绝经前后妇女性激素水平与血脂和免疫的关系

To investigate the relationship between sex hormone levels and blood lipids/immunity and to evaluate the therapeutical effects of nylestriol, 96 women without coronary heart disease(CHD) were studied during their perimenopausal period. The estimation of serum biochemical components included serum 17 beta-estradiol(E2), testosterone(T), total cholesterol(TC), triglyceride (TC), high density lipoprotein cholesterol(HDL-C), low density protein cholesterol(LDL-C), apolipoprotein A-I(ApoAI), apolipoprotein B(ApoB), lipoprotein (a)[Lp(a)], immunoglobulin G(IgG), and IgG antibody against cardiolipin(ACAIgG). Thirty-six postmenopausal volunteers were divided into two groups and randomized to treat with either 2 mg nylestriol or placebo. In postmenopausal women, serum levels of E2, E2/T, HDL, and ApoAI decreased, while those of T, TC, TG, LDL, ApoB, Lp(a), IgG, and ACAIgG increased. Serum level of E2 was positively correlated to HDL-C and negatively correlated to TC, ApoB, LDL, IgG, and ACAIgG. Serum level of T was positively correlated to LDL, IgG, and ACAIgG and negatively correlated to HDL. In the nylestriol group, as compared with the results before treatment, serum levels of TG, TC, LDL, IgG, and ACAIgG decreased and that of HDL-C increased after treatment. We conclude that estradiol is a protective factor of CHD, whereas testerone is a dangerous factor. After menopause, the imbalance of the estradiol/testosterone ratio increases the incidence of CHD. Nylestriol is an effective substitute for estradiol to prevent CHD in post menopausal women.     

Relation of gemfibrozil treatment and lipid levels with major coronary events: VA-HIT: a randomized controlled trial

CONTEXT: A low plasma level of high-density lipoprotein cholesterol (HDL-C) is a major risk factor for coronary heart disease (CHD). A secondary prevention study, the Veterans Affairs High-Density Lipoprotein Intervention Trial (VA-HIT), demonstrated that CHD events were significantly reduced during a median follow-up of 5.1 years by treating patients with the fibric acid derivative gemfibrozil when the predominant lipid abnormality was low HDL-C. OBJECTIVE: To determine if the reduction in major CHD events with gemfibrozil in VA-HIT could be attributed to changes in major plasma lipid levels. DESIGN: Multicenter, randomized, double-blind, placebo-controlled trial conducted from September 1991 to August 1998. SETTING: The Department of Veterans Affairs Cooperative Studies Program, in which 20 VA medical centers were participating sites. PARTICIPANTS: A total of 2531 men with a history of CHD who had low HDL-C levels (mean, 32 mg/dL [0.83 mmol/L] ) and low low-density lipoprotein cholesterol (LDL-C) levels (mean, 111 mg/dL [2.88 mmol/L]). INTERVENTION: Participants were randomly assigned to receive gemfibrozil, 1200 mg/d (n = 1264), or matching placebo (n = 1267). MAIN OUTCOME MEASURE: Relation of lipid levels at baseline and averaged during the first 18 months of gemfibrozil treatment with the combined incidence of nonfatal myocardial infarction and CHD death. RESULTS: Concentrations of HDL-C were inversely related to CHD events. Multivariable Cox proportional hazards analysis showed that CHD events were reduced by 11% with gemfibrozil for every 5-mg/dL (0.13-mmol/L) increase in HDL-C (P =.02). Events were reduced even further with gemfibrozil beyond that explained by increases in HDL-C values, particularly in the second through fourth quintiles of HDL-C values during treatment. During gemfibrozil treatment, only the increase in HDL-C significantly predicted a lower risk of CHD events; by multivariable analysis, neither triglyceride nor LDL-C levels at baseline or during the trial predicted CHD events. CONCLUSIONS: Concentrations of HDL-C achieved with gemfibrozil treatment predicted a significant reduction in CHD events in patients with low HDL-C levels. However, the change in HDL-C levels only partially explained the beneficial effect of gemfibrozil.     

