64层螺旋CT冠状动脉成像联合血脂动态变化评价冠心病

目的分析血脂动态变化与冠状动脉粥样硬化性心脏病的关系。方法回顾性分析108例怀疑冠心病首次住院病人,所有病人均行64层螺旋CT冠脉成像（CTA）检查,同时行血脂检查。依据CTA结果分4组,对照组（冠脉无狭窄）;轻度（狭窄〈50％）;中度（50％≤狭窄〈75％）;重度（狭窄≥75％）。结果与对照组比较,血总胆固醇（TC）、血三酰甘油（TG）、高密度脂蛋白胆固醇（HDL—C）及低密度脂蛋白胆固醇（LDL—C）均存在明显差异（P〈0．05）。TC、LDL—C在异常组间无显著性差异（P〉0．05）,而TG、HDL—C存在显著性差异（P〈0．05）。结论TC、LDL—C作为冠状动脉粥样硬化发生的始动因素,TG、HDL—C影响冠脉狭窄程度,在粥样硬化演进中可能起主要作用。动态分析血脂变化对评价冠心病具有一定指导意义。     

急性心肌梗死患者血脂水平变化与中医辩证分型的临床研究

目的：分析急性心肌梗死（AMI）患者血脂水平变化与中医辩证分型的关系。方法：AMI患者110例和冠心病组（对照组）100例进行总胆固醇（TC）、甘油三酯（TG）、甘油三酯（TG）、高密度脂蛋白－胆固醇（HDL－C）、低密度脂蛋白－胆固醇（LDL－C）水平的测定,并按中医辩证分4型：心脉瘀阻型、痰热扰心型、气阴两虚型、心阳虚脱型。结果：在AMI急性期TC＞6.2mmol/L占17.3％,4.6-6.2mmol／L占38.2％;TG＞2.2mmol／L占12.7％,1.7-2.2mmol／L占13.6％;HDL－C＜0.8mmol/L占18.2％;LDL－C＞3.5mmol／L占19.1％。且心脉瘀阻型及痰热扰心型2组TC及LDL－C升高,而HDL－C下降,与对照组比较有显著性差异。死亡15例患者中有7例HDL－C降低,占46.7％。心阳虚脱型HDL－C下降及LDL－C升高与对照组比较有显著差异。结论：高脂血症与AMI发生率有关,在AMI急性期可出现高脂血症。心脉瘀阻型及痰热扰心型易出现TC、LDL－C升高和HDL－C降低,尤以LDL－C及HDL－C改变更为突出。HDL－C降低是AMI死亡危险因子之一。     

2型糖尿病患者血浆致动脉硬化指数与其他几种动脉硬化指数的应用价值比较

目的比较2型糖尿病（DM）血浆致动脉硬化指数（AIP）、低密度脂蛋白胆固醇（LDL-C）／高密度脂蛋白胆固醇（HDL—C）比值及动脉硬化指数（AI）和血脂综合指数（LCI）的应用价值。方法测定124例2型DM患者和111名正常对照者三酰甘油（TG）、总胆固醇（TC）、HDL—C等,计算LDL-C、AIP、LDL—C／HDL—C比值、AI和LCI。将2型DM患者分为HDL—C〈0．91mmol／L及HDL—C≥0．91mmol／L2组进行分析。结果2型DM组的AIP、AI和LCI均高于正常对照组（P〈0．001）,其中AIP值最高,A1次之。2型DM患者HDL-C〈0．91mmol／L组的AIP、AI、LDL—C／HDL—C比值均高于HDL-C≥0．91mmol／L组（P〈0．001）,AIP的升高较明显。2型DM血脂升高组调脂前后AIP差异明显（P〈0．001）。结论比较AIP和其他3种指数,以AIP差异最明显。AIP是反映2型DM患者发生动脉粥样硬化危险性最有判断价值的指标。     

