中原地区冠心病患者血脂谱调查与载脂蛋白ApoB/ApoAI比值的意义

目的:通过分析中原地区冠心病患者血脂谱特征,探讨载脂蛋白B/载脂蛋白AI(ApoB/ApoAI)比值作为冠心病危险因素评估指标的必要性和优势.方法:冠状动脉造影确诊的正常对照组和冠心病患者,进行血脂及载脂蛋白生化分析,统计各血脂谱的相关性,比较各相关系数的差异.结果:①TC、LDL-C、non-HDL-C、ApoB、TC/HDL-C和ApoB/ApoAI各指标在冠心病组显著高于对照组(P<0.05).②冠心病组HDL-C浓度在各水平分层的比例均明显低于对照组(P=0.002),而TC和LDL-C差异无统计学意义(P>0.05).③LDL-C与non-HDL-C有最密切的相关性(r=0.959),两者与ApoB/ApoAI的相关性差异无统计学意义(P>0.05),而两者分别与ApoB/ApoAI的相关性与ApoB/ApoAI和ApoB、TC/HDL-C的相关性有显著差异(P<0.05).结论:中原地区冠心病患者具有低HDL-C的特征,由于各血脂谱统计学相关性的显著差异,ApoB/ApoAI比值可能是反映此类患者心血管病风险的理想标志物和治疗靶点.     

绝经后NIDDM病人的血清脂蛋白胆固醇和载脂蛋白B水平

糖尿病病人脂代谢紊乱是导致伴发冠心病的重要因素。近年来国内外的一些研究发现,冠心病病人及NIDDM病人血清中HDL-C,HDL_2-C、HDL_3-C均降低,其中以HDL_2-C下降明显;低密度脂蛋白胆固醇(LDL-C)和ApoB则增高。由于脂蛋白胆固醇受糖尿病类型、性别、年龄、月经周期的影响表现出很大差异,本文选择了一组女性绝经后NIDDM病人与相应正常人比较,以了解该组病人胆固醇代谢紊乱与冠心病的关系,并探讨了测定血清脂蛋白胆固醇以及ApoB对评估该组NIDDM病人冠心病的价值。     

糖耐量减退及空腹血糖异常患者血清载脂蛋白B、AI检测及其临床意义

目的　探讨糖耐量低减 (IGT)及空腹血糖异常 (IFG)患者血清载脂蛋白B(ApoB)及载脂蛋白AI(ApoAI)水平的变化。 方法　分三组进行研究 ,IGT组 5 8例 ,IFG组 5 5例 ,6 4例血糖正常者为对照组。分别检测其甘油三脂 (TG)、总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL c)、高密度脂蛋白胆固醇 (HDL c)、脂蛋白 (a) [LP(a) ]、载脂蛋白B(ApoB)、载脂蛋白AI(ApoAI)、空腹血糖 (FPG)、糖化血红蛋白 (HbA1c)、C 肽 (C P)、胰岛素 (Ins)及体重指数 (BMI) ,间隔 2周共检测 4次。结果　IGT及IFG患者LDL c、LP(a)、ApoB水平较对照组高 ,HDL c、ApoAI及ApoAI/ApoB水平较对照组低 ,其中ApoB升高及HDL c、ApoAI/ApoB、ApoAI降低与对照组比较差异有显著性 (P <0 .0 1) ,且IGT组ApoB较IFG组明显升高 ( P <0 .0 1)。ApoB及ApoAI与HbA1c、C P、Ins及BMI水平比较无明显相关 (P >0 .0 5 )。结论　IGT及IFG患者的脂代谢紊乱以ApoB升高及ApoAI降低为主 ,这可能是 2型糖尿病患者动脉粥样硬化的重要危险因素。     

2型糖尿病合并冠心病患者脂质及ApoA1/B变化

目的探讨2型糖尿病合并冠心病患者脂质及载脂蛋白A1/B的变化和意义。方法回顾本院收治的2型糖尿病人192例,将其分成两组:合并冠心病者(A组,n=72)和无合并冠心病组(B组,n=120);另设健康对照组(C组,n=70)。每例病人于入院后第2天采集空腹静脉血,检测甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、ApoA1、ApoB,并计算ApoA1/B值。结果与C组相比,A、B两组HDL-C及ApoA1下降(P0.05),TG、LDL-C水平升高(P0.05);A、B两组相比,A组TG、LDL-C、ApoB较B组明显升高(P0.05),HDL-C和ApoA1/B比值较B组明显下降(P0.05)。结论2型糖尿病合并冠心病患者较单一糖尿病患者血脂代谢异常更加显著,ApoB升高和ApoA1/B比例下降可能促进糖尿病患者发生冠心病的进程,可望成为糖尿病合并冠心病的临床预测指标。     

