GnRH类似物对特发性中枢性性早熟女孩血IGF-Ⅰ和IGF结合蛋白-3水平的影响

目的　研究特发性中枢性性早熟 (ICPP)女孩经促性腺激素释放激素类似物 (GnRHa)治疗后促生长素轴功能的改变和生长减速的原因。方法　比较 14例ICPP女孩GnRHa治疗开始时和治疗 6个月末的生长速度。于治疗前后行阴道涂片计算阴道上皮细胞成熟指数 (MI)、测定空腹血清E2 、胰岛素样生长因子 (IGF) Ⅰ、IGF结合蛋白 3(IGFBP 3)浓度 ,计算IGF Ⅰ /IGFBP 3,并进行比较。 13例年龄相匹配的健康青春前期女孩作为对照。结果　ICPP女孩经 6个月的GnRHa治疗后 ,生长速度较治疗开始时显著减慢〔治疗开始时 (8.2 3± 1.6 7)cm/年 ,治疗 6个月末 (6 .2 7± 1.5 4 )cm/年 ,P <0 .0 0 1〕 ;MI和血E2 浓度回复至青春前期水平。治疗开始时 ,ICPP女孩血IGF Ⅰ、IGFBP 3浓度和IGF Ⅰ /IGFBP 3〔(0 .4 9± 0 .16 )mg/L ,(4.91± 1.17)mg/L ,0 .10± 0 .0 3〕显著高于青春前期对照组〔(0 .2 1± 0 .14 )mg/L、(4.0 4± 0 .5 1)mg/L和 0 .0 5± 0 .0 2 ,P分别 <0 .0 0 1、<0 .0 5和 <0 .0 0 1〕。治疗 6个月末血IGF Ⅰ浓度〔(0 .4 9± 0 .15 )mg/L〕较治疗开始时差异无显著性 ;治疗 6个月末血IGFBP 3浓度〔(5 .2 9± 1.2 4 )mg/L〕较治疗开始时有增加趋势但差异无显著性 ;治疗 6个月末血IGF Ⅰ /IGFBP 3(0 .0 9± 0 .0     

急性淋巴细胞白血病患儿血清sTNFRs水平测定的临床价值

目的 :探讨急性淋巴细胞白血病患儿血清 TNFa、s TNFR- 和 s TNFR- 水平及其临床意义。方法 :采用 EL ISA法测定血清 TNFa、s TNFR- 和 s TNFR- 水平。结果 :2 4例 AL L患儿血清 TNFα〔(173.2 2±74.5 1) ng/L〕明显高于 2 0例正常对照儿童〔(78.5 9± 18.45 ) ng/L〕,初发与复发患儿血清 s TNFR- 〔(2 .76±1.0 5 )、(2 .44± 1.37) μg/L〕、s TNFR- 〔(2 .33± 1.18)、(2 .0 9± 1.2 2 ) μg/L〕明显高于正常儿童〔(0 .75± 0 .2 6 )、(0 .71± 0 .14) μg/L〕,均为 P <0 .0 1;血清 TNFα与 s TNFR- 呈显著性正相关 (r =0 .6 31,P <0 .0 1) ;8例患儿经有效治疗完全缓解后血清 s TNFRs均降至正常水平〔(0 .83± 0 .2 5 )、(0 .92± 0 .17) μg/L〕;血清 s TNFRs在WBC≥ 10 0× 10 9/L患儿的阳性率明显高于 WBC<10 0× 10 9/L者 (P <0 .0 1) ,其与外周血幼稚细胞数呈显著正相关 (R =0 .72 4 ,R =0 .582 ,P <0 .0 5)。结论 :AL L患儿血清 s TNFRs异常升高与白血病细胞有关 ,血清 s TNFRs水平可作为估计肿瘤负荷及治疗效果的一项指标。     

