脑梗死患者脑脊液及血清中载脂蛋白的变化

目的 观察脑梗死患者脑脊液与血清中血脂及载脂蛋白的变化。方法 脑梗死患者110名，对照组60名，收集脑脊液及血清。总胆固醇及甘油三酯用酶法测定；载脂蛋白AⅠ及载脂蛋白B用单向免疫扩散法测定。高密度脂蛋白胆固醇及低密度脂蛋白胆固醇用氧化酶法测定，载脂蛋白E及脂蛋白（a）用酶联免疫法测定。结果 脑梗死组脑脊液中脂蛋白（a）、载脂蛋白AⅠ及载脂蛋白E明显高于对照组（P〈0．01及〈0．05），总胆固醇及甘油三酯两组间无明显差异（P〉0．05）。脑梗死组血清中总胆固醇、甘油三酯、载脂蛋白B、载脂蛋白E、低密度脂蛋白胆固醇、脂蛋白（a）明显高于对照组（P〈0．05）；载脂蛋白AⅠ、高密度脂蛋白胆固醇明显低于对照组（P〈0．05）。脑脊液与血清中，各项指标间未发现相关关系（P〉0．05）。结论 脑梗死组脑脊液中脂蛋白（a）、载脂蛋白AⅠ、载脂蛋白E明显高于对照组，TC、TG两组间无明显差异；血清中总胆固醇、甘油三酯、载脂蛋白B、载脂蛋白E、低密度脂蛋白胆固醇、脂蛋白（a）明显高于对照组，载脂蛋白AⅠ、高密度脂蛋白胆固醇明显低于对照组。脑脊液及血清中脂类无相关关系。     

他汀类药物对非ST段抬高的急性冠脉综合征患者血脂及炎性指标的短期影响

目的观察非ST段抬高的急性冠脉综合征（ACS）患者短期应用他汀类药物治疗后血脂、高敏C反应蛋白及纤维蛋白原水平的变化。方法患者均在住院后24h内开始接受药物治疗，他汀组60例（阿托伐他汀组30例、普伐他汀组30例）应用他汀类药物加阿司匹林、氯吡格雷治疗8周，对照组30例单用抗血小板药物，观察三组总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、高敏C反应蛋白和纤维蛋白原水平的变化。结果治疗8周后，阿托伐他汀组、普伐他汀组胆固醇及炎性指标均有显著变化，两组低密度脂蛋白胆固醇治疗后均达标（P均〈0．05）；而对照组仅高敏C反应蛋白水平显著下降（P〈0．05）。结论他汀类药物与抗血小板药物联用改善冠心病患者血脂及炎性指标效果良好。     

宁波地区冠心病病人低密度脂蛋白胆围醇基础水平及调脂疗效

目的观察经冠状动脉造影确诊为冠心病的住院病人血脂基础水平及经药物治疗病人的血脂水平．了解宁波地区冠心病病人的血脂状态及达标水平，并对其常规调脂药使用后疗效进行分析。方法经选择性冠状动脉造影确诊为冠心病者180例，观察使用日剂量阿托伐他汀10mg、辛伐他汀20mg、氟伐他汀40mg治疗3个月对调脂的疗效。结果他汀类治疗3月后，冠心病病人低密度脂蛋白胆固醇为（2．0±0．7）mmol／L．与治疗前比较，下降幅度差异有统计学意义（P〈0．001）。与其他他汀类比较，阿托伐他汀组低密度脂蛋白胆固醇下降幅度最明显（P〈0．05），而辛伐他汀组和氟伐他汀组低密度脂蛋白胆固醇相比，差异无统计学意义（P〉0.05）。结论宁波地区冠心病病人低密度脂蛋白胆固醇水平偏低，常规剂量他汀类药物即可达强化调脂目的。 4/38     