高密度脂蛋白及亚组分在冠心病发病中的意义

测定91例老年男性血中总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及其亚组分(HDL_2-C、HDH_3-C)。发现冠心病无心肌梗塞组及心肌梗塞组HDL-C、HDL_2-c浓度分别较正常值下降1/4和1/2(P<0.001),而HDL_3-C各组间相对恒定(P>0.05)。表明HDL_2-C是HDL-C中的可变部分,极可能是HDL-C中的主要活性成分;高脂血症组是介于健康组和冠心病组之间的移行组。提高HDL-C,尤其是HDL_2-C浓度有利于防治冠心病。讨论了冠心病各项指标的敏感性和特异性,认为HDL_2-C最优。     

2型糖尿病合并冠心病脂质及ApoA1/ApoB变化分析

目的研究2型糖尿病(T2DM)合并冠心病患者脂质及载脂蛋白A1/载脂蛋白B(ApoA1/ApoB)变化的临床意义。方法收集本院收治的住院病人155例,按是否有冠心病分成两组,即A、B两组,A组为合并冠心病组,共60人;B组为不合并冠心病组,共95人。另外收集门诊健康体检病人作为对照组,即C组,共70人。比较三组间总胆固醇(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)、ApoA1、ApoB及ApoA1/ApoB值。结果 A、B两组相比,A组TC、TG、LDL-C、ApoB较B组明显升高(P<0.05),HDL-C和ApoA1/B比值较B组明显下降,差异有统计学意义(P<0.05);与C组相比,A、B两组中HDL-C及ApoA1下降(P<0.05),TC、TG、LDL-C、ApoB水平升高,差异有统计学意义(P<0.05)。结论 2型糖尿病合并冠心病存在多种脂质代谢紊乱。血清HDL-C、ApoA1水平和ApoA1/ApoB值与2型糖尿病合并冠心病病变严重程度呈负相关。     

糖尿病及急性冠状动脉综合征患者ApoB与ApoA1比值测定的临床意义

目的：研究糖尿病及急性冠状动脉综合征（ACS）患者血清载脂蛋白B（ApoB）与载脂蛋白A1（ApoA1）比值的变化并探讨其临床意义。方法：从体检人群中筛选可排除诊断为糖尿病及ACS的受检者33例为对照组、从住院患者中筛选临床确诊的单纯糖尿病患者47例、无糖尿病的ACS患者101例及ACS并发糖尿病患者52例,收集临床资料并分别检测各组空腹血糖、血脂和高敏C反应蛋白（hsCRP）水平。结果：糖尿病组、ACS非糖尿病组、ACS并发糖尿病组ApoB／ApoA1比值显著高于对照组（0．86±0．18、0．87±0．20、0．89±0．23）：（0．76±0．15）,均P〈0．05。但3个患病组之间ApoB／ApoA1比值差异无统计学意义。高ApoB／ApoA1组（上4分位组）与低ApoB／ApoA1比较,BMI、FPG、TG、TC、LDLC、hsCRP水平,糖尿病、高血压及ACS患病率均显著升高,而HDL-C水平则无显著变化。ROC曲线显示,ApoB／ApoA1较LDL-C具有更好的ACS诊断性能。结论：ApoB／ApoA1比值能较准确、灵敏地反映从糖尿病到ACS病程中脂代谢紊乱,并可用于对糖尿病预后及ACS发病风险的评估。     

二甲双胍对高脂蛋白血症患者血清载脂蛋白B及AI的影响

已有研究指出二甲双胍非常适用于2型糖尿病（DM）伴肮脂蛋白血症患者，且对非DM的高血脂者也有调脂作用，能降低TC、LDL和VLDL，升高HDL－C及降低TG。但对载脂蛋白B（ApoB)及载脂蛋白AI（ApoAI)的作用报道较少。为此，以常用的双胍类降糖药——二甲双胍为代表，评价该类药物对2型DM和非DM的血脂高者的ApoB及ApoAI的影响，并以磺脲类降糖药——格列吡嗪为对照，观察其改变是否与血糖改善有关。     

