动脉粥样硬化性脑梗死与低密度脂蛋白亚组分颗粒大小关系的研究

目的 研究动脉粥样硬化性脑梗死(ACI)发病与低密度脂蛋白(LDL)亚组分颗粒直径大小之间的关系。方法 梯度密度超速离心32例ACI患者及32例对照者的血浆LDL，采用2．5％～16．0％聚丙烯酰胺凝胶梯度电泳分析LDL颗粒直径、分布及电泳图形。结果 ①ACI组三酰甘油(TG)，总胆固醇(TC)，低密度脂蛋白胆固醇(LDL-C)及载脂蛋白B(ApoB)较对照组明显升高(t=4．03—8．37，P&;lt;0．01)。②ACI组LDL颗粒直径[(24．8&;#177;0．7)nm]较对照组[(26．0&;#177;0．6)nm]明显变小(t=4．78，P&;lt;0．O1)；两组间A型、B型的分布不同，B型LDL在ACI组分布明显高于对照组(t=6．80，P&;lt;0．05)。③ACI组小而密LDL亚组分相对含量[(50&;#177;10)％]较对照组[(17&;#177;1O)％]明显增多(t=7．76，P&;lt;0．001)。④ACI组LDL亚组分颗粒直径与TG(r=-0．47，P&;lt;0．01)，TC(r=-0．51，P&;lt;0．01)．LDL-C(r=-0．36，P&;lt;0．05)，ApoB(r=-0．46，P&;lt;0．05)呈负相关。结论：ACI组LDL以小颗粒的B型为主，与ACI发生密切相关，TG水平对LDL颗粒直径大小、组成具有调节作用。     

血脂紊乱对代谢综合征早期肾功能损害的影响

目的探讨血脂异常对代谢综合征(metabolicsyndrome,MS)早期肾功损害的影响。方法将357例患者分为高血压组(EH)、糖尿病组(DM)和MS组,将3组依血脂水平变化分为血脂正常和异常2个亚组,亚组间的血压、血糖和病程无显著差别,分别比较每组血脂正常和血脂异常组的肾功能变化,并分析血脂和肾功能的关系。结果MS组中,血脂异常组24h微量蛋白尿(MA,mg/24h)显著高于血脂正常组犤(66±3)/(45±4),t=-3.904,P<0.01犦,内生肌酐清除率(Ccr,mL/min)显著低于血脂正常组犤(57±3)/(72±4),t=-3.838,P<0.01犦;而EH和DM组的MA和Ccr水平在血脂正常和异常组中差异无显著性意义。相关分析表明,MS组中TC,LDL,ApoB与MA和Ccr有显著相关,其中TC对MA和Ccr影响最大(MA:r=0.3807,P<0.01;Ccr:r=0.3807,P<0.05);而EH和DM组中TC,LDL,ApoB与MA和Ccr无显著相关。结论与EH和DM相比,在血压和血糖相似的情况下,血脂异常是致MS肾功能损害的重要因素,早期介入康复方法进行积极的调脂治疗对保护MS的肾功能有临床意义。     

产前应用地塞米松对早产儿缺氧缺血性脑损伤的影响

目的:探讨产前预防性使用肾上腺皮质激素对早产儿缺氧缺血性脑损伤(hypoxic-ischemicbraindamage,HIBD)的影响。方法:对42例早产儿HIBD病例进行研究,比较产前用药组(n=44)与未用药组(n=38)HIBD早产儿血糖(微量血糖仪测定)、血清可溶性黏附分子1(solubleintercellularadhesionmolecule1,sICAM-1)(ELASA法),S-100B(化学发光免疫法),纠正胎龄40周时新生儿行为神经测定(neonatalbehaviorneurologicassessment,NBNA)的变化情况。结果:产前用药组微量血糖、纠正胎龄40周时NBNA犤(2.7±0.4)mmol,38.1±4.6犦高于未用药组犤(2.7±0.4)mmol/L,35.0±3.2犦(t=5.21,P<0.01;t=5.21,P<0.05)。产前用药组血清sICAM-1,S-100B犤(225.3±55.9)ng/L,(2.2±1.5)μg/L犦低于未用药组犤(270.3±53.9)ng/L,(3.8±2.5)μg/L犦(t=8.20,9.25,P<0.01)。结论:产前预防性应用肾上腺皮质激素对早产儿HIBD具有保护作用,可能与血糖升高及血清sICAM-1降低有关。     