脑梗死与脑出血患者血脂对比研究

目的研究脑梗死和脑出血的血脂水平差异。方法对183例脑梗死患者、同期住院的45例脑出血患者及150例对照组分别测定其总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和极低密度脂蛋白(VLDL),并进行比较分析。结果脑梗死组的TC、TG、LDL较对照组增高(P<0.05、P<0.05、P<0.01),HDL较对照组低(P<0.05);脑出血组HDL亦较对照组低(P<0.05),但同脑梗死相比较,TC、LDL显著降低(P<0.01)。结论高TC、TG、LDL及低HDL水平是脑梗死发病的危险因素,相反低TC、LDL水平则可能存在脑出血倾向。     

低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值对冠心病的诊断价值的探讨

目的：探讨低密度脂蛋白脂固醇（LDL－C）／高密度脂蛋白胆固醇（HDL－C）比值对冠心病（CHD）的诊断价值。方法：分析397例经冠状动脉造影确诊为冠心病的患者（CHD组）及253例冠状动脉造影阴性者（对照组）的LDL－C／HDL－C比值水平与冠心病之间的关系。结果：CHD组的LDL－C／HDL－C比值水平及异常率均明显高于对照组（P＜0．01）。相关分析显示，与三酰甘油（TG）、总胆固醇（Tch）、LDL－C和HDL－C相比，该比值显示了更有意义的相关关系（β＝0．346，P＝0．01）。经多元逐步回归分析显示，与TG、Tch、LDL－C和HDL－C相比，该比值显示了更有意义的回归关系，标准化方程式为：Y（CHD）＝0．337（糖尿病史）＋0．267（LDL－C／HDL－C）＋0.185（高血压史）（P＜0．05，复相关系数为0．525）。结论：LDL－C／HDL－C比值是诊断冠心病的一项有临床使用价值的指标。     

冠心病伴牙周炎患者血脂及炎症相关因子的水平探讨

目的：检测冠心病伴牙周炎患者血脂及炎症相关因子水平,分析其临床意义。方法方便选取2015年1月—2016年1月该院冠心病伴牙周炎患者50例,取同期单纯冠心病、慢性牙周炎、健康查体者各50例,检测其总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)、C-反应蛋白(CRP)水平。结果冠心病伴牙周炎患者治疗前血清TP(4.82±1.53)、TG(4.27±0.61)、LDL(4.52±0.32)、CRP(19.28±5.13)高于冠心病组、牙周炎组、对照组,HDL(1.03±0.13)低于冠心病组、牙周炎组、对照组,经过治疗后TP、TG、LDL升高,HDL、CRP降低(P<0.05);CRP与TP、TG、LDL呈正相关(P<0.05),与HDL呈负相关(P<0.05)。结论冠心病伴牙周炎患者会出现血清TP、TG、LDL升高, HDL降低,CRP升高,CRP与TP、TG、LDL呈正相关,与HDL呈负相关。     

2型糖尿病患者血清氧化型低密度脂蛋白和血液抗氧化能力分析

目的　通过对 5 0例 2型糖尿病患者血清甘油三酯 (TG)、胆固醇 (Chol)、高密度脂蛋白胆固醇 (HDL c)、低密度脂蛋白胆固醇 (LDL c)、氧化型低密度脂蛋白 (OX LDL)、载脂蛋白 (ApoA1、ApoB10 0 )及血液抗氧化能力 (AOC)分析 ,探讨2型糖尿病患者OX LDL与血液抗氧化状态的关系 ,寻找评价 2型糖尿病患者发生冠心病危险性的有效血液生化指标。方法　收集 5 0例经临床确诊的 2型糖尿病患者及 5 0例无心血管疾病、无糖尿病及无肾病人群的空腹血清 ,对血脂和血液AOC进行分析。结果　TG、Chol、HDL c、LDL c、ApoA1、ApoB10 0 两组比较无差异 (P >0 0 5 ) ;OX LDL 2型糖尿病组明显高于对照组 (P <0 0 1) ,血液AOC 2型糖尿病组明显低于对照组 (P <0 0 1)。结论　血清OX LDL及血液AOC分析有望成为评价 2型糖尿病患者发生冠心病危险性更灵敏、更有效的血液生化指标。     