糖尿病高脂血症行依折麦布与瑞舒伐他汀联合治疗的疗效评价

选取54例血糖控制良好的糖尿病合并高脂血症患者,随机分为两组。对照组26例,给予瑞舒伐他10mg,每日1次;治疗组28例,给依折麦布与瑞舒伐他汀各10mg,每日1次。以总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL—C）和高密度脂蛋白胆固醇（HDL—C）为参数,3个月后比较两组治疗前后血脂谱水平。结果：两组的总胆固醇、甘油三酯、低密度脂蛋白胆固醇均较治疗前有显著下降（P〈0．05）,且治疗组较对照组明显（P〈0．01）,高密度脂蛋白胆固醇较治疗前显著升高（P〈0．05）。治疗组各项指标变化与对照组比较差异有统计学意义（P〈0．05）。结论：依折麦布联合瑞舒伐他汀较单用瑞舒伐他汀能更有效地改善糖尿病患者的血脂谱,是一种理想的降脂方案。     

血脂康治疗肾病综合征高脂血症的临床观察

目的 观察血脂康对肾病综合征高脂血症患者的临床疗效。方法 选择肾病综合征合并高脂血症患者50例，分为对照组20例，采用常规治疗；治疗组30例，在常规治疗基础上加用血脂康每天1．2g，服药前及服药8周后测定血脂、肝肾功能及尿蛋白等指标。结果 治疗组在服用血脂康8周后血清总胆固醇（TC）、低密度脂蛋白-胆固醇（LDL-C）和动脉硬化指数（P〈0．01）以及甘油三酯（TG）和载脂蛋白B（ApoB）显著降低（P〈0．05）；高密度脂蛋白-胆固醇（HDL-C）、载脂蛋白Al（ApoAl）和载脂蛋白E（ApoE）增加（P〈0．05）。同时，尿蛋白显著减少，血浆白蛋白升高，肝肾功能和肌酸激酶无明显变化。结论 血脂康能有效改善肾病综合征的各项血脂指标，使尿蛋白减少血浆白蛋白升高，而且使用方便、安全。     

颈动脉斑块患者血脂及心电图关系的分析

目的探讨颈动脉斑块病变与血脂、心电图的关系。方法按颈动脉超声检查结果将166例心脏病患者分成斑块组（A组）与无斑块组（B组）。比较两组血脂数值及心电图的变化。结果A组ST-T改变明显高于B组（P〈0．025）；血脂检查显示胆固醇（TC）、甘油三酯（TG）两组比较无明显差异（P〉0．05）；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（Apo）AI、B，两组比较P〈0．05；脂蛋白（a）[LP（a）]两组比较P〈0．01。结论血脂增高、尤其是高Lp（a）者，伴有ST-T改变与颈动脉斑块之间有明显相关性。     

海洋贝类综合提取物对实验性动脉粥样硬化的治疗作用

目的研究海洋贝类综合提取物对实验性动脉粥样硬化的治疗作用。方法先建立高脂食饵性鹌鹑动脉粥样硬化模型，然后经口服连续给予5、10及20g/kg海洋贝类综合提取物，于用药第2、4周末测定血清及主动脉和心肌中脂质含量，并对主动脉、冠状动脉和肝脏进行肉眼及光镜组织学检查。结果用药2周后5、10及20g/kg海洋贝类综合提取物均可显著降低血清甘油三酯水平（P〈0．05及P〈0．01），20g/kg海洋贝类综合提取物组血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平明显降低，高密度脂蛋白胆固醇水平明显升高（P〈0．05）；用药4周后，5、10及20g/kg海洋贝类综合提取物组血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平明显降低（P〈0．05及P〈0．01），高密度脂蛋白胆固醇水平明显升高（P〈0．05及P〈0．01）；主动脉壁及心肌组织中总胆固醇、甘油三酯含量也明显降低（P〈0．05及P〈0．01）。病理检测结果发现鹌鹑冠状动脉、主动脉内膜粥样硬化斑块的病变程度较模型组明显减轻。结论海洋贝类综合提取物治疗用药具有降低高血脂，促进动脉粥样硬化消退作用。     

