HDL、LDL 的正常值、异常值

<正> 高密度脂蛋白胆固醇(HDL-Ch)一般以女性为高。脐带血的 HDL-Ch 为50mg/dl左右。其后随年龄增加可上升到60～70mg/dl 的水平。40岁以上为50～60mg/dl,略有降低。总胆固醇(TCh)减去 HDL-Ch 大致相当于极低密度脂蛋白胆固醇(VLDL-Ch)加上低密度脂蛋白胆固醇(LDL-Ch)之和。从15岁开始,TCh-(HDL-Ch)有增加的趋势,超越200mg/dl,被认为是异常高值。     

运动对血浆脂蛋白及相关酶类活性的影响

观察运动对饲胆固醇家兔血浆脂类(TG、TCh)、脂蛋白(LDL-Ch、HDL-Ch)水平及相关酶类(LPL、LCAT)活性的影响,从而进一步了解运动降血脂效应的机制。     

实验性动脉粥样硬化家兔脂蛋白与血小板的相关性研究

通过复制家兔动脉粥样硬化(AS)模型,测定血浆脂蛋白、前列腺素水平、血小板聚集(PMAR)及主动脉组织 Ch、AppB 含量和粥样病变面积,探讨血浆脂蛋白与血小饭的相关性及与二者与主动脉粥样病变的相关性。结果显示:PMAR 与血浆总胆固醇(TC、r=0.727)、血浆甘油三脂(TG,r=0.502)、血浆低密度脂蛋白胆固醇(LDL-Ch,r=0.705)、血浆载脂蛋白 B(ApoB,r=0.751)均呈直线正相关(P 均<0.01),与 HDL_2-Ch(r=-0.444),HDL-Ch/TC(r=-0.584)均呈直线负相关(P 均<0.01),主动脉组 Ch、ApoB 含量及粥样病变面积各自与血浆 ApoB,PMAR 呈正相关(P 均<0.05～0.0),而与血浆 HDL_2-Ch 里负相关(P 均<0.05～0.01)。结果提示:血浆 TC、TG、LDL-Ch、ApoB 升高具有激活血小板致 AS 作用.而 HDL_2-Ch,HDL-Ch/TC 升高再有抑制血小板抗 AS 作用     

糖尿病人血清高密度脂蛋白胆固醇及其亚组的水平和临床意义(摘要)

本文测定了204例糖尿病人和197名正常人血清高密度脂蛋白的胆固醇(HDL-Ch)及其亚组HDL_2-Ch、HDL_3-Ch水平。 在正常人中,将血脂及HDL亚组水平与年龄、性别、体重及血清甘油三脂(TG)和胆固醇(Ch)亚组的影响进行了比较,其中HDL-Ch及亚组水平显示HDL-Ch和HDL_2-Ch的性别差异大于HDL_3-Ch。男性HDL-Ch及亚组在青春期水平较低,以后相对稳定。女性HDL-Ch则有随年龄增加而上升的趋势。超重和肥胖者血清HDL-Ch及HDL_2-Ch均低于正常体重对照组。另TG和体重增加与     

血清高密度脂蛋白浓度与肝功能的相关性研究

本文对145例常规肝功能试验三项以上异常的各种肝病患者作了高密度脂蛋白胆固醇(HDL-Ch)含量测定,各组HDL-Ch含量与正常水平比较,均有非常显著性差异(P<0.01);肝硬化患者者血清白蛋白/球蛋白比值与HDL-Ch含量成正相关(γ=0.6650、P<0.001):黄疸指数与HDL-Ch浓度无相关性(γ=0.1561,P>0.05);HDL-Ch浓度的下降与肝功能减损程度成正相关,尤以重肝为甚,肝硬化、慢活肝次之。数据显示,HDL-Ch浓度测定对于肝脏功能的判定有一定的临床价值。     

糖尿病患者的血清脂类与载脂蛋白B和C

测定了42例糖尿病患者与27例健康者的血浆脂类、脂蛋白及载脂蛋白水平,结果:糖尿病患者的TG、TCh、LDL-Ch、HDL_3-Ch及Apo B均高于对照组,HDL-Ch和Apo CⅡ低于对照组,表明糖尿病患者血浆脂类、载脂蛋白代谢异常,容易发生动脉粥样硬化。     

