内源性高甘油三酯血症患者血浆VLDL、LDL及HDL对血凝的影响

目的：研究内源性高甘油三酯血症(HTG)患血浆极低密度脂蛋白(VLDL)、低密度脂蛋白(LDL)及高密度脂蛋白(HDL)是否发生了氧化修饰及其对血凝的影响。方法：对2l例内源性高甘油三酯血症患与2l例年龄性别相近的正常人的血脂、脂质过氧化物进行了分析。用一次性密度梯度超速离心法分离血浆VLDL、LDL及HDL，测定这三种脂蛋白的234nm光吸收、相对电泳迁移率(REM)和硫代巴比妥酸反应物质(TBARS)，分别将这三种脂蛋白加入由正常人新鲜混合血浆构成的反应系统中，按试剂盒分别测定凝血酶原时间(PT)及活化部分凝血酶原时间(APIT)。结果：内源性HTG患血浆TG含量平均升高2．73倍，HDLC下降l.7l倍，同时LPO升高1．22倍;HTG组VLDL、LDL及HDL的REM、234nm光吸收值、TBARS含量均较对照组显增加(P＜0．01)，表明内源性HTG患血浆VLDL、LDL及LDL均发生了氧化修饰生成Ox—VLDL、Ox-LDL.PT及APTT在分别加入HTG组的VLDL、LDL及HDL后均比加入相应正常组脂蛋白明显缩短(P均＜0．05)。相关分析表明，HTG组血浆VLDL及HDL相对电泳迁移率(REM)与PT呈负相关(P＜0．01)。结论：HTG患血浆VLDL、LDL及HDL发生了氧化修饰，并使PT及APTT明显缩短。

Effects of oxidative modification plasma very low density lipoprotein, low density lipoprotein and high density lipoprotein on blood coagulation in endogenous hypertriglyceridemia

Objective: To study whether plasma very low density lipoprotein (VLDL), low density lipoprotein (LDL), high density lipoprotein (HDL) were oxidatively modified in endogenous hypertriglyceridemia and effects of HTG VLDL, LDL and HDL on blood coagulation in vitro. Methods: Plasma VLDL, LDL and HDL were isolated by density gradient ultracentrifugation method . Human plasma triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDLC) were measured by enzyme method. The oxidative modification of LDL, VLDL and HDL was identified by agarose gel relative electrophoretic mobility (REM), absorbance at 234nm (CD) and fluorescence of thiobarbituric acid reaction substances (TBARS). With the reaction system which consisted of mixed fresh normal plasma, prothrombin time (PT) and activated partial thrombplastin time (APTT) were measured according to the direction of the kits. Results: the plasma TG, TBARS level in HTG group were 1.6 and 0.4 times of the control group ,respectively (P<0.01). The plasma HDLC in HTG group was 32% lower than that of the control group (P<0.01). The relative electrophoretic mobility (REM), absorbance at 234nm and TBARS of VLDL, LDL and HDL in HTG group were significantly higher than that of the control group (P<0.01). The PT and APTT of VLDL , LDL and HDL in HTG group were significantly shorter than that of the control group (P<0.05). The correlation analysis indicated that electrophoretic mobility of VLDL and HDL in HTG group was negatively correlated with PT (P<0.01). Conclusion: Oxidative modification of plasma very low density lipoprotein, low density Lipoprotein, high density lipoprotein are occurred in endogenous hypertriglyceridemia in vivo and LDL and HDL enhance the activity of blood clotting system in vitro.