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目的:观察银屑病患者血浆低密度脂蛋白的表达及其功能的改变.方法:选取寻常性银屑病患者25例,正常对照25例.通过酶法检测血浆低密度脂蛋白胆同醇(low-density lipoprotein-cholesterol,LDL-C)的含量.通过免疫比浊法分析血浆中载脂蛋白B-100(apolipoprotein B-100,apoB-100)的水平.通过低温超速离心法分别获取LDL颗粒;通过丙二醛(malondialdehyde,MDA)试剂盒以进行血浆及LDL氧化程度的测定;通过单核细胞粘附实验检测LDL对内皮细胞的刺激作用,通过ELISA方法检测血浆及LDL诱导巨噬细胞分泌炎症因子白细胞介素(IL)-6和肿瘤坏死因子(TNF)-α.结果:通过血浆检验发现银屑病患者血浆MDA(4.58±0.65 vs.4.16±0.61),TNF-α(20.17±3.24 vs.17.18±3.19)和IL-6(203.96±16.65 vs.181.15±20.27)水平显著升高,其中TNF-α和IL-6水平与银屑病的PASI评分呈正相关(分别为r=0.427和r=0.395).LDL-C(2.62±0.37 vs.2.43±0.40)及apoB(0.93±0.10 vs.0.87±0.13)均升高,但未达到统计学意义.银屑病患者LDL中MDA含量高于正常对照组(104.35±13.70 vs.78.24±1.33,P＜0.05).银屑病患者LDL介导的巨噬细胞分泌的炎症因子IL-6(18885.72±4673.76 vs.12336.75±3379.54,P＜0.01)和TNF-α(3421.96±586.92 vs.2902.58±298.13,P＜0.05)明显高于正常人群.银屑病患者LDL诱导的单核细胞粘附血管内皮细胞的数量明显高于正常人群(223.65％±72.77 vs.137.1％±45.46,P＜0.01).结论:银屑病患者LDL的氧化程度和炎性诱导作用升高,这可能有助于研究银屑病与心血管疾病及代谢综合征之间的关系.“,”Objective:To evaluate the levels of plasma low-density lipoprotein cholesterol(LDL-C) and its functions in psoriasis.Method:Plasma LDL-C was quantified by direct enzymatic LDL-C assay.Apolipoprotein B(apoB) was determined by immunoturbidimetric method.The LDL particles were obtained by ultracentrifugation at low temperature.Extent of plasma LDL oxidation was measured using malondialdehyde(MDA) kit.Monocyte adherence test was used to detect the stimulatory effect of LDL on the endothelial cells,and ELISA was used to detect levels of IL-6 and TNF-α in the plasma and secreted by macrophages stimulated by LDL.Results:The plasma levels of TNF-α and IL-6 were increased in psoriasis patients (20.17±3.24 vs.17.18±3.19 for TNF-α;203.96±16.65 vs.181.15±20.27 for IL-6),and positively correlated with the psoriasis area and severity index (PASI)(r=0.427 for TNF-α,and r=0.395 for IL-6).The plasma levels of MDA increased in psoriatic patients (4.58±0.65 vs.4.16±0.61).But the plasma LDL-C and apoB levels were similar between patients and normal controls.Moreover,LDL from psoriatic patients markedly stimulated the production of TNF-α and IL-6 by macrophages(TNF-α:3421.96 ±586.92vs.2902.58±298.13 in controls,P＜0.05;IL-6:18885.72±4673.76 vs.12336.75 ±3379.54 in controls,P＜0.01).Furthermore,enhanced monocyte adhesion to endothelial cells was observed following stimulation with LDL from psoriatic patients (223.65±72.77 vs.137.1±45.46 in controls,P＜0.01).Conclusions:Psoriatic patients exhibit higher levels of LDL oxidation and increased induction of inflammatory cytokines,which could facilitate the determination of the association psoriasis with cardiovascular disease and metabolic syndrome.