血脂和TG／HDL—C水平与冠状动脉为程度关系的研究

目的：研究血脂和甘油三酯／高密度脂蛋白胆固醇（TG／HDL－C）比值与冠状动脉病变程度的关系。方法：128例选择性冠状动脉造影结果以计分法评定其病变程度，并评定各组患者血脂及有关比值之间的差异及其与冠状动脉病变程度之间的相关关系。结果：出血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL－C）、TG／HDL－C水平在重度病变组显著增高（P值分别＜0.01、0.05、0.05)。它们与冠状动脉病变程度分值之间的相关系数分别为0.20、0.14、0.41。结论：TC和TG／HDL－C比值不仅和冠状动脉粥样硬化性心脏病的发病相关，而且与冠状动脉病变程度相关。     

冠心病合并2型糖尿病患者不稳定动脉粥样硬化斑块的评估及影响因素的分析

目的研究合并2型糖尿病的冠状动脉粥样硬化性心脏病（冠心病）患者与非2型糖尿病冠心病患者的不稳定动脉粥样硬化斑块的差别。方法在行冠脉造影术时,通过血管内超声（IVUS）对146例冠心病患者病变血管进行检测,测定是否有不稳定粥样硬化斑块,并评估冠脉狭窄程度。根据患者是否存在糖尿病,分为2组进行对比,同时定量分析患者相关冠心病危险因素：性别、年龄、体质指数（BMI）、高血压、甘油三酯、总胆固醇、低密度脂蛋白胆固醇水平等。结果糖尿病组的不稳定冠状动脉钙化斑块数量显著多于非糖尿病组（P〈0.05）,糖尿病组的低密度脂蛋白胆固醇水平显著大于非糖尿病组（P〈0.05）。结论合并2型糖尿病患者冠脉形成不稳定斑块较非2型糖尿病患者的风险更大,同时2型糖尿病患者的低密度脂蛋白胆固醇水平更高于非2型糖尿病患者。对于同时合并有2型糖尿病的患者在积极控制血糖水平的同时,应积极进行调整血脂治疗,使不稳定斑块向稳定型斑块转化,降低冠脉事件的发生。     

冠状动脉重度狭窄相关危险因素的临床分析

【目的】探讨引发冠状动脉重度狭窄的相关危险因素。【方法】选取笔者所在医院2011年4月至2014年4月收治的冠状动脉狭窄患者113例和体检健康者50例。将其分为三组,A组为体检健康者50例, B组为轻中度冠状动脉狭窄者61例,C组为重度冠状动脉狭窄者52例。观察各组腹型肥胖比例、高血压比例、体质量指数（BMI）、血尿酸（BUA）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL‐C）、低密度脂蛋白胆固醇（LDL‐C）、脂联素、胰岛素抵抗指数（HOMA‐IR）、心率（HR）等指标,进行组间比较。【结果】C组、B组 HOMA‐IR、BMI、HR、高血压比例、腹型肥胖比例、TC、TG、LDL‐C、BUA均高于A组,差异有统计学意义（ P ＜0．05）;C组、B组HDL‐C、脂联素均低于A组,差异有统计学意义（ P ＜0．05）;C组 HOM A‐IR、BMI、HR、高血压比例、腹型肥胖比例、TC、TG、LDL‐C、BUA均高于B组,差异有统计学意义（ P ＜0．05）;C组HDL‐C、脂联素均低于B组,差异有统计学意义（ P ＜0．05）。【结论】冠状动脉重度狭窄患者伴有糖脂代谢紊乱及血尿酸及脂联素异常,高血尿酸有显著影响其并发严重冠状动脉狭窄的可能性。     