纤溶活性及D-二聚体变化与老年高血压肾损害关系的研究

目的　了解纤溶活性和血、尿 D-二聚体 ( D-d)水平变化在老年高血压肾小动脉硬化症( HANS)中的作用。　方法　采用 ELISA法测定血、尿 D-d,用发色底物法测定纤溶酶 ( P∶ A)、组织型纤溶酶原激活剂 ( t PA∶ A)及纤溶酶原抑制剂 ( PAI∶A)活性 ,并同时用放免法测定尿微量白蛋白和光电比色法测定尿 N-乙酰 -β-葡萄糖苷酶 ( NAG)。　结果　原发性高血压 ( PH)组及 HANS组较健康对照组 P∶ A( 2 8.3 %± 1 3 .8%及 2 6.1 %± 1 3 .2 %较 4 8.8%± 1 3 .6%)和 t PA∶ A〔( 0 .3 5± 0 .1 1 )IU/ ml及 ( 0 .3 2± 0 .1 3 ) IU/ ml较 ( 0 .54± 0 .1 8) IU/ ml〕明显降低 ,PAI∶ A〔( 0 .55± 0 .1 8) IU/ ml及( 0 .78± 0 .2 1 ) IU/ ml较 ( 0 .3 6± 0 .1 1 ) IU/ ml〕和血、尿 D-d〔血 :( 0 .3 1± 0 .1 3 ) mg/ L及 ( 0 .3 8± 0 .1 4 )mg/ L较 ( 0 .1 6± 0 .1 0 ) mg/ L;尿 :( 0 .2 9± 0 .1 4 ) mg/ L及 ( 0 .52± 0 .1 3 ) mg/ L较 ( 0 .1 7± 0 .1 1 ) mg/ L〕水平显著升高 ;HANS组与 PH组比较 ,血浆 PAI∶ A、尿 D-d、尿白蛋白〔( 3 89.7± 1 1 3 .4 ) mg/ 2 4 h较( 48.4± 1 5.8) mg/ 2 4 h〕和 NAG〔( 1 6.59± 4 .87) U/ mmol Cr较 ( 1 .0 5± 0 .3 5) U/ mmol Cr〕排泄水平均明显升高 ;另外 ,P     

糖尿病大鼠一氧化氮与骨代谢变化的研究

目的　研究糖尿病 (DM )大鼠血清一氧化氮 (NO)与早期骨代谢改变的关系。方法2 0只SD大鼠分为 2组 ,一组以链脲佐菌素诱导建立糖尿病 (STZ DM )大鼠模型 ,另一为正常对照组 ,测定 2组大鼠的空腹血糖 (FBG)、HbA1c、血清胰岛素、全身、股骨和腰椎骨密度 (BMD)、骨代谢相关指标〔血清钙、骨钙素、降钙素、甲状旁腺素 (PTH)、维生素D3 及尿吡啶酚 /肌酐比〕和血清NO水平。结果　STZ DM大鼠与正常对照组相比 ,血清NO水平显著升高〔(5 1.3± 11.9vs 38.1± 12 .0 )μmol/L ,P <0 .0 1〕 ;全身、股骨和腰椎的BMD显著降低〔(0 .15± 0 .0 7vs 0 .2 1± 0 .0 2 ) g/cm2 ,P<0 .0 1;(0 .16± 0 .0 2vs 0 .19± 0 .0 3) g/cm2 ,P <0 .0 5 ;(0 .12± 0 .0 4vs 0 .18± 0 .0 6 ) g/cm2 ,P <0 .0 5〕 ;血清钙浓度显著升高〔(135 .9± 11.3vs 117.2± 6 .5 )mg/L ,P <0 .0 0 1〕 ,骨钙素水平显著升高〔(0 .0 7± 0 .0 4vs 0 .0 5± 0 .0 1) μg/L ,P <0 .0 5〕 ,维生素D3 水平显著降低〔(7.6± 1.9vs 11.6± 4 .1)μg/L ,P <0 .0 5〕 ,尿吡啶酚 /肌酐显著降低〔(4.8± 0 .8vs 75 .8± 6 0 .7)nmol/mmolCr,P <0 .0 1〕 ;而降钙素和PTH水平改变无统计学意义。相关性分析显示 ,血清NO与尿吡啶酚排泄呈负相关 (r= - 0 .74 ,     