复方苦豆子对实验性动物血脂和血压的影响

目的 观察复方苦豆子对实验性动物血脂和血压的影响.方法 正常对照组除外,给鹌鹑喂饲高脂饲料建立高脂血症模型,模型复制成功后随机分成6组:正常对照组,高脂模型组,复方苦豆子高、中、低剂量组按24.4 g/(kg·d)、12.2 g/(kg·d)、6.1 g/(kg·d)灌胃给药,血脂康组0.4 g/(kg·d).在第14周测定鹌鹑总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白-胆固醇(LDL-Ch)、高密度脂蛋白-胆固醇(HDL-Ch)、动脉硬化指数(AI).用两肾一夹法复制大鼠肾性高血压模型,模型成功后随机分成6组:正常对照组、高血压组、卡托普利组(5 mg/(kg·d))、复方苦豆子高、中、低剂量组(剂量同上),在第8、10周测定大鼠血压.结果 与高脂模型组比较复方苦豆子能明显降低高脂血症鹌鹑血清中的TC、TG、LDL-C、AI,升高血清中的HDL-C;与高血压组比较能降低肾性高血压大鼠血压.结论 复方苦豆子具有一定的调血脂及降压作用.     

大黄对慢性肾衰患者脂质代谢的影响

对198例慢性肾哀(CRF)患者分两组研究其非透析阶段的脂质代谢改变及中药大黄对脂质代谢的影响,并与100例健康人进行比较。全部病例均采用优质低蛋白、低磷饮食,定期检查血 TG,Ch,HDL-Ch,LDL-Ch,VLDL-Ch,apoA_1,apoB.结果显示,CRF 非透析患者具有以Ⅳ型高脂血症为特征的脂质代谢异常,突出表现为 TG,VLDL-Ch 升高:并有高 Ch 血症及高 LDL-Ch 血症,apoA_1/apoB 比值低于正常;部分患者亦见 HDL-Ch 及 apoA_1降低。脂质代谢异常的程度与肾功能、血压及肾衰的病因有关.经大黄治疗后,CRF 患者的血 TG,Ch 降低,其作用肯定、持续,说明大黄在延缓 CRF 进展的同时,具有改善脂质代谢异常的作用.     

三种高密度脂蛋白胆固醇测定方法的比较

高密度脂蛋白胆固醇(HDL-Ch)测定始于预防医学,以预言个体发生冠心病的可能性。识别这些人群的重要性,在于医学可能从饮食、药物控制及体育锻炼以预防和延迟冠心病的发生。1975年以后几组大数量流行病学的研究表明:血清HDL-Ch浓度的变化与临床冠心病发病率呈显著负相关;是预言冠心病较好的脂质指标;它似比总胆固醇敏感。因此受到     

大鼠肝内皮细胞脂酶代谢功能研究

8只正常雄性大鼠血清总胆固醇(TCh)为0.5876±0.0874g/L((?)±SD),总甘油三酯(TG)0.7850±0.2417g/L,总磷脂(PL)1.2699±0.1022g/L,高密度脂蛋白胆固醇(HDL-Ch)0.4123±0.050 5g/L,HDL-PL 0.6190±0.0652g/L,HDL_3-Ch 0.1741±0.0290g/L,HDL_8-PL 0.4553±0.0807g/L,HDL_2-Ch 0.2381±0.0353g/L,HDL_2-PL 0.1638±0.0476g/L,极低密度脂蛋白胆固醇(VLDL-Ch)0.0618±0.0404g/L,VLDL-PL 0.1622±0.0869g/L,低密度脂蛋白胆固醇(LDL-Ch) 0.1136±0.0713g/L,和LDL-PL 0.4887±0.1230。门静脉注射1 ml纯化大鼠肝内皮细胞脂酶(HEL)1 h后血清TCh下降0.0425±0.0197 g/L(p<0.005),TG下降0.0964±0.0573g/L(p<0.005),PL下降0.1049±0.0516g/L(p<0.001),HDL-Ch下降0.0444±0.0289g/L(p<0.005),HDL-PL下降0.0675±0.0427g/L(p<0.005),HDL_3-Ch升高0.0055±0.0200g/L(p>0.5),HDL_3-PL升高0.0246±0.0482g/L,HDL_2-Ch下降0.0499±0.0429g/L(p<0.02),HDL_2-PL下降0.0918±0.0519g/L(p<0.002),VLDL-PL下降0.0136±0.0818g/L(p>0.5),VLDL-Ch下降0.0328±0.0403g/L(p<0.05),LDL-Ch升高0.0346±0.0262g/L(p<0.01),LDL-PL下降0.0239±0.0770g/L(p>0.02)。实验结果提示:(1)HDL-PL是HEL最适宜底物;(2)HEL是HDL_2分解代谢的酶,可     