A study on body mass index (BMI) and some biochemical parameters of the medicos with family history of diabetes mellitus, hypertension and coronary heart disease

Increasing prevalence of diabetes mellitus (DM), hypertension (HT), coronary heart disease (CHD) is alarming; risk factors are fairly stable, passing fairly well from childhood to adulthood; genetic factors play a role. This is important to know the status of some biochemical parameters viz, fasting plasma glucose level, fasting serum insulin (FI), serum triglyceride (STG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) among the medicos with family history (FH) of DM, HT or CHD and the relationship of biochemical parameters with body mass index (BMI). Mean age of the sample (n=67) was 22 years with 76.12% males and 23.88% females; 44.78%, 29.85% and 19.40% had FH of DM, HT and CHD respectively; 8.96% had the FH of three diseases. High BMI was seen in 62.69% cases; it was significantly high among those with FH of DM (p<0.05) but not significant against HT (p>0.05) or CHD (p>0.05). All had normal fasting plasma glucose level. Positive association existed (a) between BMI with FI, LDL and HDL, FI with LDL and HDL, TG with TC, TC with LDL and HDL, LDL with HDL among those with FH of DM; (b) between BMI with FI, STG and HDL, FI with LDL and HDL, TC with LDL and HDL, LDL with HDL among those with FH of HT; (c) between BMI with FI, STG and HDL, FI with TC, LDL and HDL, TC with LDL and HDL, LDL with HDL among those with FH of CHD. Multiple correlation coefficients (R) also indicated moderate association.     

Hypercholesterolaemic effect of fish oil in insulin-dependent diabetic patients

The effect of the daily administration of Max EPA fish oil (equivalent to 2.7 g per day of eicosapentaenoic acid) on serum lipid levels was examined in insulin-dependent male diabetic patients with cholesterol levels of less than 6.5 mmol/L. After three weeks of fish-oil supplementation there was a significant rise in total cholesterol levels, which was due largely to increases in low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)- cholesterol levels. The increase in HDL-cholesterol levels was accounted for by its HDL2 subclass. There was a decrease in serum triglyceride levels, but this was also observed in a control group of diabetic patients who did not receive fish oil and is probably explained by weight loss in this group. Similar changes in lipid levels were found in a subgroup of diabetic patients with retinopathy. The possible detrimental effect of the increase in total cholesterol and LDL-cholesterol levels after Max EPA fish oil at this dose may be offset by the selective rise in the protective HDL2 subclass.     

慢性乙型肝炎患者血脂和载脂蛋白水平与肝组织炎症关系的研究

目的探讨慢性乙型肝炎患者血脂和载脂蛋白水平与肝组织炎症病理分级(G)的关系。方法采用RI-1000TM全自动生化分析仪检测96例经病理证实的慢性乙型肝炎患者和32例正常人血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)、脂蛋白(Lp-a)、载脂蛋白A-I(APOA-I)、载脂蛋白B(APOB)水平,并分析与肝组织病理炎症分级(G0-G4)的关系。结果各项血脂水平随着肝组织炎症活动度的增高而降低,G4级降至最低。在肝组织炎症病理分级为G4级患者,其血清TC、TG、HDL、LDL、VLDL、Lp-a、APOA-I水平均比正常对照组明显降低,差别有高度显著性(P<0.01)。降低比较敏感的是HDL和APOA-I,在G2级开始下降,与对照组比较均有高度显著性(P<0.05或<0.01)。结论血清HDL和APOA-I水平能很好地反映肝脏病理炎症活动度,能可靠地反映肝细胞损害的程度,比TC、TG更敏感。     