2型糖尿病肾病患者血清细胞粘附分子变化与氧化应激的关系

目的　探讨 2型糖尿病肾病患者 (DN)血清细胞粘附分子变化及其与氧化应激的关系。　方法　检测DN患者血清可溶性细胞间粘附分子 1(sICAM 1)、可溶性血管细胞粘附分子 1(sVCAM 1)、血清丙二醛 (MDA)含量和超氧化物歧化酶 (SOD)活性。　结果　早期DN及DN患者血清sVCAM 1水平〔分别为 (1 75± 0 48)、(1 91± 0 2 7)mg/L〕明显高于对照组〔(1 6 7± 0 72 )mg/L ,P <0 0 5和0 0 1〕 ,DN组明显高于单纯糖尿病 (DM)组〔(1 5 8± 0 39)mg/L ,P <0 0 5〕 ;DM组、早期DN组和DN组患者血清sICAM 1〔分别为 (75 6 0 0± 12 5 47)、(80 2 2 1± 12 4 81)、(897 6 0± 10 5 80 ) μg/L〕明显高于对照组〔(5 82 6 4± 10 2 73) μg/L ,P <0 0 0 1〕 ,其中DN组明显高于单纯DM组和早期DN组 (分别P <0 0 1和<0 0 5 ) ;单纯DM组、早期DN组和DN组患者血清SOD活性〔分别为 (86 5 9± 13 85 )、(85 6 9±11 32 )、(71 73± 16 35 )NU/L〕显著性低于对照组〔(92 73± 11 2 5 )NU/ml,P <0 0 1〕 ,MDA含量〔分别为(3 99± 1 36 )、(4 2 6± 1 95 )、(6 5 0± 2 98)nmol/ml〕显著性高于对照组〔(3 72± 0 5 7)nmol/ml,P <0 0 1〕。DM患者血清sVCAM 1与sICAM 1、收缩压、尿素氮 (BUN)和肌酐 (Cr)呈正相     

小于胎龄儿的血清低胰岛素样生长因子I和C肽水平

目的　动态观察轻度和重度小于胎龄儿 (SGA)血清胰岛素样生长因子 I(IGF I)和C肽 (CP)水平 ,并与适于胎龄儿 (AGA)的水平进行比较 ,以探讨SGA的可能发病机制。方法　用放射免疫分析法测定了SGA和AGA出生时脐血、生后 3～ 7天和 2 2～ 2 8天外周血IGF I和CP浓度。结果　 (1)AGA出生时、出生后 3～ 7天和 2 2～ 2 8天的IGF I水平无明显差异 ,分别为 (10 .7± 4.5 )、(10 .8± 3.5 )和 (11.1± 3.4)nmol/L ;出生时和出生后 3～ 7天的CP水平相似〔(0 .43± 0 .13)和 (0 .41± 0 .12 )nmol/L〕 ,于出生后 2 2～ 2 8天下降〔(0 .32± 0 .11)nmol/L〕。 (2 )重度和轻度SGA出生时的IGF I〔(6 .1± 1.8)和 (8.9± 2 .8)nmol/L〕和CP〔(0 .2 6± 0 .0 9)和 (0 .33± 0 .11)nmol/L〕水平均低于AGA出生时水平 ;重度SGA出生后 3～ 7天和 2 2～ 2 8天的IGF I〔(6 .8± 2 .4)和 (6 .6± 1.9)nmol/L〕和CP〔(0 .2 7± 0 .10 )和 (0 .2 5± 0 .12 )nmol/L〕水平仍相当于其出生时水平 ;轻度SGA出生后IGF I和CP水平则明显上升 ,于 1周内达到AGA水平〔(11.4± 3.4)和 (0 .41± 0 .11)nmol/L〕 ,3～ 4周超过AGA水平〔(14.0± 3.5 )和 (0 .40± 0 .14)nmol/L〕。 (3)AGA出生时、出生后 3～ 7天和 2 2～ 2 8天的IGF I和CP之间存     