降血脂剂对犬人工血管内膜增生的影响

目的探讨降血脂剂对减轻静脉系人工血管移植物内膜增生的作用。方法将自体静脉碎片种植的Dacron植入20只犬下腔静脉(IVC),除对照组(n=8)外,实验组(n=12)术后给降血脂剂口服,两组动物定期处死,测定比较两组血中总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)含量以及人工血管内膜厚度。结果实验组血管通畅率(75%)高于对照组(37.5%),Dacron腔面术后2周完全内皮化。与对照组比较,实验组移近心端(P<0.01)、中部(P<0.05)及远心端(P<0.05)的植物内膜厚度均显著薄于对照组。动物处死时,实验组血清TC与LDL-C含量均显著低于对照组(P<0.05),HDL-C含量无组间差异(P>0.05)。结论降血脂剂可显著降低犬血脂,对减轻人工血管内膜增生、提高通畅率有一定作用。     

降血脂剂对犬人工血管内膜增生的影响

OBJECTIVE: To investigate the effects of the lipid-lowering drugs in alleviating endothelial hyperplasia in the inferior vena cava (IVC) grafts in dogs. METHODS: The Dacron grafts seeded with autologous venous fragments were implanted into the IVC of 20 dogs, including 12 dogs receiving oral lipid-lowering drugs serving as the treatment group and the other 8 without medication as the control group. The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-ch) and high-density lipoprotein cholesterol (HDL-ch) in the serum were measured regularly, and all the grafts harvested to measure the thickness of the endothelium. RESULTS: The total patency rate of the IVC were higher in the treatment group (75%) than in the control group (37.5%), and new endothelial lining was formed two weeks after the operation. Compared with the control group, the endothelial thickness of the grafts at the proximal (P<0.01), middle (P<0.05) and distal segments (P<0.05) of the IVC were all smaller in the treatment group, which also had lower serum LDL-ch and TC levels (both P<0.05) but with comparable HDL-ch levels (P>0.05). CONCLUSION: Administration of lipid-lowering drugs may reduce the level of serum LDL-ch and TC and the endothelial thickness of the grafts to improve the patency rate of the vessels.     

碱提类肝素对大鼠血浆脂质的调整作用及机理

碱提类肝素及其组分1和组分2能有效地预防和治疗高脂饲料诱发的大鼠血脂紊乱,包括降低血清TC,降低LDL-ch和VLDL-ch水平,提高HDL-ch/LDL-ch比值。这一作用可能主要是通过促进血管壁脂蛋白脂酶的释放,提高血浆脂蛋白脂酶活性而发挥的。     

应用TG/HDL-ch比较老年糖尿病和非糖尿病患者sdLDL水平

目的比较和评估老年2型糖尿病和非糖尿病患者小而致密LDL(sdLDL)水平的变化情况及相关血脂谱特点。方法共有132例老年2型糖尿病和137例老年非糖尿病患者符合入组条件。检测指标主要有糖化血红蛋白(HbA1c)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-ch)、低密度脂蛋白胆固醇(LDL-ch)、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)、载脂蛋白E(Apo-E)和脂蛋白a(Lp-a),并应用TG/HDL-ch评估sdLDL水平。结果老年2型糖尿病患者除HDL-ch明显低于老年非糖尿病患者外,血脂谱中其余各项指标的组间比较无显著性差异。分别有34.10%和27.00%的老年2型糖尿病和老年非糖尿病患者存在sdLDL水平的升高。当sdLDL水平正常时,老年2型糖尿病患者的血脂谱改变表现为HDL-ch明显低于老年非糖尿病患者(P<0.05);但这一差异在sdLDL水平升高时则不明显。结论老年2型糖尿病患者的血脂谱改变主要表现为高密度脂蛋白胆固醇的降低。应用TG/HDL-ch可初步筛查出存在小而致密LDL水平升高的患者。     

