythematosus (SLE).
The study was cross sectional including all patients with SLE who were seen in our lupus clinic with fasting lipid profiles measured as part of evaluation from November 1995 to March 1999.
A total of 123 patients with a mean age of 45.3 years and mean disease duration 13.4 years were studied; 73.2% were taking prednisone with a mean +/- SD dose of 10.9 +/- 9.2 mg/day, 48.0% were taking AM, and 30.8% were taking both. In the entire group, patients taking AM had a 12.5% lower total cholesterol (TC) (5.11 +/- 1.27 vs 5.84 +/- 1.23; p = 0.002), 22.1% lower very low density lipid-cholesterol (VLDL-C) (0.66 +/- 0.40 vs 0.85 +/- 0.39; p = 0.01), and 15.7% lower LDL-C (3.01 +/- 1.14 vs 3.58 +/- 1.10; p = 0.007). For patients taking prednisone, those taking concomitant AM (n = 38) had significantly lower TC (5.26 +/- 1.30 vs 5.99 +/- 1.29; p = 0.01), VLDL-C (0.65 +/- 0.39 vs 0.85 +/- 0.41; p = 0.02), and LDL-C (3.05 +/- 1.20 vs 3.69 +/- 1.09; p = 0.01) than those without AM (n = 48). For patients taking < or = 10 mg/day prednisone, TC (4.69 +/- 0.88 vs 5.74 +/- 1.20; p < 0.001), VLDL-C (0.61 +/- 0.37 vs 0.83 +/- 0.44; p = 0.05), and LDL-C (2.57 +/- 0.76 vs 3.49 +/- 1.04; p < 0.001) were still lower in patients with concomitant AM (n = 22) than those without AM (n = 36).
TC, VLDL-C, and LDL-C levels were significantly lower in patients taking AM, including patients taking concomitant prednisone. Thus AM may have beneficial effects in SLE in addition to disease suppression.
确定抗疟药（AM）对系统性红斑狼疮（SLE）患者空腹血脂成分的相对影响。
本研究为横断面研究，纳入了1995年11月至1999年3月期间在我们狼疮门诊就诊且测量了空腹血脂谱作为评估一部分的所有SLE患者。
共研究了123例患者，平均年龄45.3岁，平均病程13.4年；73.2%的患者服用泼尼松，平均剂量±标准差为10.9±9.2mg/天，48.0%的患者服用AM，30.8%的患者同时服用两者。在整个研究组中，服用AM的患者总胆固醇（TC）降低了12.5%（5.11±1.27 vs 5.84±1.23；p = 0.002），极低密度脂蛋白胆固醇（VLDL-C）降低了22.1%（0.66±0.40 vs 0.85±0.39；p = 0.01），低密度脂蛋白胆固醇（LDL-C）降低了15.7%（3.01±1.14 vs 3.58±1.10；p = 0.007）。对于服用泼尼松的患者，同时服用AM的患者（n = 38）的TC（5.26±1.30 vs 5.99±1.29；p = 0.01）、VLDL-C（0.65±0.39 vs 0.85±0.41；p = 0.02）和LDL-C（3.05±1.20 vs 3.69±1.09；p = 0.01）显著低于未服用AM的患者（n = 48）。对于服用泼尼松≤10mg/天的患者，同时服用AM的患者（n = 22）的TC（4.69±0.88 vs 5.74±1.20；p < 0.001）、VLDL-C（0.61±0.37 vs 0.83±0.44；p = 0.05）和LDL-C（2.57±0.76 vs 3.49±1.04；p < 0.001）仍低于未服用AM的患者（n = 36）。
服用AM的患者，包括同时服用泼尼松的患者，其TC、VLDL-C和LDL-C水平显著降低。因此，AM除了抑制疾病外，可能对SLE还有有益作用。