新蝶呤和白介素-6在不稳定型心绞痛中的变化

目的 :研究不稳定型心绞痛 (UAP)患者血中免疫反应标记物新蝶呤和炎症反应标记物白细胞介素 6 (IL 6 )的变化。方法 :采用酶联免疫法测定 77例经冠状动脉造影证实的冠心病患者血中新蝶呤、IL 6、C 反应蛋白 (CRP)的浓度。 77例中UAP 36例 ,年龄 4 2～ 82 (6 3± 11)岁 ;慢性稳定型心绞痛 (SAP)患者 4 1例 ,年龄 4 0～ 80(6 4± 9)岁。结果 :与SAP患者相比 ,IL 6〔(12 .72± 13.4 2 )∶(7.0 1± 3.0 8)ng/L ,P <0 .0 1〕、CRP〔(2 .0 3± 3.6 8)∶(0 .85± 0 .99)mg/L ,P <0 .0 5〕、新蝶呤〔(7.0± 3.16 )∶(5 .38± 3.2 0 )nmol/L ,P <0 .0 5〕及经血肌酐校正的新蝶呤水平 (× 10 -2 ) (7.5 9± 2 .87∶5 .0 9± 2 .86 ,P <0 .0 1)在UAP患者中显著增高。结论 :新蝶呤和IL 6、CRP在UAP患者中增高 ,均可作为提示斑块不稳定性的指标 ,辅助UAP的诊断。免疫反应和炎症反应均参与了UAP的发生     

原发性高血压患者与正常人心率变异性的比较

目的　研究原发性高血压 (EH)患者与正常人心率变异性 (HRV)的比较。方法　 5 0例EH患者和 5 0例健康成人 (对照组 )行 2 4h动态心电图检查各 1次 ,分析心率时域和频域指标。结果　EH患者与对照组比较 ,代表心率总变异程度的SDNN〔(10 8 4± 33 2 )msvs (130 6± 35 6 )ms,P <0 0 1)〕、SDANN〔(96 2± 2 5 5 )msvs (118 3± 2 4 7)ms,P <0 0 1)〕和SDNNI〔(41 2± 16 3)msvs (5 4 1± 17 6 )ms,P <0 0 1)〕明显下降 ;代表迷走神经功能的RMSSD〔(2 8 4±10 3)msvs (32 8± 11 2 )ms,P <0 0 5 )〕和PNN5 0〔(6 1±1 5 )msvs (7 2± 1 8)ms ,P <0 0 5 )〕也有下降 ;频域指标VLF〔(186 2 7± 82 1 6 )Hzvs (15 34 8± 738 5 )Hz,P <0 0 5 )〕和LF〔(472 3± 2 6 5 8)Hzvs (396 2± 113 6 )Hz ,P <0 0 5 )〕升高 ,HF〔(112 5± 86 4 )Hzvs (2 0 3 6± 94 7)Hz,P <0 0 1)〕明显下降。结论　分析EH患者HRV有助于预测心脏功能受损的程度和预后     

中国人2型糖尿病家系中糖尿病患者及其一级亲属血脂和载脂蛋白的研究

目的　探讨 2型糖尿病家系中 2型糖尿病患者及其正常糖耐量的一级亲属 (NFDR)的血脂和载脂蛋白 (Apo)水平变化的临床意义。方法　测定 2 9个中国人 2型糖尿病家系中的 62例 2型糖尿病患者和 67名NFDR ,以及 45名无糖尿病家族史的正常糖耐量对照者 (NC)的甘油三酯 (TG) ,总胆固醇(TC) ,高密度脂蛋白胆固醇 (HDL C) ,ApoAⅠ ,ApoB10 0 ,ApoCⅢ和ApoE水平。 结果　 (1) 2型糖尿病患者的TG显著高于NFDR和NC ,NFDR的TG水平也显著高于NC〔3组分别为 (1.85± 1.3 1)、(1.3 9± 0 .91)、(0 .92± 0 .45 )mmol/L ,均P <0 .0 5〕。 (2 ) 2型糖尿病患者和NFDR的HDL C水平都显著低于NC组〔3组分别为 (1.17± 0 .2 9)、(1.2 3± 0 .2 8)、(1.43± 0 .2 7)mmol/L ,均P <0 .0 5〕。 (3 ) 2型糖尿病患者ApoCⅢ水平显著高于NFDR与NC〔3组分别为 (0 .14± 0 .0 9)、(0 .11± 0 .0 4)、(0 .10± 0 .0 3 ) g/L ,均P <0 .0 5〕。(4 )糖尿病组TC、LDL C、ApoB10 0 虽高于NFDR和NC ,ApoAⅠ水平低于NC ,但均无统计学意义 ,ApoE在 3组间差异无显著性。 (5 ) 2型糖尿病患者与其子女配对后 ,其TC、LDL C和ApoB10 0 显著高于其子女 (均P <0 .0 5 ) ,而TG、ApoCⅢ有升高趋势 ,HDL C有降低趋势。 结论　 2型糖尿病患者的NFDR有着和 2型     