纺织女工服用咖啡因对血脂、脂蛋白的影响及血清PK活性值的测定——Ⅰ.纺织女工服用咖啡因对血脂、脂蛋白的影响

测定了接触强噪声的纺织女工在饮用含咖啡因的咖啡前后血液TG,Ch,LDL-ch,和HDL-ch;以不接触噪声的女大学生作对照。结果表明,纺织女工血液TG、ch,LDL-ch显著升高,服用咖啡因后明显降低,而HDL-ch含量增多,提示咖啡因可改善接触强噪声的纺织女工的脂代谢异常。     

低密度脂蛋白-胆固醇达标的冠心病患者脂蛋白(a)水平与冠脉病变复杂程度的相关性研究

目的:探讨低密度脂蛋白-胆固醇达标的冠心病患者脂蛋白（a）水平与冠脉病变复杂程度的相关性。方法:收集低密度脂蛋白-胆固醇已达标的212例行冠脉造影的冠心病患者临床资料,根据SYNTAX评分将患者分为低危组（0～22分）104例和中高危组（≥23分）108例,采用Pearson相关分析血脂指标与SYNTAX评分的相关性,绘制ROC曲线评估脂蛋白（a）对冠脉病变复杂程度的预测价值并确定最佳临界值。采用多因素Logistic回归分析脂蛋白（a）与冠脉病变复杂程度的关系。结果:中高危组脂蛋白（a）水平高于低危组[28.55（13.98,52.00）nmol/L vs.13.55（8.10,33.60）nmol/L（P <0.01）]。Pearson相关分析显示,脂蛋白（a）水平与SYNTAX评分呈正相关（r =0.235,P <0.01）。ROC曲线显示,脂蛋白（a）预测冠状动脉病变复杂程度的曲线下面积为0.653（95%CI:0.580~0.727,P<0.01）,最佳临界值12.70 nmol/L,灵敏度78.7%,特异度49%。多因素Logistic回归分析结果显示,脂蛋白（a）是冠脉病变复杂程度的独立危险因素（OR=2.734,95%CI:1.358~5.504,P <0.01）。结论:低密度脂蛋白-胆固醇达标的冠心病患者中脂蛋白（a）是冠状动脉病变复杂程度的独立危险因素,为冠心病药物治疗提供了新靶点。     

阿司匹林与培哚普利合用对兔动脉粥样硬化模型血中PGI2，TXA2，NE及心功能的影响

OBJECTIVE: To explore the interactive effect of low-dosage aspirin (ASA) combined with perindopril (PER), on prostacyclin (PGI2), thromboxone A2 (TXA2), and norepinephrine (NE) in the blood of arteriosclerosis rabbit models and the cardiac function. METHODS: Sixty adult New Zealand rabbits were randomly distributed into 5 groups with 12 rabbits in each group. One group was fed with standard fodder; the others were fed with high lipoid-diet (1% cholesterol content). Before and after 8 weeks' administration consecutively, LVEDP, LVSP, HR, +/- dp/dtmax, plasma PGI2 and TXA2, serum NE, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-ch), high-density lipoprotein cholesterol (HDL-ch) and triglycerides (TG) were evaluated. RESULTS: TG, TC, LDL-ch and pathological results confirmed arteriosclerosis rabbit models successfully. ASA combined with PER led to a significant increase in PGI2/TXA2 (P < 0.01) together with a significant decrease in the NE levels (P < 0.01) in the rabbits' blood, and then improved the cardiac output, i.e. increased LVSP (P < 0.01), and decreased the heart rate (P < 0.01) and LVEDP (P < 0.01) to a greater extent in the arteriosclerosis rabbit models. CONCLUSION: The ratio of PGI2 to TXA2 increased, and the NE levels decreased significantly; meanwhile, the heart rate decreased and the cardiac function improved during the administration of aspirin combined with perindopril in arteriosclerosis rabbit models. The results suggest that there is a synergism-action between low-dosage aspirin and ACE inhibitors due to increased PGI2/TXA2 and decreased NE levels.     