中原地区冠心病患者ApoB/ApoAI比值预测冠状动脉病变的价值研究

目的:探讨中原地区载脂蛋白ApoB/ApoAI比值与冠心病冠脉动脉(冠脉)狭窄程度的相关性。方法:对1 015例拟诊冠心病患者行冠脉造影,将其分为冠脉组(770例)和对照组(245例),Gensini积分(GS)系统评价冠脉病变程度。分析血脂特点及其与GS积分的相关性。结果:①LDL-C、LDL-C/HDL-C、ApoB、ApoB/ApoAI、Lp(a)冠心病组中显著高于对照组(P<0.05)。②ApoB/ApoAI(r=0.186)、LDL-C(r=0.149)、Lp(a)(r=0.194)、ApoB(r=0.166)与GS积分呈显著正相关(P<0.05)。③ApoB/ApoAI(B=30.129,P=0.021),Lp(a)(B=0.355,P=0.023)进入GS方程,是GS独立决定因子。④Logistic多元回归分析ApoB/ApoAI,Lp(a)的OR分别为12.410,1.029(P<0.05),是冠心病的独立预测因素。⑤ApoB/ApoAI的ROC曲线面积最大(0.647;95%CI,0.559~0.735;P=0.002),此研究人群诊断冠心病的最佳分界点0.885。结论:ApoB/ApoAI能预测中原地区冠心病的发生、评估冠脉粥样硬化严重程度。     

糖尿病心肌病临床特点分析

目的 :分析糖尿病心肌病临床表现 ,为其诊治提供依据。方法 :回顾性分析 2 5 3例相关病例的脂代谢、糖代谢及其超声心动图指标。结果 :1糖尿病并发冠心病组与糖尿病心肌病组的 TC,TG值无显著性差异 ,但糖尿病患者较非糖尿病患者的 TC,TG值均偏高 ;2糖尿病心肌病组较糖尿病并发冠心病组的 HDL值偏低 ,但无统计学意义 ;3糖尿病并发冠心病组的 L DL值 （4.83± 2 .91mmol/ L ）较糖尿病心肌病组的 L DL值 （1.3 6± 1.74mm ol/ L ）明显偏高 ,差异有显著性 （P<0 .0 1） ;4糖尿病心肌病组左室舒张功能较糖尿病并发冠心病组明显减低 （P<0 .0 5 ） ,较其他组也均减低 ,女性患者较男性患者更为明显。结论 :糖尿病病程、体重指数、L DL及超声心动图中 L PWd,IVST,EF值等与糖尿病心肌病临床表现关系密切     

137例“正常人”血清载脂蛋白Al及B的数值与血脂的关系

本文报道137名“正常人”血清载脂蛋白Al(Apo AI),载脂蛋白B(Apo B)、血清总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及甘油三酯(TG)水平的测定结果,提出“正常人”血清Apo AI、Apo B及Apo AI/Apo B的“正常值”,并对血清Apo AI、Apo B、Apo AI/Apo B与性别、年龄及血脂(TC、TG、HDL-C、TC-HDL-C/HDL-C)的关系进行讨论。     

Effects of long-term overfeeding on plasma lipoprotein levels in identical twins

Twelve pairs of male monozygotic (MZ) twins (mean age +/- S.D.: 21 +/- 2 years) were subjected to an overfeeding protocol of 4.2 MJ (1000 kcal) above their pre-established individual daily energy needs, 6 days a week, over a period of 100 days. Body weight increased significantly (gain of 8.1 kg, P<0.001), as did fat mass (5.4 kg, P<0.001) after overfeeding. Plasma triacylglycerol (TG) levels significantly increased (P<0.05) without change in plasma cholesterol (CHOL). Plasma very-low-density-lipoprotein (VLDL)-TG, VLDL-Apoprotein (Apo) B, low-density-lipoprotein cholesterol (LDL-C) and LDL-Apo B (P相似文献   

慢性肾功能衰竭患者血脂质变化

为研究慢性肾功能衰竭患者血脂质变化，检测40例慢性肾功能衰竭患者血清甘油三酯、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AI和B水平。结果显示，慢性肾功能衰竭患者血清甘油三酯及载脂蛋白B较对照组明显升高（1．27±0．60mmol／L比0．79±0．23mmol／L，P＜0．01；0．89±0．18g／L比0．80±0．17g／L，P＜0．05）；高密度脂蛋白胆固醇、载脂蛋白AI和载脂蛋白AI／B比值均明显降低（分别为1．07±0．47mmol／L比1．41±0．29mmol／L；1．26±0．28g／L比1．46±0．10g／L；1．41比1．82，P均＜0．01）。以上提示，慢性肾功能衰竭患者脂质代谢紊乱主要表现为甘油三酯和载脂蛋白B浓度升高，高密度脂蛋白胆固醇和载脂蛋白AI浓度降低。     