内皮素受体基因在心力衰竭患者外周血的表达及意义

目的 :研究充血性心力衰竭 (心衰 )患者血浆内皮素 (ET)水平和ET受体基因在其外周血单个核细胞表达情况。方法 :在 36例心衰 (心衰组 )患者和 12例健康人 (对照组 )中分别采用放免法测定血浆ET水平、逆转录聚合酶链反应检测ET受体基因在其外周血单个核细胞的表达。结果 :心衰组血浆ET水平〔(4 .90± 1.96 )pmol L〕明显高于对照组〔(1.76± 0 .82 )pmol L〕(P <0 .0 1)。ET受体基因表达阳性率在两组差异无显著性意义(P >0 .0 5 ) ,半定量后 ,心衰组ETA受体 (0 .82± 0 .2 6 )表达水平明显高于对照组 (0 .5 9± 0 .17) (P <0 .0 1)。结论 :ET及其A受体与心衰的发生、发展有密切关系     

Effect of a six month gemfibrozil treatment and dietary recommendations on the metabolic risk profile of visceral obese men

OBJECTIVE: The aim of the present study was to investigate the effects of a 6 month gemfibrozil treatment. SUBJECTS: A sample of 64 visceral obese men (age 46+/-6 y; body mass index 31+/-3 kg/m(2); waist circumference 104+/-7 cm; mean+/-s.d.) who received dietary recommendations. METHODS: Subjects were randomly assigned to receive a placebo (n=32) or gemfibrozil (1200 mg/day) (n=32). RESULTS: In both placebo and gemfibrozil treated groups, significant reductions were noted in body weight, fat mass, waist circumference and visceral adipose tissue area measured by computed tomography (0.0001相似文献   

不同剂量阿司匹林对冠心病患者C反应蛋白的影响

目的探讨不同剂量阿司匹林(ASP)对冠心病(CHD)患者血浆C反应蛋白(CRP)的影响。方法120例CHD患者根据ASP用量随机分为50mg、100mg、300mgASP治疗组。观察在ASP治疗后1周、2周、4周及12周CRP浓度的变化。结果CHD患者血浆CRP水平明显增高,与正常对照组相比,差异有统计学意义(P<0.01)。ASP100和300mg组用药2周和1周后,CRP浓度有明显下降,与治疗前相比,差异有统计学意义(P<0.01,P<0.05)。结论ASP可显著降低CHD患者血浆CRP含量。     

血脂异常对青年男性心肌梗死患者早、中期预后的影响

目的观察青年男性急性心肌梗死（acute myocardial infarction, AMI ）患者的临床特点及血脂异常对其1年内再发心血管事件的影响。方法以50例≤45岁的青年男性AMI患者作为青年组,按电脑随机数字表法抽取同期住院50例≥65岁的老年男性AMI患者作为老年组。观察两组临床特点,出院后第3、6、9、12个月复查血脂,随访1年内再发主要心血管事件及血脂浓度,并进行比较分析。结果青年组血脂异常检出率高于老年组[28％（14／50）讯8％（4／50）,P〈0．01]。青年组血脂浓度高于老年组（P〈0．05）,以血清甘油三酯浓度升高为主。青年组血清甘油三酯浓度高于老年组,差异有统计学意义[（170．384±101．12）mg／dL强（118．56±60．18）mg／dL,P〈0．011。药物调脂治疗后复查,青年组血清甘油三酯浓度降低最为显著,下降水平明显低于老年组,差异有统计学意义（42％慨12％,P〈0．05）。青年组1年内再发主要心血管事件发生率低于老年组,差异有统计学意义[36％（18／50）眠60％（30／50）,P〈0．05]。青年组心肌梗死后再发主要心血管事件时的血清三酰甘油浓度较入院时明显升高,差异有统计学意义[（175．07±94．79）mg／dL帆（115．19±61．22）rag／dL,P〈0．05]。结论（1）青年男性AMI患者的血脂水平高于老年组,其血脂异常以高三酰甘油为主。（2）调脂治疗后青年男性AMI患者1年内心血管事件的再发生率低于老年组,其血脂下降水平也明显低于老年组。（3）青年男性AMI患者随着血清三酰甘油浓度的升高再发主要心血管事件增加。     

