高脂血清对人内皮细胞前列环素、脂质过氧化物的影响及维生素E的保护作用

实验比较了高脂兔血清（ＨＲＳ）和正常兔血清（ＮＲＳ）对培养的人脐静脉内皮细胞（ＥＣ）脂质过氧化物（ＬＰＯ）的形成和ＥＣ利用外源性花生四烯酸（ＡＡ）合成前列环素（ＰＧＩ２）能力的影响；同时观察了抗氧化剂ＶｉｔＥ对ＥＣ的保护作用。结果表明，ＨＲＳ对ＥＣ合成ＰＧＩ２的影响有一时间和浓度相关的反应过程。用ＨＲＳ孵育培养呈融合状的ＥＣ，在４８ｈ前刺激ＰＧＩ２的产生，４８ｈ达最高值，然后急骤下降；而ＬＰＯ含量随着孵育时间的延长呈直线上升（ｒ＝０．９８７）。随着ＨＲＳ浓度的增加，ＬＰＯ含量逐渐升高，ＥＣ合成ＰＧＩ２能力呈下降趋势。ＶｉｔＥ可阻止ＨＲＳ引起的ＥＣ中ＬＰＯ含量的增加和ＰＧＩ２合成能力的下降。     

石榴叶鞣质对高血脂高血糖模型动物脂代谢的影响

目的 :观察石榴叶鞣质对高脂模型鼠脂代谢的影响 ,以及体外对HMG CoA还原酶的抑制作用。方法 :造大鼠高脂模型 ,以四氧嘧啶诱导高血糖伴高血脂小鼠模型 ,检测TC、TG等生化指标 ;制备大鼠肝微粒体HMG CoA还原酶液 ,测 1min内A34 0nm的变化。结果 :石榴叶鞣质大中剂量 (15 0、75mg kg)对高脂大鼠的TC和TG具有显著的降低作用 ,大小剂量 (30 0、75mg kg)对高血糖伴高血脂小鼠的TC降低作用明显 ,体外抑制HMG CoA还原酶的最低有效浓度为 1× 10 - 6 g mL ,抑制率 15 16 %。结论 :石榴叶鞣质对高脂模型鼠脂代谢紊乱具有较好的调节作用 ,体外可较强的抑制HMG CoA还原酶活性。     

高脂血症性急性胰腺炎的临床特点

目的分析、总结高脂血症性胰腺炎(hyperlipidemic pancreatitis,HLP)的临床特点。方法对宣武医院自1988年1月至2004年12月收治的979例急性胰腺炎(AP)患者进行回顾性对照研究,其中613例为急性胆石性胰腺炎(acute gallstonepancreatitis,AGP),90例为HLP。结果HLP组患者入院时的血、尿淀粉酶明显低于AGP组,HLP组的循环衰竭、呼吸衰竭、肾衰竭及肺部感染的发生率明显高于AGP组。结论在诊断时应注意HLP常不伴有血、尿淀粉酶的显著升高。在治疗HLP过程中应注意预防和积极治疗器官功能衰竭和肺部感染。     

软坚散结法治疗痰瘀交结型高脂血症性脂肪肝的临床疗效观察

【目的】观察具有软坚散结作用的经验方心脉康片治疗痰瘀交结型高脂血症性脂肪肝的临床疗效及安全性。【方法】采用分层随机原则将64例痰瘀交结型高脂血症性脂肪肝患者随机分成试验组和对照组,每组各32例。2组患者均予禁酒以及对饮食、运动和生活规律进行指导的常规处理,在此基础上,对照组给予阿托伐他汀钙片治疗,试验组给予阿托伐他汀钙片联合心脉康片治疗,疗程为12周。观察2组患者治疗前后血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、肝功能指标[谷丙转氨酶(ALT)/谷草转氨酶(AST)]和腹部B超评分的变化情况,并评价2组的中医证候疗效及安全性。【结果】(1)研究过程中,试验组和对照组分别有1例和2例患者退出,实际纳入研究试验组31例,对照组30例。(2)中医证候疗效方面,疗程结束后,试验组的总有效率为87.09%,对照组为73.33%,试验组的疗效明显优于对照组(P<0.05)。(3)血脂方面,治疗后,2组患者的TC、TG、LDL-C水平均较治疗前降低,HDL-C水平均治疗前升高(P<0.05),且试验组对TC、TG、LDL-C水平的降低作用和对HDL-C水平的升高作用均明显优于对照组(P<0.05)。(4)B超评分方面,治疗后,2组患者的B超评分均较治疗前明显降低(P<0.05),且试验组对B超评分的降低作用明显优于对照组(P<0.05)。(5)治疗后,2组患者的血清ALT、AST水平均较治疗前明显降低(P<0.05);但治疗后组间比较,差异均无统计学意义(P>0.05)。(6)观察过程中,2组患者的血常规、离子、肌酶、肾功能等均未见明显异常。【结论】心脉康片治疗痰瘀交结型高脂血症性脂肪肝,疗效确切且安全性高,初步证明软坚散结法是治疗痰瘀交结型高脂血症性脂肪肝的一种新思路和新方法。     

高脂血症性急性胰腺炎43例诊治分析

目的总结高脂血症性急性胰腺炎(HLAP)临床诊治经验。方法回顾性分析2009年1月—2011年4月收治的43例HLAP患者的临床资料。结果治愈41例,死亡2例,治愈率95.3%,住院时间13.5～183 d。出院后37例获得随访,其中3例复发,34例无异常,生活质量良好。结论掌握HLAP的临床特征,禁止或限制脂肪乳的摄入,迅速降低血脂是HLAP治疗的关键。     