HD02对慢性前脑缺血大鼠神经细胞凋亡的影响

目的:研究HD02在大鼠慢性前脑缺血过程中对神经细胞凋亡的作用。方法:16～18个月SD大鼠64只,雄性,体质量300～350g。利用末端标记法和流式细胞仪,测定HD02干预前后脑缺血大鼠脑组织神经细胞的凋亡情况,并检测Caspase-3免疫阳性细胞、Calcineurin和钙激活中性蛋白酶(Calpain)活性。结果:HD02有减少阳性凋亡细胞出现率犤(5.40±1.38)%与模型对照组(12.72±3.45)%比较,t=4.84,P<0.01犦及减少Caspase-3免疫阳性细胞表达(HD02组比模型对照组:缺血15d:7.10±1.90比12.55±3.30,t=3.86,P<0.01;缺血30d:4.60±1.15比9.50±4.20,t=4.67,P<0.01),降低CalcineurinD02组比模型对照组:大脑皮质每克蛋白中含犤(38.24±5.58)比(48.98±5.04)nmol/s,t=3.64,P<0.01犦;海马每克蛋白中含犤(37.87±3.38)比(52.58±4.92)nmol/s,t=3.75,P<0.01犦和Calpain活性犤大脑皮质每毫克蛋白中含(2.96±0.77)比(4.56±0.85)A/h,t=3.84,P<0.05犦;海马每毫克蛋白中含犤(2.90±0.28)比(4.91±0.94)A/h,t=3.97,P<0.01犦的作用。结论:HD02有一定的抗神经细胞凋亡的作用。     

蛋白激酶A在干扰素-γ抑制创面愈合和瘢痕形成中的作用

目的:观察干扰素γ(IFN-γ)用于兔耳伤口肉芽组织和瘢痕组织后蛋白激酶A(ProtinaseA,PKA)活性变化及对伤口愈合和瘢痕形成影响,探讨PKA的信号转导作用。方法:用32P掺入法测定使用IFN-γ前后兔耳伤后3,6,11～16d(上皮化时),以及上皮后14,30,45和60d组织的PKA活性,观察伤口愈合时间和瘢痕变化。结果:上皮化时肉芽组织和伤口周边组织的PKA活性高于正常皮肤犤(1.5±0.6)pmol/min·mg,t=3.76,P<0.001和(1.4±0.5)pmol/min·mg,t=2.96,P<0.01犦。IFN-γ延迟创面愈合约1.5d(t=2.64,P=0.01),同时进一步活化PKA:肉芽组织在伤后6d和上皮化时犤(1.6±0.6)pmol/min·mg,t=2.59,P<0.05和(1.8±0.7)pmol/min·mg,t=2.92,P<0.01犦和周边组织上皮化时犤(1.7±0.6)pmol/min·mg,t=2.42,P<0.05犦高于对照。增生性瘢痕组织的PKA活性仅在上皮化时升高犤(1.5±0.5)pmol/min·mg,t=2.26,P<0.05犦,非增生性瘢痕组织的PKA活性在上皮化时犤(1.4±0.5)pmol/min·mg,t=2.08,P<0.05犦和上皮化后14d犤(1.4±0.5)pmol/min·mg,t=2.08,P<0.05犦时较高;IFN-γ进一步升高上皮化时IFN-γ1组:犤(1.8±0.7)pmol/min·mg,t=2.92,P<0.01犦和伤后14d时非增生性瘢痕组织的PKA活性犤IFN-γ1组:(1.79±0.6)pmol/min·mg,t=2.59,P<0.05和IFN-γ2组:(     

体育运动对大学生心肺功能及运动能力的影响

目的:探讨体育运动对大学生心肺功能及其运动能力的影响。方法:利用美国产心肺功能测试系统对2004-03在徐州师范大学体育学院经常参加体育运动的大学生16人(运动组)和不经常参加体育运动的大学生16人(对照组)心肺功能的测试。结果:运动组安静时心率犤(73.7±11.4)次/min犦显著低于对照组犤(92.3±12.8)次/min犦,最大心输出量、最大吸氧量、最大通气量犤(分别为(20.11±2.83),(3.49±0.44),(114.35±10.21)L/min犦均显著高于对照组犤(16.78±1.19),(2.81±0.38),(102.11±8.56)L/min犦。运动组与对照组在运动时身体工作能力明显不同,运动组持续运动时间犤(16.24±2.34)min犦显著高于对照组犤(13.70±1.84)min犦(t=3.41,P<0.01);运动组能够达到最大运动强度犤(5.49±0.65)级犦,显著高于对照组犤(4.54±0.59)级犦(t=4.33,P<0.01)。结论:体育运动能够提高大学生的心肺功能,增强运动能力,达到强身健体的作用。     