Haplotype analysis of Apo AI-CIII-AIV gene cluster and lipids level: Tehran Lipid and Glucose Study

Iranian populations show an increased tendency for abnormal lipid levels and high risk of Coronary artery disease. Considering the important role played by the ApoAI-CIII-AIV gene cluster in the regulation of the level and metabolism of lipids, this study aimed at elucidating the association between five single nucleotide polymorphisms on the Apo11q cluster gene and lipid levels. A cross-sectional study of 823 subjects (340 males and 483 females) from the Tehran lipid and glucose study (TLGS) was conducted. Levels of TG, Chol, HDL-C, Apo AI, Apo AIV, Apo B, and Apo CIII were measured, and the selected segments of the APOAI-CIII-AIV gene cluster were amplified by PCR and the polymorphisms were revealed by RFLP using restriction enzymes. The allele frequencies for each SNP between males and females were not significantly different. The distribution of Genotypes and alleles was in Hardy-Weinberg equilibrium except for Apo AI (+83C>T). The results showed a significant association between TG, HDL-C, HDL(2), Apo AI, and Apo B levels and the presence of some alleles in the polymorphisms studied. After haplotype analysis not only did the association between these variables and SNPs remain but also levels of Chol and LDL-C were added. This study demonstrates that the level of lipids such as TG, HDL-C, HDL(2), Apo AI, and Apo B, maybe regulated partly by genetic factors and their haplotype within the Apo11q gene cluster.     

Effects of hormone replacement therapy and hepatic lipase polymorphism on serum lipid profiles in postmenopausal Japanese women

The purpose of this study was to evaluate the relationships among hepatic lipase (HL) polymorphism, serum lipids, lipoproteins, and remnant-like particle cholesterol (RLP-C) and to determine the effects of hormone replacement therapy (HRT). We assessed the HL polymorphism in 209 postmenopausal Japanese women. Levels of serum total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, apolipoprotein (Apo) AI, Apo B, Apo E, Apo CII, Apo CIII, and RLP-C were measured before and after 3 months of HRT. The frequency of each genotype was 32% for -514 C/C, 41% for C/T, and 27% for T/T. Subjects with the C/T and T/T genotypes had higher levels of HDL cholesterol and Apo AI than those with the C/C genotype. Those with the T/T genotype had higher levels of RLP-C than those with the C/C or C/T genotype. Serum total cholesterol, LDL cholesterol, Apo B, Apo E, and Apo CII were decreased, and HDL cholesterol and Apo AI were increased significantly in all genotypes after 3 months of HRT. There were no differences in these changes with genotype. The HL polymorphism was associated with higher levels of HDL cholesterol, Apo AI, and RLP-C, and the HL gene variation may contribute to HL activity and affect serum lipoprotein metabolism. Effects of HRT on serum lipids, lipoproteins, and remnant lipoprotein metabolism were unaffected by the HL polymorphism.     

胎盘提取液对实验性高脂大鼠的抑制作用及其机制探讨

目的 :观察人胎盘提取液对高脂鼠脂蛋白 -胆固醇代谢及血小板聚集功能的影响。方法 :Wistar大鼠定量给予高脂饲料建立高脂模型 ,用胎盘提取液 4ml/(kg· d)连续灌胃 1 2 d,测定血脂 ,脂蛋白 ;血浆中前列环素 (PGI2 ) ,血栓素 A2 (Tx A2 )含量及血小板最大聚集率 (MA)。结果 :胎盘提取液可使高脂鼠血清中高密度脂蛋白明显升高 ,甘油三酯、胆固醇、低密度脂蛋白含量明显降低 (P <0 .0 1 ) ;使血浆中前列环素含量明显升高 (P <0 .0 1 ) ,Tx A2 含量无明显变化 ,并明显降低 MA(P <0 .0 1 )。结论 :胎盘提取液通过改善脂蛋白 -胆固醇代谢及抑制血小板聚集的综合效应拮抗动脉粥样硬化的发生和发展     