糖尿病合并冠心病的发病特征与冠状动脉病变程度相关性研究

目的:观察糖尿病合并冠心病(CAHD)患者血脂指标、C反应蛋白(CRP)和胰岛素抵抗水平与冠状动脉病变的关系及其相关性.方法:经冠状动脉造影证实的糖尿病合并冠状动脉粥样硬化性心脏痛患者76例,无糖尿病组合并冠状动脉粥样硬化性心脏病患者46例,另选36例冠状动脉造影阴性者为对照组,测定其高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、血糖(GLU)、胰岛素敏感指数(ISI)、甘油三酯(TG)、胰岛素抵抗水平指数(HOMA-IR)和血浆CRP水平.结果:(1)糖尿病组冠脉多支病变(2支病变及3支病变)发生率均显著高于无糖尿病组(P<0.05),两组每支血管狭窄总积分无明显差异;(2)糖尿病合并冠状动脉粥样硬化性心脏病组LDL、GLU、CRP、TG、HOMA-IR值高于无糖尿病冠状动脉粥样硬化性心脏病组和对照组,ISI、HDL值低于无糖尿病冠状动脉粥样硬化性心脏病组和对照组,差异有统计学意义(P<0.05);(3)3支血管病变组(n=19)与双支血管病变组(n=55)和对照组(n=36)比较,其LDL、GLU、CRP、TG、HOMA-IR值高于对照组和双支血管病变组,ISI、HDL值低于无糖尿病冠状动脉粥样硬化性心脏病组、对照组,差异有统计学意义(P<0.05);(4)血管病变支数与LDL、GLU、CRP和HOMA-IR呈明显正相关(P<0.05),与HDL、ISI呈负相关(P<0.05).结论:糖尿病合并冠状动脉粥样硬化性心脏病患者存在较严重血脂代谢紊乱、炎症反应和胰岛素抵抗水平,程度与冠状动脉病变程度相关,可能是冠心病的危险因素.     

蜂蜇伤患者血脂检测结果分析

目的探讨蜂蜇伤患者血脂代谢特点。方法检测21例野蜂蜇伤患者与83名同期健康体检者血清总胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、三酰甘油（TG）浓度并进行比较。结果与对照组比较,蜂蜇伤组TC、HDL—C、LDL—C、TG显著降低（P〈0．0I）,且TC、HDL—C、LDL—C降低幅度较TG更大。蜂蜇伤组血脂各指标异常率分别为LDL．C95．3％、TC71．4％、HDL—C61．9％、TG19．0％,与对照组比较,差异均有统计学意义（P〈0．01）。结论蜂蜇伤患者存在明显的脂质代谢紊乱,表现为低脂血症,其改变机制及其与病情发展、预后的关系有待进一步探讨。     

辛伐他汀联合阿司匹林治疗颈动脉粥样硬化疗效观察

目的观察辛伐他汀、阿司匹林合用治疗颈动脉粥样硬化的临床疗效。方法将100例颈动脉粥样硬化患者随机均分为2组：I组口服阿司匹林100mg,1次／d;Ⅱ组口服辛伐他汀20mg,1次／d。阿司匹林100mg,1次／d。治疗6个月后,分别比较治疗前、后颈动脉内膜中层厚度（IMT）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、C反应蛋白（CRP）水平。结果治疗6个月后,2组TC、TG、LDL、HDL、IMT、CRP比较：Ⅱ组均优于I组（P〈O．05）。结论辛伐他汀和阿司匹林对颈动脉粥样硬化均有治疗作用,辛伐他汀、阿司匹林联合应用效果更优。     

冠状动脉病变患者血清同型半胱氨酸和非高密度脂蛋白胆固醇检测

目的 探讨血清同型半胱氨酸（Hcy）和非高密度脂蛋白胆固醇（non—HDL—C）的水平与冠状动脉病变（CAD）程度的关系。方法 选取299例60～75岁无糖尿病史及肾功能损伤的冠状动脉造影阳性患者，94例无糖尿病史及肾功能损伤的冠状动脉造影阴性者，分别测定总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、载脂蛋白A—I（apoA—I）、载脂蛋白B（apoB）、载脂蛋白E（apoE）、脂蛋白（a）[Lp（a）]及Hcy。并通过Frost法计算出non—HDL—C。结果 冠状动脉造影阳性患者的non—HDL—C显著高于冠状动脉造影阴性者（P〈0.01），并且随冠状动脉狭窄支数的增加而升高。冠状动脉造影阳性患者的Hcy显著高于冠状动脉造影阴性者（P〈0．01），并且随冠状动脉狭窄支数的增加而升高。冠状动脉造影阳性患者的non—HDL—C与Hcy无相关性（r=0．281，P〉0。05）。结论 高浓度的血清Hcy及non—HDL—C水平是CAD的危险指标。血清Hcy浓度与non—HDL—C水平之间无相关性。血清Hey和non—HDL—C与Lp（a）三者同时检测是评价和预测CAD的可信且敏感的指标。     