国人载脂蛋白E基因多态性与冠心病发病之间的相关性

目的 探讨载脂蛋白E基因112bp与158bp位点多态性与血脂水平及冠心病发生之间的关系。方法采用生物化学法分别测量经冠状动脉造影证实的89例冠心病患者及43例正常人空腹血脂水平，应用聚合酶链反应限制片长多态性分析方法对载脂蛋白E基因DNA244bp的5’末端片段进行限制性片段长度多态性分析。结果冠心病组甘油三酯、总胆固醇、低密度脂蛋白、载脂蛋白B及脂蛋白（a）水平均高于对照组（P〈0．05），而载脂蛋白A1水平则低于对照组（P〈0、05）；冠心病组载脂蛋白Eε2基因型频率明显为低（P〈0．001）。结论载脂蛋白E基因多态性特征会明显影响人群中个体的血浆脂质水平，从而增加人群中个体发生冠心病的危险。     

老年冠心病患者餐后高甘油三酯血症与颈动脉及股动脉粥样硬化的关系

探讨餐后血脂代谢异常与动脉粥样硬化的关系。47例冠心病患者及30例对照组禁食12－14h后，均接受低脂实验餐负荷试验。分别于空腹及餐后4h采血测定血清甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A及载脂蛋白B的浓度。利用二维彩色多普勒超声，检测两组颈动脉内膜中层厚度及颈动脉、股动脉斑块的发生状况。与对照组相比，冠心病组空腹血清总胆固醇、载脂蛋白B浓度显著增高，冠心病组餐后4h血清甘油三酯、低密度脂蛋白胆固醇浓度显著增高（P＜0．05），餐后血清高密度脂蛋白胆固醇浓度显著降低（P＜0．05）。冠心病组颈总动脉内膜中层厚度、颈内动脉内膜中层厚度、颈动脉及股动脉斑块指数均较对照组增高（P＜0．01）。餐后血清甘油三酯与空腹血清甘油三酯浓度呈正相关。颈动脉斑块指数与空腹总胆固醇呈正相关。提示餐后高甘油三酯血症可能与动脉粥样硬化有关。     

血浆脂质成分与冠状动脉病变支数和严重程度的相关性研究

目的研究冠状动脉病变支数和程度与血浆脂质成分的相关性。方法对664例反复发作胸闷、胸痛，拟诊冠心病的住院患者行冠状动脉造影。根据冠脉造影的结果分为正常组（90例）和病变组（574例，包括动脉粥样硬化组、单支病变组、双支病变组和三支病变组）；按Gensini标准对冠状动脉病变程度进行评分，并在入院时进行血浆脂质成分的测定。结果冠心病病变支数的增加与冠心病危险因素糖尿病、高血压、吸烟的增多呈一致性，各组中糖尿病患病率、高血压患病率、吸烟人数差异有统计学意义（P〈0．01）；病变组中载脂蛋白B（apoB）、非高密度脂蛋白胆固醇、低密度脂蛋白胆固醇（LDL—C）和甘油三酯与正常组比较差异有统计学意义（P〈0．05）；经Spearman相关分析表明，冠状动脉病变支数与apoB的相关系数最大（r=0．290），病变程度与apoB相关系数最大（r=0．211）。在排除他汀类药物对脂质的影响后，脂质指标与冠心病的相关性更加密切。结论血浆脂质成分中的apoB是冠心病发生与发展的相关因素，其对冠心病的预测作用可能优于LDL—C等其他脂质指标。     

颈动脉粥样斑块和脂质代谢的关系

目的探讨颈动脉粥样斑块和脂质代谢的关系方法检测９８例老年颈动脉粥样斑块患者和９８例正常老年人血浆中血脂、氧化低密度脂蛋白、丙二醛水平结果病例组中，总胆固醇、低密度脂蛋白胆固醇、载脂蛋白Ｂ、氧化低密度脂蛋白、丙二醛均高于对照组（Ｐ＜００５），载脂蛋白Ａ低于对照组（Ｐ＜００５）。结论脂质代谢异常，氧化低密度脂蛋白、丙二醛等参与老年人颈动脉粥样斑块的形成。     