原发性高血压患者血清瘦素浓度的测定及意义

目的 :探讨血清瘦素与原发性高血压患者性别及体重指数间的关系。方法 :用放射免疫法检测了 2 0例健康正常人 (正常对照组 )和 48例原发性高血压患者 (高血压组 )血清瘦素浓度 ,同时测血压和体重指数 (BMI) ;根据体重指数将 2组研究对象又分为肥胖者和非肥胖者。检测血清甘油三酯 (TG)、总胆固醇 (TC)、高密度脂蛋白 (HDL C)、低密度脂蛋白 (LDL C)等指标。并将血清瘦素水平与血压、体重指数、性别、TG、TC、HDL C和LDL C进行相关分析。结果 :高血压组血清瘦素水平高于正常对照组 ,有显著性差异 (P <0 0 5 ) ;高血压组和正常对照组肥胖者血清瘦素浓度均高于非肥胖者 ,有显著性差异 (P <0 0 5～ 0 0 1) ;女性血清瘦素明显高于男性 ,有显著性差异 (P <0 0 1) ;血清瘦素与收缩压、舒张压、TG呈正相关 ,而与TC、HDL C、LDL C无明显相关性。结论 :血清瘦素与原发性高血压患者血压及肥胖程度呈正相关 ,女性高于男性     

Hypertriglyceridemia is positively correlated with the development of colorectal tubular adenoma in Japanese men

AIM: To determine the real association between serum lipid levels and colonic polyp formation. METHODS: We performed a large scale retrospective study to analyze the correlation between the incidence of colorectal adenoma or carcinoma and the fasting serum levels of total cholesterol (TC) and triglycerides (TG) in patients who underwent total colonoscopy for screening for colon cancer. RESULTS: Both levels were significantly elevated in patients with adenomas as compared with patients without any neoplastic lesion (TC 207.6+/-29.5 vs 199.5+/-34.3, n=4883, P<0.001; TG 135.0+/-82.2 vs 108.7+/-71.5, n=4874, P<0.001). The difference was significant in patients with tubular adenoma but not in those with villous or serrated adenoma. Multiple logistic regression analysis including age and sex revealed that TG was an independent correlation factor in male (P<0.01), but not in female patients. The level of TG in patients with invasive carcinoma did not show a significant elevation from that in patients with adenoma. These findings suggest that hypertriglyceridemia is an independent risk factor for colonic adenoma in men. CONCLUSION: Although a high level of serum triglyceride does not appear to be mechanically involved in the development of carcinoma, reduction of serum TG and intensive surveillance with total colonoscopy may have benefit in men with hypertriglyceridemia.     

Increased fasting plasma acylation-stimulating protein concentrations in nephrotic syndrome