脑出血发病与血脂水平的关系研究

目的：对脑出血（ ICH）的发生与总胆固醇（ TC）、三酰甘油（ TG）、高密度脂蛋白（ HDL）、低密度脂蛋白（ LDL）和载脂蛋白A、B（ Apo-A、Apo-B）水平的关系进行研究。方法：取本院自2011年以来因ICH入院的118例患者作为实验组,将同期在本院经过体检后正常的120例患者作为对照组。对两组患者的TC、TG、HDL、LDL、Apo-A和Apo-B的水平进行检测分析,得出ICH的发病与血脂水平的关联性。结果：实验组患者的TC和TG水平较对照组明显升高,而HDL、Apo-A水平较对照组明显降低;实验组患者血脂异常的检出率较对照组更高。上述统计数据具有明显差异（ P＜0．05）。结论：血脂水平与ICH的发病存在直接的关联性,因而血脂异常可能是ICH发病的重要因素。     

COPD患者血脂比值和氧化应激状态及其与#br# 肺动脉高压及预后的关系

目的：探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者血脂比值和氧化应激状态与其肺动脉高压及预后的关系。方法：随机选取河北省人民医院COPD患者120例为COPD组,另选取30例同期体检健康者为对照组。检测对照组和COPD组急性加重期和稳定期的低密度脂蛋白(LDL)/高密度脂蛋白(HDL)、三酰甘油(TG)/HDL、总胆固醇(TC)/HDL等血脂比值和血清超氧化物歧化酶(SOD)、丙二醛(MDA)和总抗氧化能力(total antioxidative capability,T-AOC)等氧化应激指标水平,统计其肺动脉高压的发生率和3年生存率并采用Spearman秩相关法分析其血脂比值和氧化应激状态与其肺动脉高压的发生率和3年生存率的关系。结果：与对照组比较,COPD组急性加重期和稳定期的LDL/HDL,TG/HDL,TC/HDL等血脂比值和血清MDA水平均升高,血清SOD和T-AOC水平则降低;与稳定期比较,COPD组急性加重期的血脂比值和血清MDA水平均升高,血清SOD和T-AOC水平则降低(P<0.05)。COPD组随访3年间肺动脉高压的发生率和3年生存率分别为56.67%和81.67%,且出现肺动脉高压和死亡的COPD患者的急性加重期和缓解期的血脂比值和血清MDA水平均高于无肺动脉高压和存活患者,血清SOD和T-AOC水平则低于无肺动脉高压和存活患者(P<0.05)。Spearman秩相关法分析结果显示,COPD患者LDL/HDL,TG/HDL,TC/ HDL等血脂比值和血清MDA水平与其3年间肺动脉高压的发生率均呈正相关(r=0.752,0.748,0.773,0.734;P<0.05),与其3年生存率则呈负相关(r=–0.722,–0.751,–0.736,–0.748;P<0.05);COPD患者血清SOD和T-AOC水平与其3年间肺动脉高压的发生率均呈负相关(r=–0.711,–0.734;P<0.05),与其3年生存率则呈正相关(r=0.726,0.733;P<0.05)。结论：COPD患者血脂比值和氧化应激水平均较高,抗氧化能力则降低,且其血脂比值和氧化应激状态与其肺动脉高压及预后均相关,这可能和血脂与动脉硬化及营养状态相关和氧化应激影响COPD患者血管内皮功能等相关,因此COPD患者血脂比值和氧化应激状态可能用于其肺动脉高压及预后的评估。     

365例胸痹心痛患者证型与血脂分析

[目的]了解胸痹心痛患者的血脂和中医证型间的关系。[方法]对365例胸痹心痛患者进行辨证,并检查血脂,对 比研究证型与血脂间的关系。[结果]365例胸痹心痛患者有278例至少有一项血脂异常,87例血脂正常;血脂异常组和正 常组各证型分布无显著性差异(P>0.05);血瘀证患者的平均高密度脂蛋白(HDL)低于非血瘀证,痰浊证患者的HDL低 于非痰浊证,血清甘油三酯(TG)高于非痰浊讧;随着证型的复杂化,血清总胆固醇(TC)和低密度脂蛋白(LDL)水平 升高;证型虚实与血脂无关。[结论]胸痹心痛不一定与血脂增高有关,虚实证均可发生,但以血瘀证和疾浊证的血脂异常 较为明显。     

Successful management of primary hypercholesterolaemia with simvastatin and low-dose colestipol.