进食淡水鱼对洞庭湖区人群血脂的影响

目的 :探讨淡水鱼在预防高脂血症中的价值。方法 :以长年生活在渔船上的渔民为试验组 ,当地农民为对照组。采空腹 12 h晨血检测血清胆固醇 (TC) ,甘油三酯 (TG) ,高密度脂蛋白 (HDL) ,载脂蛋白 A(apo A)和载脂蛋白 B(apo B)含量 ,然后对上述各项指标进行 t检验。结果 :试验组 TC、TG、apo B水平较对照组低 (P<0 .0 1) ,而 HDL、apo A及 apo A/ apo B比值较对照组明显升高 (P<0 .0 1)。结论 :长期进食淡水鱼能有效地调节血脂水平 ,这可能不失为一种有待开发的有效的冠心病一级预防措施。     

Changes of lipid metabolism in plasma, liver and bile during cholesterol gallstone formation in rabbit model

AIM To find out the relationship between the disturbances of lipid metabolism and the formation of cholesterol gallstones by studying the changes of lipid metabolism in plasma, liver tissue and the bile.METHODS Male and female white Japanese rabbits were divided randomly into a control group (Con) and four experimental groups of 10 rabbits each fed with a diet containing 1.2% cholesterol for one, two, three and four weeks (1wk, 2wk, 3wk and 4wk group). The measurement of plasma triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and its subfractions (HDL2-C, HDL3-C), very low and low density lipoprotein cholesterol (VLDL-C, LDL-C) was taken with standard enzymatic techniques. Apolipoprotein (apo) concentrations in plasma were measured by radial immunodiffusion assay for apoA1, apoB100, aopCⅡ and apoCⅢ. Total cholesterol of liver was measured by the enzymatic procedure for each animal. Bile acids, mainly glycocholate (GCA) and glycodeoxycholate (GDCA) were detected by dual wavelength thin layer scanner.RESULTS In all the experimental groups fed with dietary cholesterol, cholesterol crystal was found in the gallbladder in 2/10 cases of the 1wk group, 4/10 of the 2wk group, 6/10 of the 3wk group and 7/10 of the 4wk group respectively. The concentration of plasma total cholesterol (TC), triglyceride (TG), phospholipid (pl), VLDL-C, LDL-C, apoB100, apoCⅡ, apoCⅢ gradually increased (P＜0.05) with the prolonged feeding time of dietary cholesterol. High density lipoprotein cholesterol and its subfractions (HDL-C, HDL2-C, HDL3-C) showed a tendency to decrease, but without statistical significance (P＞ 0.05). ApoA1 was reduced with increased feeding time of dietary cholesterol (P ＜0.05). The hepatic and biliary cholesterol increased 1-1.5 times as compared with the control group (t=5.221 and 3.445, P＜0.05). The GCA gradually decreased beginning from the control group to the 4wk group (P＜0.05).CONCLUSION Owing to the high cholesterol diet, the increased concentrations of plasma TC, TG, VLDL-C, LDL-C, hepatic TC and TG, apoB100, apoCⅡ and apoCⅢ possibly enhanced the secretion of biliary cholesterol into bile; the decreased plasma apoA1 level might reduce the secretion of antinucleating factor into bile. All those factors mentioned above probably contribute to the formation of cholesterol gallstones.     

Association between paraoxonase-1 activity and lipid peroxidation indicator levels in people living in the Antalya region with angiographically documented coronary artery disease