Acylation-stimulating protein (ASP) is an adipocyte-derived protein that has recently been suggested to play an important role in the regulation of lipoprotein metabolism and triglyceride (TG) storage. ASP also appears to have a role in the regulation of energy balance. In addition to its role as a hormonal regulator of body weight and energy expenditure, leptin is now implicated as a regulatory molecule in lipid metabolism. However, little is known about the alterations in fasting plasma ASP and leptin concentrations in the nephrotic syndrome. As hyperlipidemia is one of the most striking manifestations of the nephrotic syndrome, we have investigated fasting plasma ASP and leptin levels and their relation to lipid levels in this syndrome. Twenty-five patients with untreated nephrotic syndrome and 25 age-, sex-, and body mass index-matched healthy controls were included in the study. Fasting plasma lipoproteins, TG, total cholesterol, lipoprotein(a), apolipoprotein AI (apoAI), apoB, urinary protein, plasma albumin, third component of complement (C3), ASP, and leptin levels were measured in both groups. Total cholesterol, TG, low and very low density lipoproteins, lipoprotein(a), apoB, and urinary protein levels were increased in the patient group, whereas plasma albumin, high density lipoprotein cholesterol, and apoAI levels were decreased compared with those in the control group (P < 0.001). Plasma ASP levels were significantly higher in the patient group compared with the control subjects (133.72 +/- 65.14 vs. 29.93 +/- 12.68 nmol/liter; P < 0.001), whereas leptin (2.69 +/- 2.06 vs. 3.99 +/- 2.99 ng/ml; P = 0.118) and C3 (1.01 +/- 0.25 vs. 1.06 +/- 0.23 g/liter; P = 0.662) levels were not significantly different between the two groups. Plasma leptin levels were correlated with body mass index in both nephrotic patients (r(s) = 0.86; P < 0.001) and controls (r(s) = 0.98; P < 0.001), but were not correlated with the other parameters. Fasting ASP concentrations showed no correlation with body mass index, proteinuria, plasma albumin, leptin, or any lipid parameter in either group, but C3 levels (in patient group: r(s) = 0.92; P < 0.001; in control group: r(s) = 0.68; P < 0.001). Our findings showed that plasma ASP levels were significantly elevated, whereas leptin levels were normal in the nephrotic syndrome. Increased ASP levels in the setting of dyslipidemia in the nephrotic syndrome raise the possibility of an ASP receptor defect in adipocytes, which also suggests the existence of so-called ASP resistance. Moreover, it is possible that ASP activity is maximal, but cannot keep up with increased rates of lipid production by the liver. Thus, further studies are needed to elucidate the mechanism or source (adipocytes, the liver, or both) of elevated ASP concentrations in the nephrotic syndrome.     

微粒化非诺贝特调节老年代谢综合征患者血脂及尿酸代谢的研究

目的观察微粒化非诺贝特(非诺贝特)对老年代谢综合征患者血脂及尿酸代谢的影响,并探讨其潜在机制。方法入选131例老年代谢综合征患者,同时伴有高TG及高尿酸血症,每日顿服非诺贝特胶囊200 mg,疗程为4周。观察治疗前和治疗4周后主要血脂参数、血尿酸、24 h尿尿酸的变化及不良反应。结果非诺贝特治疗4周后:(1)患者血清TG下降最为显著,与基线比较下降49%,血清HDL-C水平升高18%,此外患者血清TC和LDL-C水平也有一定程度的下降(分别为11%和14%);(2)患者血尿酸水平由(472.5±74.8)μmol/L降至(325.0±82.1)μmol/L,下降幅度为31.2%。其中男性患者血尿酸水平下降32.6%,女性患者下降29.7%,差异均有统计学意义(P<0.01)。(3)患者24 h尿尿酸排泄明显增多,由(2 885.2±502.7)μmol/L增加至(3 701.7±768.2)μmol/L,排泄增加28.8%,其中男性24 h尿尿酸排泄高于女性(P<0.01)。结论非诺贝特具有同时改善老年代谢综合征患者的血脂及尿酸代谢异常的双重疗效,能明显促进尿尿酸排泄,且该作用与性别无关。     