脂蛋白与动脉粥样硬化关系的研究

本文报道作者与同事们近十多年来在脂蛋白与动脉粥样硬化关系方面进行的研究成果,如高脂蛋白血症表现分型、高脂血症基因分析、新生儿脐带血及健康成人血清各种脂蛋白-胆固醇(Ch)的变化、实验性LCAT缺乏家兔的脂蛋白代谢、胰岛素和甲状腺素对家兔脂蛋白脂肪酶(LPL)和肝脂酶(HL)活性的影响、实验性动脉粥样硬化家兔主动脉LPL活性与Ch 沉积的关系、载脂蛋白β(apoβ)的分离、提纯及其免疫定量与apoc的分离、定量等。     

EFFECTS OF SIMVASTAIN COMBINED WITH OMEGA-3 FATTY ACIDS ON HIGH SENSITIVE C-REACTIVE PROTEIN,LIPIDEMIA,AND FIBRINOLYSIS IN PATIENTS WITH MIXED DYSLIPIDEMIA

Objective To evaluate the effects of simvastatin combined with omega-3 fatty acids on high sensitive C-reactive protein (HsCRP), lipidemia, and fibrinolysis in coronary heart disease (CHD) and CHD risk equivalent patients with mixed dyslipidemia.Methods A randomized, double-blind placebo controlled and parallel group trial was conducted. Patients with CHD and CHD risk equivalents with mixed dyslipidemia were treated with 10 or 20 mg simvastatin for 6-12 weeks. Following with the treatment of patients whose low-density lipoprotein cholesterol (LDL-ch) reaching goal level (＜ 100 mg/dL) or close to the goal (＜ 130 mg/dL), while triglyceride (TG) ≥ 200 mg/dL and ＜ 500 mg/dL, was combined with omega-3fatty acids (3 g/d) or a placebo for 2 months. The effects of the treatment on HsCRP, total cholesterol (TC), LDL-ch, highdensity lipoprotein cholesterol (HDL-ch), TG, lipoprotein (a) [LP (a)], apolipoprotein Al (apoAl), apolipoprotein B (apoB),plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (tPA) were investigated. Forty patients finished the study with each group consisting of twenty patients.Results (1) There were significant reductions of HsCRP, TG, TC, and TC/HDL-ch, which decreased by 2.16 ± 2.77mg/L (38.5%), 94.0± 65.4 mg/dL (31.1%), 13.3 ± 22.3 mg/dL (6.3%), 0.78 ± 1.60 respectively in the omega-3 fatty acids group (P ＜ 0.01, ＜ 0.001, ＜ 0.05, ＜ 0.05) compared to the baseline. HsCRP and triglyceride reduction were more significant in omega-3 fatty acids group compared to the placebo group (P= 0.021 and 0.011 respectively). (2) In the omega-3 fatty acids group, the values and percentage of TG reduction had a significantly positive relation with HsCRP reduction (r = 0.51and 0.45, P=0.021 and 0.047 respectively).Conclusion In CHD and CHD risk equivalent patients with mixed dyslipidemia, dyslipidemia's therapeutic effect using simvastatin and omega-3 fatty acids may result from not only the combination of lipid adjustment, but also enhancement of their own nonlipid influences.     

MELD评分联合血清高密度脂蛋白胆固醇水平预测非酒精性肝硬化预后

目的评估终末期肝病模型(model for end-stage liver disease,MELD)联合血清高密度脂蛋白胆固醇(HDL-C)水平对预测肝硬化肝功能失代偿期患者的短期、中期死亡危险的价值。方法入选57例非酒精性肝硬化肝功能失代偿期患者,分别根据随访6月及12月的存活情况分组,观察死亡者与存活者中血清HDL-C值、MELD评分。结果随访至6月及12月,死亡者血清HDL-C显著低于存活者,MELD评分显著高于存活者,均具有统计学差异(均P<0.01)。MELD评分与HDL-C密切相关(r=-0.96,P<0.01)。MELD评分联合血清HDL-C预测6个月死亡敏感性100.0%,特异性92.1%。结论MELD评分系统、血清HDL-C水平是预测非酒精性肝硬化患者6个月、12个月生存率的独立的较好预后指标。MELD评分联合血清HDL-C水平在预测非酒精性肝硬化肝功能失代偿期患者短、中期死亡率方面具有更好的作用。