家族聚集性脑梗死发病与低密度脂蛋白胆固醇的相关性

目的:探讨血脂水平与脑梗死的关系。方法:检测和比较40例家系中无脑卒中史的普通脑梗死(CI)患者、26例家族中有明确脑梗死先证者的家族聚集性脑梗死(FMACI)患者和90例江苏地区无血缘关系的健康汉族人群的总胆固醇、三酰甘油、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)和脂蛋白(a)犤Lp(a)犦的血清含量。结果:FMACI组血清总胆固醇(5.80±0.81)mmol/L,LDL-C(3.47±0.82)mmol/L,ApoB(1.17±0.14)g/L,Lp(a)(0.36±0.11)g/L分别较CI组犤(5.53±0.74),(3.30±0.70)mmol/L,(1.09±0.16),(0.29±0.10)g/L犦有升高趋势,并且均明显高于对照组犤(4.79±0.72),(2.57±0.70)mmol/L,(0.87±0.17),(0.20±0.15)g/L犦(F=25.94,23.43,46.85,17.70,P<0.01);HDL-C在对照组、GI组、FMACI组分别为犤(1.46±0.38),(1.34±0.28),(1.07±0.30)mmol/L犦(F=12.91,P<0.01);FMACI组HDL-C水平明显低于对照组和CI组(分别为P<0.01和P<0.05),而后两组间差异无显著性意义。结论:脂质代谢异常与脑梗死密切相关,LDL-C促发脑梗死的发生,尤其与家族聚集性脑梗死的发病似有更大的相关性,HDL-C对脑梗死的发生有保护作用。     

儿童法乐氏四联症手术后运动功能自然恢复与运动状态的关系

目的:了解法乐氏四联症(tetralogyofFallot,TF)儿童手术后运动功能的自然恢复及其与运动量的关系。方法:对44例TF根治手术后4.0～8.5年的儿童运动量分级同时进行踏车运动试验,记录最大运动功量(maximumworkcapacity,MWC)及MWC时的心率,收缩压和舒张压,并与25例年龄,性别相当的正常儿童进行比较。结果:TF儿童手术后的MWC犤(92.9±32.4)W犦明显低于对照组犤(136.4±39.1)W犦,差异有显著性(t=3.55,P<0.01),达MWC时的心率犤(165±19)次/min犦和收缩压犤(129±14.2)mmHg犦亦明显低于对照组(t=2.09,2.32,P<0.05)。MWC及达MWC时的心率和收缩压与运动耐量分级有关,运动量为Ⅰ～Ⅱ级的儿童,其MWC犤(73.8±21.3)W犦、心率犤(155±21)次/min犦和收缩压犤(121±7.2)mmHg犦不仅低于对照组(t=2.73～3.48,P<0.01)而且低于运动量为Ⅲ～Ⅳ级的儿童(t=2.12～3.24,P<0.05～0.01)。结论:手术治疗不能使TF儿童的运动耐量达到正常,康复训练可能有利于整体运动和心血管功能的恢复。     

偏头痛患者血浆同型半胱氨酸的变化及意义

目的:测定偏头痛患者及正常人同型半胱氨酸水平,评价同型半胱氨酸水平在偏头痛诊断治疗中的意义。方法:收集38例无先兆或有先兆的偏头痛患者及40例健康人血液标本,采用高效液相色谱法测定血浆同型半胱氨酸水平,放射免疫检测法测定血浆维生素B12和叶酸水平,比较二者间差异。结果:偏头痛组血浆同型半胱氨酸主要分布8mmol/L以上范围,均值为(11.4±3.6)mmol/L。对照组主要分布在4.9～8.0mmol/L,均值为(6.6±1.1)mmol/L,两组比较差异有显著性意义(t=2.03,P<0.001)。而偏头痛组平均血浆维生素B12犤(124.8±38.6)pmol/L犦及叶酸水平犤(9.9±3.9)nmol/L犦较对照组犤(267.4±64.8)pmol/L,(25.8±7.8)nmol/L犦显著下降(t=3.56,t=2.69,P<0.001),对照组及病例组维生素B12、叶酸与同型半胱氨酸水平呈显著负相关(r=-0.33～-0.50,P<0.001)。结论:血浆同型半胱氨酸水平升高与偏头痛发生有关。     