蒙药童格勒格-1对大鼠高脂血症的影响

目的观察蒙药童格勒格-1(TGLG-1)对高脂血症大鼠血清血脂的调节作用。方法建立大鼠高血脂模型。高血脂症大鼠分为四组,一组为实验对照组,其余三组分别以低、中、高剂量TGLG-1灌胃,21d后测定血脂值。结果与高脂对照组相比,中、高剂量TGLG-1能显著降低血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白一胆固醇(LDL-C)水平。结论TGLG-1具有良好的降低血脂浓度和预防高血脂症的作用。     

Effect of atorvastatin upon platelet activation in hypercholesterolemia, evaluated by flow cytometry

Hyperlipidemia is a well established risk factor for cardiovascular disease and atherothrombotic events, in which platelet activation also plays a significant role. However, very few studies have addressed platelet activation in hypercholesterolemia, the potential effect of lipid lowering drugs upon platelet hyperfunction, and the question of whether changes in the latter are correlated to normalization of plasma lipids. This study used whole blood flow cytometry to assess in vivo and in vitro platelet activation in a group of 33 patients with hypercholesterolemia, and also the ex vivo effect of atorvastatin (20 mg/day) upon such activation. A control group of 40 normolipidemic volunteers matched in terms of age, sex and added risk factors to the patient group was used. The results showed that hypercholesterolemic patients had in vivo a significantly greater percentage of GPIIb/IIIa- and phosphatidylserine-positive platelets compared with the control group (4.62+/-3.51% and 2.58+/-1.19% versus 2.73+/-1.08% and 1.54+/-0.68%, respectively). In vitro response of CD62 expression to thrombin was also greater in the patients than in the controls (92.51+/-6.00% versus 89.63+/-10.72%, p<0.05). Atorvastatin therapy normalized platelet hyperfunction in the patients studied and reduced GPIIb/IIIa response to ADP (from 82.65+/-6.43% to 75.84+/-4.89%, p<0.01). A significant correlation can be seen between such normalization and the decrease in plasma levels of total and LDL cholesterol.     

丹参酮ⅡA磺酸钠对高脂性脂肪肝大鼠肝脏脂质过氧化的影响

目的研究丹参酮ⅡA磺酸钠对高脂性脂肪肝（HFL）大鼠肝脏脂质过氧化的影响,并初步探讨其作用机制。方法用高脂饲料诱发大鼠HFL模型,8周后将建模成功的大鼠随机分为模型组、丹参酮ⅡA磺酸钠（大、小剂量组）和阳性药易善复（PPC）组,每组均给予高脂饲料及相应药物,正常对照组喂以基础饲料。连续给药6周后比较各组间肝指数、血脂、血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（ASL）活性和超氧化物歧化酶（SOD）、丙二醛（MDA）的含量;检测肝脂质、肝脏组织中SOD、MDA含量并进行肝脏病理学检查。结果丹参酮ⅡA磺酸钠可显著降低HFL模型大鼠肝指数,降低血清和肝组织中TG、TC、MDA水平,降低血清LDL-C含量和ALT、AST活性;增加血清和肝组织中SOD活性及HDL-C含量,与模型组相比差异显著（P〈0.05或〈0.01）;并可明显减少肝细胞浆内脂滴分布的程度和炎症范围。结论丹参酮ⅡA磺酸钠可通过改善肝功能及脂质代谢紊乱,减少肝中脂质沉积,减轻肝组织损伤,对高脂性脂肪肝有一定的治疗作用。     

Estrogen and phytoestrogens: Effect on eNOS expression and in vitro vasodilation in cerebral arteries in ovariectomized Watanabe heritable hyperlipidemic rabbits

OBJECTIVES: To evaluate the effect of estrogen replacement therapy or soy isoflavones supplement on endothelium-dependent relaxation in vitro and gene expression of endothelial nitric oxide synthase (eNOS) in cerebral arteries in a rabbit model of human hypercholesterolemia. STUDY DESIGN: Thirty-six female ovariectomized Watanabe heritable hyperlipidemic (WHHL) rabbits were randomised to treatment with 17beta-estradiol (17beta-E(2)), SoyLife 150 or control for 16 weeks. Ring segments of basilar artery (BA) and posterior cerebral artery (PCA) were mounted in myographs for isometric tension recordings. Concentration response curves to carbamylcholine chloride, sodium nitroprusside (SNP) and l-NAME were evaluated after precontraction with potassium. Total RNA was extracted, reverse transcribed and eNOS quantitated by real-time polymerase chain reaction (real-time PCR). RESULTS: Plasma cholesterol was significantly higher at termination in the SoyLife group (P<0.0001), whereas low-density lipoprotein (LDL) cholesterol was comparable in all treatment groups. Neither treatment influenced the endothelium-dependent responses to carbamylcholine chloride or l-NAME or the endothelium-independent response to SNP in any of the arteries. Correspondingly, eNOS mRNA was similarly expressed in all treatment groups in both arteries. CONCLUSIONS: Improvement of cerebral endothelial function by estrogen or soy isoflavones in ovariectomized WHHL rabbits is not supported by the present data. The findings may be unique to the WHHL rabbit in which the hypocholesterolemic effect of estrogens mediated by upregulation of liver LDL receptors is excluded.