OBJECTIVE: To examine whether a small dose of bile acid sequestrant used in combination with a hydroxymethylglutaryl coenzyme A reductase inhibitor is more effective in reducing serum and low-density lipoprotein (LDL) cholesterol levels than inhibitor used alone. DESIGN: A randomised, double-blind study. SETTING: Subjects receiving tertiary care at a hospital lipid clinic. PATIENTS: Subjects with severe primary hypercholesterolaemia (types IIa and IIb), already stabilised on a cholesterol-lowering diet, with serum cholesterol levels of 7.0 mmol/L or more and triglyceride levels of 6.0 mmol/L or less. Sixty-four subjects were randomly assigned to the treatment groups; three withdrew before any outcome observations; 61 completed the trial and their results were analysed. INTERVENTIONS: Subjects were randomly assigned to receive either colestipol placebo or colestipol 5 g or 10 g each morning in fixed dosage for 18 weeks. They simultaneously received incremental doses of simvastatin: placebo for six weeks, then 20 mg/night for six weeks, then 40 mg/night for a final six weeks. MAIN OUTCOME MEASURES: Lipids, lipoproteins, and haematological and biochemical safety parameters were measured at the end of each treatment period. Adverse events were monitored. RESULTS: Respective maximum reductions (95% confidence intervals) in serum cholesterol, LDL cholesterol and apolipoprotein B (apo-B) values in subjects taking combination therapy were 41% (38%-45%), 50% (46%-53%) and 43% (39%-46%), compared with lesser reductions of 32% (26%-37%), 38% (31%-45%) and 37% (32%-41%) in those taking simvastatin monotherapy. The percentage changes in LDL cholesterol with combination therapy were independent of baseline cholesterol level or lipid phenotype. Combination therapy reduced serum triglyceride levels by up to 24% (15%-32%) and increased high-density lipoprotein (HDL) cholesterol levels by up to 9% (3%-15%). Three subjects withdrew within a few weeks because of severe gastrointestinal side effects related to colestipol; 19 experienced milder gastrointestinal side effects, 15 were taking combination therapy. CONCLUSIONS: A combination of low-dose colestipol and simvastatin was found to be more effective in reducing serum and LDL cholesterol than simvastatin used alone. Such combination therapy offers the possibility of improved cholesterol lowering without the need for full dosage of either drug.     

重症患者血脂水平与心脑血管疾病的相关性

目的探讨血脂水平与冠心病、脑卒中的相关性。方法选择301例重症医学科住院患者,分为非冠心病＋非脑卒中组（n=158）、单纯冠心病组（n=62）、单纯脑卒中组（n=57）、冠心病＋脑卒中组（n=24）,分析4组间血清低密度脂蛋白（low density lipoprotein,LDL）、高密度脂蛋白（high density lipoprotein,HDL）、总胆固醇（total cholesterol,TC）、甘油三脂（triglycerides,TG）共4项指标入院值、最大值差异。结果①非冠心病＋非脑卒中组和单纯脑卒中组入院时TC、最大TC、最大HDL、入院时LDL、最大LDL差异具有统计学意义（P〈0．05）。②非冠心病＋非脑卒中组和单纯冠心病组TG最大、最大HDL、人院时LDL、最大LDL差异具有统计学意义（P〈0．05）。③非冠心病＋非脑卒中组和冠心病＋脑卒中组人院时TC、最大TC、TG入院、入院时LDL、最大LDL、最大HDL异常、入院时TC异常、最大TC异常、最大LDI,异常方面差异具有统计学意义（P〈0．05）。④单纯冠心病组和冠心病＋脑卒中组在最大TC异常、TG最大异常方面差异具有统计学意义（P〈0．05）。结论LDL、HDL与冠心病、脑卒中有关,TG与冠心病有关,TC与脑卒中有关,在存在冠心病的基础上TG与脑卒中有关。     