Lipid modification in type 2 diabetes: the role of LDL and HDL

Patients with type 2 diabetes feature important modification of both low density lipoprotein (LDL) and high density lipoprotein particles which are likely to play an important role in the development of atherosclerosis. Although plasma LDL cholesterol level is usually normal in type 2 diabetic patients, LDLs show a significant increase in their plasma residence time which may promote cholesterol deposition in the arterial wall. Moreover, important qualitative abnormalities of LDLs, potentially atherogenic, are observed in type 2 diabetic patients: small dense, triglyceride-rich, LDL particles (known as subclass B), oxidized LDL and glycated LDL. All these qualitative modification of LDLs amplify the atherosclerotic process.
Plasma high density lipoprotein (HDL) cholesterol is decreased in type 2 diabetes related to increased catabolism of HDL particles. One of the mechanism responsible for increased catabolism of HDLs is hypertriglyceridemia, promoting through cholesteryl ester transfer protein (CETP) the transfer of triglycerides (TG) to HDL leading to the formation of TG-rich HDLs which are very good substrates for hepatic lipase, enzyme in charge of HDLs catabolism. The reduction in plasma adiponectin level, observed in type 2 diabetes may be another mechanism involved in the diminution of HDL cholesterol. Furthermore, qualitative abnormalities of HDLs are described in type 2 diabetes: enrichment in triglycerides and glycation, which may impair HDL-mediated cholesterol efflux and reverse cholesterol transport. In addition to their role in reverse cholesterol transport, HDLs usually show antioxidative, anti-inflammatory, anti-thrombotic and endothelium-dependent vasorelaxant effects. It has been shown that HDLs from patients with type 2 diabetes have a significant reduction in their antioxidative and endothelium-dependent vasorelaxant properties.     

血脂、腰臀比异常对糖尿病血管并发症的影响及护理干预

目的对544例2型糖尿病(T2DM)患者及278例健康人进行空腹血糖(FBG)、总胆固醇(TC)、甘油三酯TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、LDL/HDL及腰臀比(WHR)、体重指数(BMⅠ)的测定,探讨其T2DM血管并发症与血脂代谢及WHR的关系。方法将T2DM组(A、B组)的FBG、TC、TG、HDL、LDL、LDL/HDL及WHR、BMI与正常对照组及组间进行比较分析。结果T2DM组(A、B组)与正常对照组相比FBG、TC、TG、LDL、LDL/HDL及WHR有显著增高,HDL明显降低。特别是有血管病变组与无血管病变组相比TC、LDL、LDL/HDL增高差异有显著意义(P<0.001),HDL也降低,差异有显著意义(P<0.001),同时WHR及BMI增高差异有显著意义。结论血脂代谢紊乱是DM患者导致血管病变的主要原因,而WHR及BMI增高是发生T2DM的重要危险因素,同时,WHR及BMI可作为自我了解健康状况的重要指标之一。     

Prognostic evaluation of primary non-small cell lung carcinoma patients using biological fluid variables. A systematic review