Background: Paraoxonase‐1 (PON1) is a high‐density lipoprotein (HDL)‐associated enzyme capable of hydrolyzing lipid peroxides. Thus, PON1 plays a preventing role in atherosclerosis by protecting against lipid peroxidation. Hypothesis: The incidence of coronary artery disease (CAD) is high in the Turkish population, and many risk factors have been studied as determinants of CAD. In Turkish people living in the Antalya region, we aimed to determine serum PON1 activity and its relation to lipoproteins and lipid peroxidation markers. Methods: We measured the activity of serum PON1 together with concentrations of a variety of lipid constituents—total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C), very low‐density lipoprotein cholesterol (VLDL‐C), HDL cholesterol (HDL‐C), triglycerides (TG), apolipoprotein (apo) A‐I, apoB, and lipid peroxidation indicators (conjugated diene [CD] and thiobarbituric acid‐reactive substances [TBARS])—in 108 patients with CAD and 64 healthy subjects (controls). Results: We found that the PON1 activity was significantly reduced in patients with CAD (222.37 ± 11.31 IU/l)compared with controls (331.75 ± 20.98 IU/l). These patients had significantly lower HDL‐C, PON1/HDL‐C, apoA‐I, PON1/ApoA‐I, and ApoA‐I/ApoB, and higher LDL‐C, TC/HDL‐C, LDL‐C/HDL‐C, apoB, CD and TBARS than did controls. Total cholesterol and apoA‐I concentrations were significantly higher in women than in men in both groups. After multiple logistic regression analysis, TBARS (odds ratio [OR] 568.87; p = 0.000), age (OR 1.10; p = 0.000), gender (OR 4.58; p = 0.008), apoA‐I/apoB (OR 0.046; p = 0.003), and PON1/apoA‐I (OR 0.58; p = 0.007) were independently indicative of the presence of CAD. Conclusions: This is the first report of decreased serum PON1 activity and increased lipid peroxidation indicators (CD and TBARS) of patients with CAD living in Antalya, Turkey. Our results indicate that TBARS levels, age, gender, apoA‐1/ApoB, and PON1/apoA‐I ratios are important markers of CAD.     

辛伐他汀对高脂血症患者载脂蛋白E的影响

目的探讨辛伐他汀对高脂血症患者血清总载脂蛋白E(apoE)水平的影响。方法40例高脂血症患者每晚顿服辛伐他汀10mg4周,比较服药前后血清甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、apoA1、apoB、apoE及脂蛋白(a)〔Lp(a)〕水平的变化。结果用药后血清TC及TG分别下降21．3％及9．2％(P<0．001,<0．05),LDL-C下降24．7％(P<0．01),apoB及apoE分别下降13．8％及34．7％(P<0．05,<0．001),apoA1增加7．5％(P<0．05)。apoE下降幅值分别与其自身基础值和TG及LDL-C基础值呈正相关(P<0．01,<0．01,<0．05)。HDL-C呈增高趋势,Lp(a)改变无统计学差异。结论辛伐他汀能导致血清apoE水平显著下降其可能参与了抗动脉粥样硬化过程。     

Relationships between lipoprotein components and risk of myocardial infarction: age, gender and short versus longer follow-up periods in the Apolipoprotein MOrtality RISk study (AMORIS)

Objectives. Examine and compare lipoprotein components associated with fatal and nonfatal acute myocardial infarction (AMI) by time period in the Apolipoprotein MOrtality RISk (AMORIS) Study. Design. Prospective follow‐up study of nonfatal and fatal myocardial infarction through linkage with Swedish hospital discharge and Swedish mortality registers. Setting. Measurements of lipoprotein components from health check‐ups in the larger Stockholm area. Subjects. The AMORIS subjects (n = 149 121) free of AMI at blood sampling were followed from 1985 to 2002 with respect to n = 6794 first cases of AMI. Results. Hazard ratios of nonfatal and fatal AMI by lipoprotein parameters were highly significant and about equally strong in both genders. Apolipoprotein B (apoB), nonhigh density cholesterol and low density cholesterol predicted nonfatal AMI (NFAMI) better than fatal AMI, but high density cholesterol or apolipoprotein A‐1 did not. Atherogenic components were weaker predictors after 1997 than before. In multivariate analyses apoB/apoA‐1 was a better predictor than TC/HDL‐C. ApoB/apoA‐1 added clinically significant information to TC/HDL‐C in men as reflected by a net reclassification improvement (NRI) of 9.4% (P < 0.0001). Conclusion. ApoB, apoB/apoA‐1 and non‐HDL‐C were found about equally predictive with LDL‐C being slightly less, but multivariate analyses showed apoB/apoA‐1 to be the strongest predictor. Attenuation of prediction ability between nonfatal and fatal AMI may be due to modern treatment of CHD after a NFAMI and attenuation of hazard ratios after 1997 may be due to selection of lower risk subjects surviving to 1997.     