施普善对D-半乳糖拟衰老小鼠学习记忆功能的影响

目的:探讨施普善对D-半乳糖拟衰老小鼠学习记忆能力的影响及其机制。方法:采用D-半乳糖诱导的脑老化小鼠动物模型,分别用游泳水迷宫测定小鼠学习记忆能力;用化学发光法测定超氧化物歧化酶(SOD)活性;用硫代巴比妥酸比色法测定丙二醛含量。结果:D-半乳糖模型组小鼠的游泳时间明显延长犤(44.91±12.86)s犦、正确次数明显降低犤(2.58±1.87)次/d犦,与正常对照组犤(28.11±12.75)s,(4.33±1.72)次/d犦相比,差异有显著性意义(t=3.694,t=3.258,P<0.01)。应用施普善6周后,其大、中剂量组小鼠的游泳时间明显降低犤(28.06±13.06),(27.85±13.21)s犦,正确次数明显增加(4.58±1.66),(4.63±1.81)次/d犦,与D-半乳糖组相比,差异均有显著性意义(t=3.574,3.508;t=3.416,3.349,P<0.01);并能显著提高脑组织中SOD的活性犤(30232.38±5133.53),(29653.26±4878.64)nkat犦,降低丙二醛含量犤(630.00±59.40),(626.74±49.68)nmol/g犦,与D-半乳糖组犤(22892.74±4540.07)nkat,(749.69±92.80)nmol/g犦相比,差异均有显著性意义(t=3.418,3.277;t=3.168,3.337,P<0.01)。结论:施普善能明显的改善D-半乳糖诱导的脑老化小鼠学习记忆能力,提高脑组织中SOD的活性,降低丙二醛的含量。     

湖北地区汉族人群动脉硬化性脑梗死与载脂蛋白(a)5''''调控区(TTTTA)n基因多态性的关系

背景载脂蛋白(a)具有促进动脉粥样硬化斑块形成的作用,在载脂蛋白(a)5'存在一个五核苷酸重复序列(pentanuclotide repeats,PNR),对研究遗传和预测动脉硬化性脑梗死(atherosclerosis cerebral infarction,ACI)的危险性具有一定的价值,但在不同人种中与ACI的关系尚处在探索阶段,载脂蛋白(a)PNR基因多态性在汉族人群ACI发病中的意义如何?目的研究载脂蛋白(a)PNR基因多态性与ACI的关系.设计以湖北地区汉族ACI患者和正常人群为研究对象的病例-对照研究.单位一所大学医院的检验科.对象选择1998-02/1999-03武汉大学中南医院和武汉大学亚太医院神经内科确诊的ACI患者82例(ACI组)及健康体检者153例(对照组),均为无血缘关系的湖北地区汉族人.方法对所有受试者分别检测血清脂蛋白(a)、总胆固醇、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(ligh density lipoprotein cholesterol,LDL-C)、三酰甘油、载脂蛋白AⅠ及载脂蛋白B水平.同时采用聚合酶链反应结合高压聚丙烯酰胺凝胶电泳检测载脂蛋白(a)5'调控区五核苷酸重复序列基因多态性,并加以对照分析.结果ACI患者脂蛋白(a)[(239.9±225 4)mg/L]、总胆固醇[(4.76±0.74)mmol/L]、三酰甘油[(1.74±0.60)mmol/LI、LDL-C[(2.84±0.63)mmol/L]水平明显高于对照组[(133.5±97.7)mg/L,(4.29±0.72)mmol/L,(1.05±0.52)mmol/L,(2.84±0.63)mmol/L],HDL-C水平[(0.88±0.17)mmol/L]明显低于对照组[(1.03±0.35)mmol/L],差异均有显著性意义(t=3.65～9.18,P均＜0.01),载脂蛋白A Ⅰ[(1.13±0.15)和(1.25±0.19)mmol/L]、载脂蛋白B[(0.93±0.12)和(0.89±0.15)mmol/L],与对照组比较差异无显著性意义;ACI组中重复序列数为5的等位基因频率(0.098)明显高于正常对照组(0.026),差异有显著性意义(x2=5.62,P＜0.05),重复序列数为9的等位基因频率(0.073)明显低于对照组(0.213),差异有显著性意义(x2=7.83,P＜0.01),且重复序列数为5的等位基因还与血浆TC下降和Lp(a)升高有关联.结论提示Apo(a)PNR基因多态性与人群易感ACI有关,可能在一定程度上参与ACI的发生和发展过程.     