There is growing experimental evidence to suggest the role of oxidatively modified low‐density lipoprotein (LDL) in the initiation and progression of atherosclerosis. The oxidation of lipoprotein moiety causes modification of positively charged lysine residues and results in negative net charge of lipoprotein particles. Objective: To measure the amount of circulating electronegatively charged LDL particles (LDL–) in plasma of patients with angiographically documented coronary artery disease (CAD). Methods: Thirty patients were assigned to the study group (CAD+) and 10 patients to the control group (Ctrl). LDL– was quantitated in homogeneous LDL fractions obtained by ultracentrifugation, using ion exchange high performance liquid chromatography. Plasma lipids were measured using enzymatic kits. Results: The CAD+ group had significantly higher levels of LDL– in the whole LDL fraction (7.66±1.92 vs. 5.14±0.84%, p=0.0003). Moreover the CAD+ group had significantly higher levels of total cholesterol (255.4±35.1 vs. 210.4±22.4?mg/dL), LDL cholesterol (154.5±26.9 vs. 122.4±21.1?mg/dL) and significantly lower levels of high‐density lipoprotein (HDL) cholesterol (40.4±9.4 vs. 51.0±11.5?mg/dL). LDL– remained significantly higher in the CAD+ group after adjustment for total cholesterol, LDL cholesterol and HDL cholesterol (6.3 vs. 5.14% at p=0.0095). There is a trend towards a positive correlation between LDL– levels and LDL cholesterol in the control group (Spearman R=0.55 at p=0.098). Conclusions: Electronegatively charged LDL appears to be an additional hallmark of coronary artery disease, independently of established lipid risk factors. The trend towards a positive correlation between LDL cholesterol concentration and the level of LDL– in the control group may reflect the susceptibility of LDL cholesterol to autoxidation, Moreover, this may indicate other oxidative mechanisms in coronary artery disease. Nonetheless, further studies assessing the prognostic value of electronegatively charged LDLs are necessary.     

Is atherosclerosis in diabetes and impaired fasting glucose driven by elevated LDL cholesterol or by decreased HDL cholesterol?

OBJECTIVE: To evaluate the atherogenicity of lipids in coronary patients with normal fasting glucose (NFG), impaired fasting glucose (IFG), and type 2 diabetes. RESEARCH DESIGN AND METHODS: Serum lipid values, the presence of angiographic coronary artery disease (CAD) at baseline, and the incidence of vascular events over 2.3 years were recorded in 750 consecutive patients undergoing coronary angiography. RESULTS: Triglycerides significantly (P < 0.001) increased and HDL cholesterol (P < 0.001) as well as LDL particle diameter (P < 0.001) significantly decreased from subjects with NFG <5.6 mmol/l (n = 272) over patients with IFG > or =5.6 mmol/l (n = 314) to patients with type 2 diabetes (n = 164). Factor analysis revealed two factors in the lipid profiles of our patients: triglycerides, HDL cholesterol, apolipoprotein A1, and LDL particle diameter loaded high on an HDL-related factor, and total cholesterol, LDL cholesterol, and apolipoprotein B loaded high on an LDL-related factor. In patients with type 2 diabetes, the HDL-related factor (odds ratio 0.648 [95% CI 0.464-0.904]; P = 0.011), but not the LDL-related factor (0.921 [0.677-1.251]; P = 0.597), was associated with significant coronary stenoses > or =50%. Consistently, in the prospective study, the HDL-related factor (0.708 [0.506-0.990]; P = 0.044), but not the LDL-related factor (1.362 [0.985-1.883]; P = 0.061), proved significantly predictive for vascular events in patients with type 2 diabetes. CONCLUSIONS: The low HDL cholesterol/high triglyceride pattern is associated with the degree of hyperglycemia. In coronary patients with type 2 diabetes, this pattern correlates with the prevalence of CAD and significantly predicts the incidence of vascular events.     

Bay Leaves Improve Glucose and Lipid Profile of People with Type 2 Diabetes

Bay leaves (Laurus nobilis) have been shown to improve insulin function in vitro but the effects on people have not been determined. The objective of this study was to determine if bay leaves may be important in the prevention and/or alleviation of type 2 diabetes. Forty people with type 2 diabetes were divided into 4 groups and given capsules containing 1, 2 or 3 g of ground bay leaves per day for 30 days or a placebo followed by a 10 day washout period. All three levels of bay leaves reduced serum glucose with significant decreases ranging from 21 to 26% after 30 d. Total cholesterol decreased, 20 to 24%, after 30 days with larger decreases in low density lipoprotein (LDL) cholesterol of 32 to 40%. High density lipoprotein (HDL) cholesterol increased 29 and 20% in the groups receiving 1 and 2 g of bay leaves, respectively. Triglycerides also decreased 34 and 25% in groups consuming 1 and 2 g of bay leaves, respectively, after 30 d. There were no significant changes in the placebo group. In summary, this study demonstrates that consumption of bay leaves, 1 to 3 g/d for 30 days, decreases risk factors for diabetes and cardiovascular diseases and suggests that bay leaves may be beneficial for people with type 2 diabetes.     