垂体性侏儒症患儿血脂及载脂蛋白A1,B水平

对25例垂体性侏儒儿的血胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C),低密度脂蛋白(LDL-C)、载脂蛋白A_1(Apo A_1)、载脂蛋白(Apo B)等进行了测定,并与相应健康儿作了比较;与此同时,还着重观察了基因重组人生长激素(hGH)治疗3个月后对患儿上述指标的影响。结果表明:(1)患儿组TC、TG、LDL-C和Apo B值均明显高于对照组(P分别<0.01、<0.05、<0.01和<0.01);其中TC值高于正常值上限者14例,占56％;TG升高者2例,占8％;Apo B升高者13例,占52％;而Apo　A_1水平较对照组明显降低(P<0.01)。(2)hGH治疗3个月后随访,患儿组的TC,LDL-C和Apo B水平较治疗前明显下降(P分别<0.05,<0.01和<0.01);而TG和Apo A_1水平皆有不同程度的上升(P<0.01)。提示垂体性侏儒儿存在着不同程度的脂质代谢紊乱,而生长激素缺乏是其主要原因之一。     

老年冠心病患者血清脂质和脂质过氧化物测定的临床意义

本文观测了４４例老年冠心病患者血清脂质，丙二醛和超氧化物歧化酶，并与健康老年人对照比较，结果显示除胆固醇外其余各项指标２组间均有显著差异，老年ＣＨＤ组ＭＤＡ明显高于对照组，而ＳＯＤ则与之相反。多元回归分析表明，血清低密度脂蛋白胆固醇，而血清高密度脂蛋白胆固醇与ＳＯＤ呈显著正相关。提示老年ＣＨＤ患者高脂血症与脂质过氧化间有一定关系，它对判断老年ＣＨＤ的病情及预后有重要参考意义。     

乐瓦停治疗原发性和继发性高脂血症的临床观察

本文报道乐瓦停(Lovastatin)对伴有高脂血症的陈旧性心肌梗塞(OMI)、非胰岛素依赖型糖尿病(NIDDM)及肾病综合征(NS)三组患者34例的降血脂疗效。结果显示,与治疗前比,服安慰剂4周,各组血脂均无明显变化;服乐瓦停4周,各组血脂均有明显改善,继续服药,疗效稳定。服乐瓦停12周,TC降34.1%(P<0.001),LDL-C降43.6%(P<0.001),TC/HDL-C降35.6%(P<0.001),TG降30.8%(P<0.01),OMI组及NIDDM组ApoB都明显下降(P<0.01—0.001),Apo A Ⅰ/Apo B比值都明显上升(P<0.01—0.001);三组Apo A-Ⅰ、HDL-C及NS组的Apo B及Apo A-Ⅰ/Apo B比值均未见明显变化(P>0.05)。疗程中,乐瓦停与环磷酰胺或雷公藤合用的2例SGPT均明显升高,停药后迅速回降。本文未见其它重要副作用。     

Cholesterol fractions in subjects with cerebral, coronary and peripheral vasculopathy

An epidemiological investigation of certain lipaemic parameters in some expressions of atherosclerotic disease with particular reference to HDL-cholesterol fractions is reported. The series consists of 94 normal weight subjects (45 m, 49 f, average age 61 +/- 5) subdivided as follows: 38 suffering from cerebral vasculopathy (group A), 41 from ischaemic cardiopathy (group B), 15 from peripheral vasculopathy (group C). One hundred controls aged between 41 and 70 and free from hepato-renal, endocrinometabolic and vascular diseases were also considered. In the case of each sample, plasma levels of triglycerides (TG), total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), HDL-3 cholesterol (HDL-3-C), HDL-2-cholesterol HDL-2-C), HDL-C/TC and HDL-2-C/HDL-C ratios were determined with the enzymatic method. In group A, an increase in TG (P less than 0.05) was observed with respect to the controls, while values of TC and LDL-C were slightly lower: values of HDL-C, HDL-3-C and HDL-2-C were decidedly down (P less than 0.01); the HDL-C/TC and HDL-3-C/HDL-C ratios were decidedly reduced (respectively P less than 0.05 and P less than 0.01). In subjects suffering from ischaemic cardiopathy (group B), TG values (P less than 0.05) were somewhat higher than the controls and TC and LDL-C did not differ significantly. The cholesterol fractions HDL-C, HDL-3-C (P less than 0.05) and HDL-2-C (P less than 0.05) and the ratio HDL-C/TC (P less than 0.05) were sharply reduced; the HDL-2/HDL-C ratio was normal.(ABSTRACT TRUNCATED AT 250 WORDS)