Ilowite N T, Copperman N, Leicht T, Kwong T, Jacobson M S
Department of Pediatrics, Schneider Children's Hospital, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY, USA.
J Rheumatol. 1995 Jul;22(7):1347-51.
To determine if a program of dietary modification and fish oil supplementation is effective in treating the dyslipoproteinemia in pediatric systemic lupus erythematosus (SLE).
Prospective clinical trial where each patient serves as his/her own control. Twenty-four consecutive adolescents fulfilling SLE classification criteria were screened with fasting lipid profiles. Patients were identified as having dyslipoproteinemia of active disease or of corticosteroid therapy. Patients were treated for 6 weeks with dietary modification and if dyslipoproteinemia did not normalize with another 6 weeks of dietary modification and fish oil supplementation.
Seventeen patients (71%) had dyslipoproteinemia; 10 of active disease, 4 of steroid therapy; 3 with a combined pattern. Eleven patients underwent dietary modification. There was a significant decrease in serum triglyceride concentrations (p < 0.05). Total cholesterol, low density lipoprotein cholesterol, and high density lipoprotein cholesterol did not change significantly. A further significant decline in serum triglycerides was achieved with fish oil supplementation (p < 0.05). Five of the 11 patients who underwent treatment continued to have dyslipoproteinemia.
Dyslipoproteinemia is common in pediatric SLE. Dietary modification and fish oil supplementation appear to be effective in improving serum lipid profiles, and blinded studies are warranted. a significant number of patients may require pharmacologic therapy for persistent dyslipoproteinemia to prevent complications of premature atherosclerosis.
确定饮食调整和补充鱼油方案对治疗儿童系统性红斑狼疮（SLE）的血脂异常是否有效。
前瞻性临床试验，每位患者以自身作为对照。对连续24名符合SLE分类标准的青少年进行空腹血脂筛查。确定患者血脂异常是由活动性疾病还是皮质类固醇治疗引起。患者先进行6周的饮食调整治疗，若血脂异常在另外6周的饮食调整和补充鱼油后仍未恢复正常。
17名患者（71%）存在血脂异常；其中10名由活动性疾病引起，4名由类固醇治疗引起；3名呈现混合模式。11名患者接受了饮食调整。血清甘油三酯浓度显著降低（p<0.05）。总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇无显著变化。补充鱼油后血清甘油三酯进一步显著下降（p<0.05）。接受治疗的11名患者中有5名仍存在血脂异常。
血脂异常在儿童SLE中很常见。饮食调整和补充鱼油似乎对改善血脂谱有效，有必要进行盲法研究。相当一部分患者可能需要药物治疗持续性血脂异常以预防过早动脉粥样硬化的并发症。