Effects of atorvastatin 10 mg and fenofibrate 200 mg on the low-density lipoprotein profile in dyslipidemic patients: A 12-week, multicenter, randomized, open-label, parallel-group study

Background: Elevated plasma low-density lipoprotein cholesterol (LDL-C) concentrations are highly atherogenic, especially the small, dense LDL (sdLDL) species. Fenofibrate has been reported to shift the LDL profile by decreasing the sdLDL subfraction and increasing larger LDL subclasses. Atorvastatin, anantihyperlipidemic agent, has been reported to reduce plasma total cholesterol (TC) and triglyceride (TG) concentrations and thus could modify the LDL profile.Objective: The aim of this study was to compare the effects of fenofi brate and atorvastatin on standard lipid concentrations and the LDL profile.Methods: In this randomized, open-label, parallel-group study, men and women aged 18 to 79 years with type II primary dyslipidemia, defined as LDL-C ≥160 and TG 150 to 400 mg/dL, after a 4- to 6-week washout period while eating an appropriate diet, were randomized to receive either atorvastatin 10 mg once daily or fenofi-brate 200 mg once daily. Plasma lipid concentrations and cholesterol and apolipoprotein (apo) B (reflecting the LDL particle number) in each LDL subfraction prepared by ultracentrifiigation were determined at baseline and after 12 weeks of treatment. Tolerability was assessed using adverse events (AEs) obtained on laboratory analysis and vital sign measurement. Adherence was assessed by counting unused drug supplies.Results: A total of 165 patients (117 men, 48 women; mean [SD] age, 50.1 [10.7] years; mean TC concentration, 289 mg/dL) were randomized to receive atorvastatin (n = 81) or fenofibrate (n = 84). Compared with fenofibrate, atorvastatin was associated with a significantly greater mean (SD) percentage decrease in TC (27.0% [12.3%] vs 16.5% [12.9%]; P < 0.001), calculated LDL-C (35.4% [15.8%] vs 17.3% [17.2%]; P < 0.001), TC/high-density lipoprotein cholesterol (HDL-C) ratio (29.1% [16.3%] vs 22.9% [15.9%]; P = 0.001), and apoB (30.3% [12.7%] vs 19.6% [15.5%]; P < 0.001). Compared with atorvastatin, fenofibrate was associated with a significantly greater decrease in TG (37.2% [25.9%] vs 20.2% [27.3%]; P < 0.001) and a significantly greater increase in HDL-C concentration (10.4% [15.7%] vs 4.6% [12.1%]; P = 0.017). Fibrinogen concentration was significantly different between the 2 groups (P = 0.002); it was decreased with fenofibrate use (4.6% [23.7%]) and was increased with atorvastatin use (5.7% [23.5%]). Atorvastatin did not markedly affect the LDL distribution; it was associated with a homogeneous decrease in cholesterol and apoB concentrations in all subfractions, whereas fenofibrate was associated with a marked movement toward a normalized LDL profile, shifting the sdLDL subfractions toward larger and less atherogenic particles, particularly in those patients with baseline TG ≥200 mg/dL. No serious AEs related to the study treatments were reported. A total of 5 AEs were observed in 8 patients, including: abdominal pain, 3 patients (2 in the atorvastatin group and 1 in the fenofibrate group); abnormal liver function test results, 1 (fenofibrate); increased creatine Phosphokinase activity, 2 (atorvastatin); gastrointestinal disorders, 1 (fenofibrate); and vertigo, 1 (fenofibrate).Conclusion: In these dyslipidemic patients, fenofibrate treatment was associated with an improved LDL subfraction profile beyond reduction in LDL-C, particularly in patients with elevated TG concentration, whereas atorvastatin was associated with equally reduced concentrations of cholesterol and apoB in all LDL subfractions independent of TG concentrations.     