血液透析及腹膜透析对尿毒症患者血脂的影响及分析

目的 观察尿毒症患者行血液透析或腹膜透析治疗前后的血脂水平的变化,对比血液透析及腹膜透析对尿毒症患者血脂影响的差别,并分析其可能的原因.方法 纳入血液透析治疗组56例,腹膜透析组48例,所有患者均在透析治疗前及治疗 12个月时测定血浆胆固醇（TCH）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、血浆白蛋白（ALB）、血肌酐（Scr）、血糖（Glu）等指标.结果 经血液透析治疗的患者,TG较透析前明显升高（P＜0.05）,接受腹膜透析治疗的患者,TCH,TG,LDL,LDL/HDL较透析前均明显升高（P＜0.05）,腹膜透析与血液透析患者比较,前者TCH,LDL,LDL/HDL高于后者,ALB明显低于后者（P＜0.05）.结论 透析治疗加重脂代谢紊乱,腹膜透析患者脂代谢紊乱更明显,可能与含糖腹透液的使用及白蛋白大量丢失等因素相关.     

Investigation of the effect of ginger on the lipid levels. A double blind controlled clinical trial

OBJECTIVE: To study the effect of fine powder of ginger on lipid level in volunteer patients. METHODS: This is a double blind controlled clinical trial study in 2 cardiac clinics Cardiac Disease Clinic, Babol, north of Iran, between April to May 2004. We randomly divided the patients with hyperlipidemia into 2 groups, treatment group (receiving ginger capsules 3 g/day in 3 divided doses) and placebo group (lactose capsule 3 g/day in 3 divided doses) for 45 days. All subjects with diabetes mellitus, hypothyroidism, nephrotic syndrome, and alcohol drinking, pregnancy and peptic ulcer were excluded. Lipid concentrations profile before and after treatment was measured by enzymatic assay. RESULTS: Forty-five patients in the treatment group and 40 patients in placebo group participated in this study. There was a significant reduce in triglyceride, cholesterol, low density lipoprotein (LDL), very low density lipoprotein (VLDL), levels of before and after study separately in each group (p<0.05). Mean changes in triglyceride and cholesterol levels of ginger group were significantly higher than placebo group (p<0.05). Mean reduction in LDL level and increase in high density lipoprotein level of ginger group were higher than the placebo group, but in VLDL level of placebo was higher than ginger (p>0.05). CONCLUSION: The results show that ginger has a significant lipid lowering effect compared to placebo.     

职业接触噪声对作业工人血脂影响的研究

目的通过比较同期接触粉尘和噪声的职业人群与仅接触粉尘的职业人群的血脂各项指标之间的差异,探索噪声对血脂的影响规律,为保护职业噪声接触人群的健康提供依据。方法采用现况研究方法,通过问卷调查收集观察对象的一般情况。采用自动生化分析仪检测血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）水平。比较同时接触粉尘和噪声与仅接触粉尘二组之间血脂各指标差异。结果与正常对照组比较,噪声可引起接噪人员血清TC、TG水平升高和HDL水平下降（P〈0.05）,但未发现噪声导致的LDL水平升高;长期接触噪声后,血清TC和TG的异常率升高（P〈0.05）,而HDL和LDL的异常率没有明显变化。结论长期的噪声接触可使接噪工人血清TC、TG、HDL水平升高;并使作业工人发生高TC血症和高TG血症的机会增加。     