冠心病患者性激素水平失衡的研究

目的 :研究冠心病患者性激素水平的变化。方法 :选择冠心病患者 5 0例 ,用放射免疫法测定血清雌二醇 （E2 ）、孕酮 （P）、促卵泡刺激素 （FSH）、促黄体生成素 （L H）、睾酮 （T）、泌乳素 （PRL）及生长激素 （GH）的变化 ;采用酶法观测空腹总胆固醇 （TC）、甘油三酯 （TG）、高密度脂蛋白 （HDL）及低密度脂蛋白胆固醇 （L DL- C）的变化。结果 :1男性冠心病组与对照组比 E2 、P均升高 （P<0 .0 5 ） ,T水平亦明显下降 （P<0 .0 1） ;女性冠心病组与对照比 ,P水平均显著升高 （P<0 .0 1） ,E2 水平下降 （P<0 .0 5 ）。 2男性冠心病患者 TC,TG,L DL- C均显著高于对照组 （P<0 .0 1） ,HDL 显著低于对照组 （P<0 .0 1） ;女性冠心病患者 TC,TG,L DL- C均高于对照组 （P<0 .0 5 ） ,HDL 低于对照 （P<0 .0 5 ）。结论 :冠心病患者存在血脂代谢异常。但男性与女性冠心病患者的性激素水平失衡存在差异 :男性 E2 ,P升高 ,T降低 ,女性 P升高 ,E2 降低     

The effects of prednisone therapy on plasma lipoproteins and apolipoproteins: a prospective study

The effect of prednisone therapy on plasma lipoproteins and apolipoproteins A-I, A-II, and E levels was studied prospectively in a heterogeneous group of six male and six female subjects. All patients were in a good general condition. The patients had normal hepatocellular, renal, and thyroid functions. During the first month of therapy, the following changes were noted: Plasma triglyceride (TG) levels increased slightly in female patients only. In the entire group, plasma cholesterol level increased (17.3% of initial value, P less than 0.01). Plasma high-density lipoprotein cholesterol (HDL-C) level increased by 68% (P less than 0.001), while plasma low-density lipoprotein cholesterol (LDL-C) level increased by only 10.9% (not significant), resulting in an increased ratio of cholesterol in the two (P less than 0.01). No change in levels of plasma apolipoproteins A-I, A-II, and E was evident. The ratio of HDL-C to plasma apolipoprotein A-I increased (P less than 0.01), indicating an increased lipid to protein ratio for this lipoprotein. Most of these changes were already apparent and significant 48 hours after initiation of treatment and persisted throughout the follow-up period (up to 18 months in some patients). Our results show that in patients with no major metabolic abnormality, prednisone induces significant changes of the lipoprotein system, especially in HDL.     

Coronary Flow Velocity Reserve is Improved by PPAR‐α Agonist Fenofibrate in Patients with Hypertriglyceridemia

Summary Introduction: Fenofibrate, an agonist of peroxisome proliferator‐activated receptor‐α (PPAR‐α), has a vascular protective effect. Aims: We investigated the effect of the PPAR‐α agonist on coronary artery endothelial function in patients with hypertriglyceridemia. Methods: Fifty‐eight patients with hypertriglyceridemia were divided into two groups: control (no treatment; n = 23) and fenofibrate treatment (n = 35), 200 mg/d, for 6 months. The patients had undergone rest and adenosine treatment to induce hyperemia for quantification of coronary flow velocity reserve (CFVR) by noninvasive Doppler echocardiography before treatment and at 6‐month follow‐up. Pulse wave velocity (PWV) was measured before treatment and at 6‐month follow‐up. Results: CFVR was significantly improved with fenofibrate treatment as compared with baseline level and control group (3.14 ± 0.36 vs. 2.80 ± 0.58 and 2.79 ± 0.65, P < 0.01 and 0.05, respectively), with no difference between baseline levels and untreated controls. In addition, at 6 months, plasma level of homocysteine was significantly increased with fenofibrate treatment as compared with at baseline and control group (median 18.13 [range 14.46–22.02]μmol/L vs. 14.09 [12.01–18.81] and 13.34 [9.69–17.06]μmol/L, P < 0.001 and 0.01, respectively). Furthermore, at 6 months, PWV was significantly decreased with fenofibrate treatment as compared with control group (1446 ± 136 cm/s vs. 1570 ± 203 cm/s, P < 0.05). Conclusions: Treatment with PPAR‐α agonist fenofibrate significantly improved CFVR and arterial stiffness in patients with hypertriglyceridemia. This endothelial protective effect may be reduced in part by the side effect of increasing homocysteine.