Circulating electronegatively charged low-density lipoprotein in patients with angiographically documented coronary artery disease

There is growing experimental evidence to suggest the role of oxidatively modified low-density lipoprotein (LDL) in the initiation and progression of atherosclerosis. The oxidation of lipoprotein moiety causes modification of positively charged lysine residues and results in negative net charge of lipoprotein particles. OBJECTIVE: To measure the amount of circulating electronegatively charged LDL particles (LDL-) in plasma of patients with angiographically documented coronary artery disease (CAD). METHODS: Thirty patients were assigned to the study group (CAD+) and 10 patients to the control group (Ctrl). LDL- was quantitated in homogeneous LDL fractions obtained by ultracentrifugation, using ion exchange high performance liquid chromatography. Plasma lipids were measured using enzymatic kits. RESULTS: The CAD+ group had significantly higher levels of LDL- in the whole LDL fraction (7.66+/-1.92 vs. 5.14+/-0.84%, p=0.0003). Moreover the CAD+ group had significantly higher levels of total cholesterol (255.4+/-35.1 vs. 210.4+/-22.4 mg/dL), LDL cholesterol (154.5+/-26.9 vs. 122.4+/-21.1 mg/dL) and significantly lower levels of high-density lipoprotein (HDL) cholesterol (40.4+/-9.4 vs. 51.0+/-11.5 mg/dL). LDL- remained significantly higher in the CAD+ group after adjustment for total cholesterol, LDL cholesterol and HDL cholesterol (6.3 vs. 5.14% at p=0.0095). There is a trend towards a positive correlation between LDL- levels and LDL cholesterol in the control group (Spearman R=0.55 at p=0.098). CONCLUSIONS: Electronegatively charged LDL appears to be an additional hallmark of coronary artery disease, independently of established lipid risk factors. The trend towards a positive correlation between LDL cholesterol concentration and the level of LDL- in the control group may reflect the susceptibility of LDL cholesterol to autoxidation, Moreover, this may indicate other oxidative mechanisms in coronary artery disease. Nonetheless, further studies assessing the prognostic value of electronegatively charged LDLs are necessary.     

高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及其比值检测在中老年冠心病患者诊断和临床治疗中的意义

目的 探讨血清高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、LDL-C/HDL-C检测在中老年冠心病(CHD)患者中的意义.方法 分析经冠状动脉造影确诊为冠状动脉粥样硬化(药物治疗组)83例、CHD(支架植入组)163例及冠状动脉造影阴性(对照组)44例中老年病例的血清HDL-C、LDL-C、LDL-C/HDL-C比值与冠状动脉病变程度之间的关系.并比较各组间男女血脂水平的差异.结果 药物治疗组、支架植入组与对照组总胆固醇(T()、LDL-C、LDL C/HDL-C比值水平差异有统计学意义(P＜0.05或＜0.01).支架植入组TC、LDL-C、TC/HDLC比值水平明显高于药物治疗组及对照组(P＜0.05或＜0.01).支架植入组HDL-C显著低于药物治疗组及对照组(P＜0.05).药物治疗组女性HDL-C水平高于男性(P＜0.05),但女性TC/H DL-C比值、LDL-C/HDL-C比值低于男性(P ＜0.05).支架植入组女性TC和HDL-C高于男性(P＜0.05).对照组女性TC、HDL-C高于男性(P＜0.05),但女性TG/HDL C、LDLC/HDL-C低于男性(P＜0.05).结论 血清HDL-C、LDL-C、LDL-C/HDL-C比值与冠状动脉病变相关,对中老年CHD患者的诊断及临床治疗有使用价值.     