载脂蛋白E基因多态性与青年动脉粥样硬化性脑梗死的关系(英文)

目的分析载脂蛋白E(ApoE)基因在青年动脉粥样硬化性脑梗死(ACI)患者与正常人群中的分布,探讨这些基因多态性在青年脑梗死发病中的意义。方法ACI患者组:36例ACI患者为中国医科大学附属第二医院神经内科住院患者,男30例,女6例。对照组:自愿健康体检沈阳籍汉族100例,男66例,女34例。用PCR技术检测其ApoE基因多态性,分析等位基因分布及其与血脂、脂蛋白含量的关系。结果(1)ACI组ε3/4型频率、ε2/4型频率和ε4等位基因频率均明显高于对照组(χ2=4.14,5.09,4.48,P<0.05)。(2)ε4等位基因引起血清三酰甘油(TG)、总胆固醇(TC)、脂蛋白(a)犤Lp(a)犦升高及高密度脂蛋白(HDL-C)降低的发病风险率(RR)依次为8.23,4.85,4.39,29.9(χ2=16.0,8.76,7.89,16.7,P<0.01～0.001)。结论ApoE基因多态性影响血脂、脂蛋白代谢;ApoE等位基因ε4与青年ACI关系密切,是一种遗传易感性因子。     

动脉硬化性脑梗死相关生化指标分析

目的探讨同型半胱氨酸(Hcy)及血脂代谢指标与动脉硬化性脑梗死(atherosclerotic cerebral infarction,ACI)的关系。方法选择我院明确诊断的ACI 150例(ACI组)及同期健康体检的140例(对照组)同时行血清Hcy、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯(TG)、脂蛋白(a)〔Lp(a)〕、载脂蛋白(Apo)A1、ApoB、超敏C反应蛋白(hs-CRP)检测,并进行对比分析。结果 ACI组血清Hcy、Lp(a)及TC、hs-CRP、LDL、TG、ApoB水平均高于对照组,血清中HDL水平低于对照组,组间比较差异均有统计学意义(P<0.05,P<0.01);ACI组Hcy、Lp(a)、TC、LDL、TG、hs-CRP阳性检出率明显高于对照组,差异有统计学意义(P<0.05,P<0.01)。结论血浆Hcy、hs-CRP和血脂相关指标变化与ACI密切相关,及早检测对ACI的预防及治疗有重要意义。     

老年痴呆患者的血脂水平分析

目的 收集郴州市精神病医院老年科阿尔茨海默病(AD)又称为老年性痴呆患者的血脂指标,以期发现本地区人群中AD患者血脂水平的特点.方法 选取AD患者206例,健康对照267名,于清晨对AD患者及健康对照采集空腹静脉血,分离血清,采用全自动生物化学分析仪直接法测定血脂指标,并对数据进行统计分析.结果 (1)AD组血浆胆固醇水平低于对照组,差异有统计学意义,u=12.33,P<0.01.(2)女性AD组血浆三酰甘油水平高于对照组,差异有统计学意义,u=2.32,P<0.05,男性AD组血浆三酰甘油水平低于对照组,差异有统计学意义,u=4.29,P<0.01.(3)AD组血浆高密度脂蛋白水平低于对照组,差异有统计学意义,u=16.64,P<0.01.(4)AD组血浆低密度脂蛋白水平低于对照组,差异有统计学意义,u=14.52,P<0.01.结论 郴州地区AD患者血浆胆固醇、高密度脂蛋白、低密度脂蛋白水平均降低,女性AD患者血浆三酰甘油水平增高,而男性AD患者血浆三酰甘油水平降低.     

Effects of atorvastatin and simvastatin on low-density lipoprotein subfraction profile, low-density lipoprotein oxidizability, and antibodies to oxidized low-density lipoprotein in relation to carotid intima media thickness in familial hypercholesterolemia.