血管紧张素转化酶基因多态性对血清血管紧张素转化酶水平及血脂的影响

为探讨血管紧张素转化酶基因多态性对本地人群高血压患者和正常人血清血管紧张素转化酶及血脂水平的影响,采用聚合酶链反应技术,对118例高血压患者和98例正常人的血管紧张素转化酶基因插入/缺失多态性进行分型,并检测血清血管祭张素转化酶活性及血脂含量。结果发现,高血压组血管紧张素转化酶三种基因型(缺失纯合子型、插入纯合子型和杂合子型)及插入/缺失等位基因的频率与正常对照组比较差异无统计学意义(X2=0.468,P=0.791;X2=0.379,P=0.538)。血清血管紧张素转化酶活性在三种基因型之间差异有显著性意义(F=17.107,P=0.000)。高血压组总胆固醇、低密度脂蛋白胆固醇、脂蛋白(a)高于正常对照组(P<0.05);高血压组三种基因型之间血脂各指标含量及正常对照组三种基因型之间总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和载脂蛋白B含量差异有显著性意义(P<0.05)。此结果提示,血管紧张素转化酶基因多态性与血清血管肾张素转化酶活性及血脂含量有关,缺失纯合子型高血压患者血清血管紧张素转化酶活性最高且易患高脂血症。     

脂质代谢水平与冠状动脉粥样硬化病变的关系

目的探讨脂质代谢水平与冠状动脉粥样硬化病变的关系。方法回顾性分析182例疑似冠状动脉粥样硬化病变患者的资料,均实施冠状动脉数字减影血管造影(DSA)检查,将有冠状动脉粥样硬化病变者列为研究组,否则列为对照组。检测受试者血浆甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、载脂蛋白AⅠ(ApoAⅠ)、载脂蛋白B(ApoB)水平,采用Logistic逐步回归分析探讨这些指标与冠状动脉粥样硬化病变的关系;根据研究组Gensini积分分组,对比Gensini积分<20分、20~40分、>40分患者脂质代谢水平差异;采用Pearson相关性分析法评价研究组脂质代谢指标水平与Gensini积分的相关性。结果受试者中冠状动脉粥样硬化病变检出率为59.34%,且研究组血浆HDLC、ApoAⅠ水平均低于对照组(P<0.05),TG、TC、LDLC、ApoB水平均高于对照组(P<0.05);研究组年龄≥80岁、合并高血压、合并2型糖尿病、合并高脂血症、肥胖、吸烟史、饮酒史、TG>2.3 mmol/L、TC>5.98 mmol/L、HDLC<1.2 mmol/L、LDLC>3.1 mmol/L、ApoAⅠ<1.02 g/L、ApoB>1.14 g/L占比均高于对照组(P<0.05),且均是冠状动脉粥样硬化病变的危险因素。研究组中不同Gensini积分患者血浆ApoAⅠ、ApoB水平对比差异均有统计学意义(P<0.05),血浆HDLC、ApoAⅠ水平在Gensini积分<20分组最高,20~40分组稍低,>40分组最低,而血浆TG、TC、LDLC、ApoB水平在Gensini积分>40分组最高,20~40分组次之,<20分组最低;研究组中血浆HDLC、ApoAⅠ与Gensini积分呈负相关(r=-0.842,P=0.023;r=-0.789,P=0.007),TG、TC、LDLC、ApoB水平与Gensini积分呈正相关(r=0.798,P=0.004;r=0.812,P=0.015;r=0.803,P=0.008;r=0.808,P=0.013)。结论在冠状动脉粥样硬化病变患者中血浆HDLC和ApoAⅠ水平偏低,TG、TC、LDLC、ApoB水平偏高,均可增加冠状动脉粥样硬化病变发生风险,且前者与Gensini积分呈负相关,后者与Gensini积分呈正相关。     