超声评价2型糖尿病患者股动脉应变参数与血生化及血流变指标相关性的研究

目的：应用X-Strain技术检测2型糖尿病（T2DM）患者股动脉应变参数,探讨动脉管壁形变功能改变特点及相关影响因素。方法 T2DM组88例,正常对照组44例,应用Xstrain技术检测股总动脉应变参数,比较两组间的差异,并分析应变参数与生化学及血流动力学指标的相关性。结果 T2DM 组股动脉最大圆周应变和应变率明显低于对照组（P＜0.05）。应变参数与各测量参数间有一定的相关性（P＜0.05）,且应变和应变率与空腹血糖（FPG）、糖化血红蛋白（GHb）、甘油三酯（TG）、总胆固醇（TC）、极低密度脂蛋白（LDL）、血管最大内径（Ds）、全血黏度（η）呈负相关,与高密度脂蛋白（HDL）、最大血流速度（Vmax）、剪切力（τ）呈正相关;GHb、TG、HDL对应变（S）的影响显著（P＜0.05）, TG及τ对应变率（SR）的影响显著（P＜0.05）。结论 T2DM患者下肢动脉应变及应变率明显减低;其下肢动脉粥样硬化的发生与血糖及GHb超标,血脂水平异常,血黏度高,血流剪切力低等因素密切相关。GHb、TG、HDL为应变的独立影响因素,TG及τ为应变率的独立影响因素,且作用显著。     

Atherogenic risk factors in cerebrotendinous xanthomatosis

In a study of coronary artery disease in patients with cerebrotendinous xanthomatosis (CTX), we documented the presence or absence of atherogenic risk factors and performed detailed analyses of serum lipid and lipoprotein profiles. Four of the seven patients examined had coronary arterial narrowing and/or obstruction, but multiple atherogenic risk factors were not found in any of these patients. Total cholesterol (T.ch) levels and low density lipoprotein-cholesterol (LDL-ch) levels were lower, and high density lipoprotein2-cholesterol (HDL2-ch) levels were higher in CTX patients than in controls. Triglyceride and very low density lipoprotein (VLDL) levels were significantly lower in the former. Indices correlating with the risk of atherosclerosis, such as the atherogenic index, and the ratios of apolipoprotein B/apolipoprotein AI, HDL2-ch/LDL-ch, HDL2-ch/HDL3-ch, indicated that CTX serum was, in fact, 'anti-atherogenic'. However, coronary artery disease is frequently seen in patients with CTX. This discrepancy suggests the existence of a unique mechanism by which atherosclerosis is induced in patients with CTX. We discuss a mechanism of disturbed lipoprotein metabolism which might be responsible for the deposition of sterols in the tissues of patients with CTX.     

Comparison of laboratory parameters as risk factors for the presence and the extent of coronary or carotid atherosclerosis: the significance of apolipoprotein B to apolipoprotein all ratio.

We compared several "new" risk factors (autoantibodies to oxidatively modified low density lipoprotein (LDL), sialic acid content of LDL, bilirubin and C-reactive protein) with "conventional" risk factors (apolipoprotein (apo) AI, AII and B, lipoprotein(a), triglycerides, and total, LDL and high density lipoprotein (HDL) cholesterol) for the presence and the extent of coronary or carotid atherosclerosis. Forty male patients with angiographically proven coronary atherosclerosis and 31 male patients with ultrasound-proven extracranial carotid atherosclerosis were compared to 40 age matched (53+/-5 years) healthy males as control subjects, with negative parental history of atherosclerosis, no clinical signs of systemic or organ-related ischemic disease and normal extracranial carotid arteries. The apo B/apo All ratio most powerfully indicated the presence and the extent of coronary or carotid atherosclerosis. Elevated lipoprotein(a) contributed significant additional information in the assessment of the atherosclerotic risk. Increase in C-reactive protein indicated the presence (but not the extent) of coronary or carotid atherosclerosis with a similar power as lipoprotein(a). Decreased values of total bilirubin indicated the presence of atherosclerosis only in smokers. Autoantibodies to oxidatively modified LDL additionally described the atherosclerotic process, but were less important than apolipoproteins, lipoprotein(a), C-reactive protein or bilirubin. Sialic acid content of LDL added no information to the parameters discussed above. We demonstrated that in male patients apolipoproteins, especially the apo B/apo All ratio, were better indicators of the presence and the extent of coronary or carotid atherosclerosis than C-reactive protein, bilirubin, autoantibodies to oxidatively modified LDL or sialic acid content of LDL.