BACKGROUND: Little is known about the effects of statins on the quality of circulating low-density lipoprotein (LDL) in relation to atherosclerosis progression. METHODS: In a double-blind, randomized trial of 325 patients with familial hypercholesterolemia (FH), we assessed the effects of high-dose atorvastatin (80 mg) and conventional-dose simvastatin (40 mg) on LDL subfraction profile (n = 289), LDL oxidizability (n = 121), and circulating autoantibodies to oxidized LDL (n = 220). Progression of atherosclerosis was measured by carotid intima media thickness (IMT) (n = 325). RESULTS: At baseline, the patients showed an intermediate LDL subfraction profile composed of three LDL subfractions (LDL1, LDL2, LDL3), with LDL2 as the predominant subfraction. A strong negative correlation was found between plasma triglycerides and the LDL subfraction profile (r = -.64, p = .000). Both plasma levels of triglycerides and small dense LDL3 correlated weakly with baseline IMT (r = .11, p = .04 and r = .15, p = .01, respectively; n = 289). No association was found between baseline IMT and oxidation parameters or circulating antibodies to oxidized LDL. Atorvastatin reduced triglycerides, LDL cholesterol, and all LDL subfractions to a greater extent than did simvastatin and led to regression of carotid IMT. However, LDL subfraction pattern and plasma levels of autoantibodies to oxidized LDL remained unchanged in both treatment groups, and LDL oxidizability increased minimally to a similar extent in both groups. Significant treatment differences were found for the rate of in vitro oxidation of LDL and the amount of dienes formed during in vitro oxidation of LDL, which both decreased more following atorvastatin than after simvastatin. CONCLUSION: Change of IMT after statin treatment was associated with baseline IMT (r = .41), LDL cholesterol (r = -.20), and the amount of dienes formed during in vitro oxidation of LOL (r = .28) but not with plasma levels of antibodies to oxidized LDL, in vitro LDL oxidizability, and LDL subfraction profile.     

Heterogeneity of low-density lipoproteins in cholesterolosis of the gallbladder and cholelithiasis

The heterogeneity of serum low-density lipoproteins (LDL) was studied in patients with cholelithiasis (CL) and gallbladder cholesterolosis (GBC). Native gradient (3-12%) polyacrylamide gel electrophoresis was used, followed by densitometric scanning and analysis; a correlation analysis of the levels of cholesterol levels, the body-mass index (BMI), and age was made. Various heterogeneity of LDL was revealed in CL and GBC. In the group of patients with GBC, the subfraction spectrum of LDL was characterized by a predominance of minor dense particles of LDL (Rf = 0.171 +/- 0.003), which significantly differed from that in the patients with CL (Rf = 0.146 +/- 0.004) and the controls (Rf = 0.144 +/- 0.013, p < 0.05). The increased levels of total cholesterol were associated with the changes in the subfraction spectrum of LDL with a moderate correlation (r = 0.596 and r = 0.343, respectively). However, a correlation was found between the variability of LDL, BMI, and age (r = 0.533 and r = 0.363, respectively) whereas in GBC it was absent (r = 0.148 and r = 0.117). The findings suggest that the minor dense subfractions of LDL are a risk factor for GBC irrespective of age and body mass. The modified minor particles of LDL more rapidly penetrate than other LDL fractions into the gallbladder tissue, where the gallbladder wall is intensively captured by macrophages, and participate in the formation of foamy cells. In CL, the increase in total cholesterol levels is not followed by so marked changes in the structure of LDL. The much lower proportion of minor dense particles that are components of LDL is a cause of the low entry of apolipoproteins into the gallbladder wall in CL as compared with GBC.     