老年冠心病病人血清甲状腺激素与血脂水平的检测

①目的　探讨老年冠心病病人血清中甲状腺激素水平及与血脂的关系。②方法　测定 30例正常对照者及 4 7例冠心病病人血清中总胆固醇 (TC)、三酰甘油 (TG)、高密度脂蛋白 (HDL)、低密度脂蛋白 (LDL)、载脂蛋白A1、载脂蛋白B、游离三碘甲状腺原氨酸 (FT3 )、游离甲状腺素 (FT4)、促甲状腺素 (TSH)水平。③结果　冠心病组FT3 、HDL、载脂蛋白A1明显低于正常对照组 (t=4 .12 4～ 5 .910 ,P <0 .0 1) ;FT4、TSH、TG、TC两组间比较无显著性差异 (t=1.4 33～ 1.85 4 ,P >0 .0 5 ) ;LDL与载脂蛋白B明显高于正常对照组 (t=3.70 5、7.6 5 0 ,P <0 .0 1)。冠心病病人FT3 、FT4与TC、TG无相关性 (r=- 0 .0 5 9～ - 0 .0 0 3,P >0 .0 5 ) ,与HDL、载脂蛋白A1呈正相关 (r =0 .32 8～ 0 .72 0 ,P<0 .0 1) ,与LDL、载脂蛋白B呈负相关 (r=- 0 .80 2～ - 0 .4 0 7,P <0 .0 5 )。④结论　冠心病病人存在FT3 下降 ,甲状腺激素水平下降可影响脂蛋白的正常代谢。     

血清游离脂肪酸水平与冠心病心肌损伤程度相关性研究

目的探讨血清游离脂肪酸（free fatty acid,FFA）作为一种非酯化的脂肪酸对心肌是否存在损伤作用,以及总胆固醇（total cholesterol,TCHO）、甘油三酯（triglyceride,TG）、高密度胆固醇（high densisty lipoprotein,HDL）、低密度胆固醇（low densisty lipoprotein,LDL）对心肌损伤的影响。方法抽取189例冠心病患者血样,根据心肌肌钙蛋白T检测结果,将研究对象分为心肌损伤组（心肌肌钙蛋白T〉0．08ng／L）88例与非心肌损伤组（心肌肌钙蛋白T正常）101例,抽取正常人群93例为对照组,利用酶终点法测FFA,酶法测TCHO,GPO—PAP法测TG,免疫比浊法测HDL和LDL。结果冠心病心肌损伤组冠心病心肌损伤组FFA水平显著高于非心肌损伤组和对照组（P〈0．05）,而血样中其他指标如TCHO、TG、HDL、LDL差异无统计学意义（P〉0．05）。ROC曲线发现FFA曲线下面积为0．89。以0．65作为Cutoff值时,FFA诊断灵敏度可达71％,特异度达90％。冠心病患者的血脂正常组较血脂异常组的心肌损伤发生率显著降低（P〈0．05）,进一步统计分析显示FFA、TCHO、TG、LDL、HDL无相关性。结论血清FFA水平与心肌损伤明显相关,可作为冠心痛患者心肌损伤的预测指标,而TCHO、TG、HDL、LDL与心肌损伤关系较小。FFA可成为监测心肌损伤独立的危险因素。     

Comparison of lovastatin and gemfibrozil in normolipidemic patients with hypoalphalipoproteinemia

This study compared lovastatin and gemfibrozil therapy for effects on lipid and lipoprotein levels in 22 normolipidemic patients with reduced high-density lipoprotein cholesterol levels. Most patients had coronary heart disease. A randomized, crossover design consisted of two drug phases (lovastatin and gemfibrozil) alternating with placebo. Lovastatin reduced total and low-density lipoprotein cholesterol and apolipoprotein B levels by 28%, 34%, and 24%, respectively. These were unaffected by gemfibrozil. Both drugs reduced very low-density lipoprotein and intermediate-density lipoprotein cholesterol levels by 30% to 40%. Both caused small but significant increases in high-density lipoprotein cholesterol, but not in apolipoproteins A-I or A-II. Both significantly lowered ratios of total (and low-density lipoprotein) cholesterol-to-high-density lipoprotein cholesterol, but lovastatin more than gemfibrozil. Thus, for normolipidemic patients with low levels of high-density lipoprotein cholesterol, neither drug markedly raised high-density lipoprotein levels, but lovastatin produced the better overall change in lipoprotein cholesterol and apolipoprotein B levels.