活动期系统性红斑狼疮患者脂代谢紊乱与重要脏器损害的关系探讨

目的 探讨活动期系统性红斑狼疮(SLE)患者血脂水平变化与脏器损害的关系.方法 收集71例活动期SLE患者和30名健康对照者临床资料,分析血脂变化.结果 活动期SLE患者平均血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、载脂蛋白B100(apoB)水平均高于健康对照组,高密度脂蛋白胆固醇(HDL)、apoA1水平显著低于健康对照组(P<0.05或P<0.01).有重要脏器损害患者的病程较长,血清TC、TG、LDL和apoB水平显著高于无脏器损害患者(P<0.05或P<0.01),尤其并发心血管病患者更明显(P<0.01).TC、TG、LDL、apoB水平与病程呈正相关(P<0.05或P<0.01),与C3水平呈负相关(P<0.05或P<0.01),TC和LDL与C4水平呈负相关(P<0.05).结论 活动期SLE患者存在严重脂代谢紊乱,且脂代谢紊乱与病程、疾病活动性和重要脏器损害密切相关.     

Apolipoprotein B/A-I and total cholesterol/high-density lipoprotein cholesterol ratios both predict cardiovascular events in the general population independently of nonlipid risk factors, albuminuria and C-reactive protein

Kappelle PJWH, Gansevoort RT, Hillege JL, Wolffenbuttel BHR, Dullaart RPF on behalf of the PREVEND study group (University Medical Center Groningen and University of Groningen, Groningen, The Netherlands). Apolipoprotein B/A‐I and total cholesterol/high‐density lipoprotein cholesterol ratios both predict cardiovascular events in the general population independently of nonlipid risk factors, albuminuria and C‐reactive protein. J Intern Med 2011; 269 : 232–242. Abstract. Background. The total cholesterol/high‐density lipoprotein cholesterol (TC/HDL‐C) and apolipoprotein (apo) B/A‐I ratios predict major adverse cardiovascular events (MACEs). The extent to which these associations are modified by high‐sensitivity C‐reactive protein (hs‐CRP) and albuminuria is largely unknown. We compared the strength of these ratios with first MACE in the general population and determined whether these associations remain when taking account of these risk markers. Subjects and methods. A prospective case–cohort study was performed among 6948 subjects (PREVEND cohort) without previous cardiovascular disease and who did not use lipid‐lowering drugs initially. Fasting serum TC, low‐density lipoprotein cholesterol (LDL‐C), HDL‐C, non‐HDL‐C, apoB, apoA‐I, triglycerides, hs‐CRP and albuminuria were measured at baseline. The composite endpoint was incident MACE. Results. A total of 362 first cardiovascular events occurred during 7.9 years of follow‐up. All pro‐ and anti‐atherogenic measures of lipoproteins and apos predicted MACEs in age‐ and sex‐adjusted Cox proportional hazard analyses (P = 0.018 to P < 0.001). The age‐ and sex‐adjusted hazard ratio (HR) was 1.37 [95% confidence interval (CI), 1.26–1.48] for the apoB/apoA‐I ratio and 1.24 (95% CI, 1.18–1.29) for the TC/HDL‐C ratio (both P < 0.001). These relationships were essentially unaltered after additional adjustment for triglyceride levels. Pair‐wise comparison revealed that these ratios were of similar importance in age‐ and sex‐adjusted analysis (P = 0.397). The HRs of apoB/apoA‐I (P < 0.001) and TC/HDL‐C (P < 0.001) for risk of MACEs were only marginally attenuated by additional controlling for traditional risk factors (hypertension, diabetes, obesity and smoking), hs‐CRP and albuminuria. Conclusions. First MACE is associated with both the fasting serum apoB/apoA‐I ratio and the TC/HDL‐C ratio in the general population, independently of triglycerides, hs‐CRP and albuminuria.