2型糖尿病患者动脉粥样硬化病变与血清CTRP3和CTRP9水平的相关性研究

目的探讨2型糖尿病(T2DM)患者血清 C1q/TNF 相关蛋白3(C1q tumor necrosis factor related protein 3,CTRP3),C1q/TNF相关蛋白9(C1q tumor necrosis factor related protein 9,CTRP9)与动脉粥样硬化病变(atherosclerosis,AS)的相关性。方法随机选取2014年1月~2015年1月陕西省人民医院内分泌科住院的成人新发T2DM患者196例,入选T2DM组,并根据颈动脉彩色多普勒超声结果将其分为糖尿病伴动脉粥样硬化组(AS组,71例)和单纯糖尿病组(非AS组,125例),另外随机选取同期健康体检者152例作为正常对照组,测定所有受试者的体重指数(BMI),腰围(WC),臀围(HIP),腰臀比(WHR),收缩压(SBP),舒张压(DBP),空腹血糖(FBG),餐后2h血糖(2hPBG),糖化血红蛋白(HBA1c),三酰甘油(TG),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),CTRP3及CTRP9。结果①T2DM组血清与正常对照组比较CTRP3(0.67±0.34 ng/ml vs 0.99±0.32 ng/ml),CTRP9(9.04±3.11 ng/ml vs 12.11±2.89 ng/ml),HDL-C(1.48±0.27 mmol/L vs 1.23±0.57 mmol/L),FBG(4.62±0.53 mmol/L vs 9.41±2.61 mmol/L),2hPBG(5.90±0.80 mmol/L vs 11.55±3.20 mmol/L),HBA1c(4.86±0.45 mmol/L vs 8.79±2.14 mmol/L),LDL-C(2.48±0.36 mmol/L vs 3.58±0.89 mmol/L),TC(3.64±1.10 mmol/L vs 5.77±0.97 mmol/L),TG(1.23±0.34 mmol/L vs 1.71±0.75 mmol/L)差异有统计学显著性意义(t=-13.069~5.88,P值均<0.01)。②AS组与非AS组比较CTRP3(0.67±0.34 ng/ml vs 0.99±0.32 ng/ml),CTRP9(9.04±3.11 ng/ml vs 12.11±2.89 ng/ml),年龄(55.82±8.80岁 vs 62.49±6.54岁)差异有统计学显著性意义(t/χ2=0.036~7.345,P值均<0.01),两组血清TC(5.61±0.90 mmol/L vs 6.05±1.02 mmol/L),LDL-C(3.44±0.80 mmol/L vs 3.83±1.01 mmol/L)差异亦有统计学显著性意义(t=-2.083~-2.197,P值均<0.05)。③相关性研究:CTRP3与WC(r=-0.932),DBP(r=-0.932),FBG(r=-0.856),TG(r=-0.728),TC(r=-0.920)呈负相关(P值均<0.01),CTRP9和年龄(r=-0.958)呈负相关(P值均<0.01),与HDL-C(r=0.860)呈正相关(P<0.01)。④多元逐步回归分析:WC,DBP,FBG是CTRP3的独立危险因子(P<0.01),年龄,HDL-C是CTRP9的独立危险因子(P<0.01)。结论CTRP3,CTRP9可能具有抗动脉粥样硬化作用,是糖尿病动脉粥样硬化的保护因子。     

血脂代谢紊乱与中青年脑梗死危险因素的相关性分析

目的探讨血脂与中青年人脑梗死的关系. 方法检测了 111例中青年人脑梗死患者及 80例对照者的三酰甘油、总胆固醇、高密度脂蛋白胆固醇 (High density lipoprotein cholesterol, HDL-C)、低密度脂蛋白胆固醇 (Low density lipoprotein cholesterol,LDL-C)、载脂蛋白 A-I(apolipoproteinA-I,ApoA-I)、载脂蛋白 B100(apolipoprotein B100, ApoB100)和脂蛋白 (a)血清含量. 结果脑梗死组三酰甘油 [(1.92± 1.33)mmol/L],总胆固醇 [(5.21± 1.08)mmol/L],LDL-C[(3.13± 0.96)]mmol/L,ApoB100[(1.10± 0.29)g/L]及脂蛋白 (a)[(0.23± 0.18)]g/L水平高于对照组 (t=2.523～ 3.796,P< 0.05),总胆固醇与年龄呈正相关 [青年 (4.96± 1.14)mmol/L,中年 (5.27± 1.06)mmol/L], HDL-C与年龄呈负相关 [青年 (1.39± 0.43)mmol/L,中年 (1.26± 0.35)mmol/L].亚组分析发现青年人脑梗死亚组的脂蛋白 (a)水平和中年人脑梗死亚组的三酰甘油、总胆固醇、 LDL-C、 ApoB100及脂蛋白 (a)水平均显著高于相应的对照组 (t=2.571～ 4.107,P< 0.05);皮层支动脉闭塞亚组脂蛋白 (a)水平显著高于穿通支动脉闭塞亚组 (t=5.414,P< 0.01);首发脑梗死亚组与复发脑梗死亚组之间的血脂水平无显著差异. 结论血脂代谢紊乱是中青年人脑梗死的危险因素.