血脂康对冠心病纤维蛋白原、血粘度和胰岛素抵抗的影响

目的;观察国产血脂康在调脂治疗的同时对冠心病患者纤维蛋白原、血粘度和胰岛素抵抗的影响。方法:54例冠心病伴血清总胆固醇(TC)>5.2mmol/L或低密度脂蛋白胆固醇(LDL-C)>3.12mmol/L患者口服血脂康(0,6,2次/d),治疗8周,观察治疗前、后TC、LDL\IC、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)及纤维蛋白原、血粘度和胰岛素敏感性指数(ISI)变化,另选择20例正常健康者作为对照组。结果:血脂康治疗8周后,TC、LDL-C和TG水平分别下降24.6％、34.1％和17.5％,HDL-C水平升高13.4％(P均<0.05或<0.01);纤维蛋白原和不同切变率的血粘度均显著降低(P<0.05或<0.01)。血脂康治疗前胰岛素敏感指数显著低于正常对照组,而治疗后则明显升高(P<0.05)。结论;血脂康对于冠心病患者不仅能够有效调整血脂,而且还具有降低纤维蛋白原和血粘度及改善胰岛素抵抗的有益作用。     

血脂康对冠心病合并高脂血症患者疗效的Meta分析

目的评价血脂康治疗冠心病合并高脂血症患者的疗效。方法计算机检索PubMed、Cochrane图书馆、EBSCO host、中国学术期刊网络出版总库(CNKI)、万方医学数据库、维普中文科技期刊全文数据库(VIP),检查时间为2013年10月之前。纳入标准为血脂康治疗高脂血症的随机对照试验。采用Revman 5.2软件进行Meta分析。系统评价血脂康对血清总胆固醇(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)的影响。结果共纳入19项随机对照试验,包括6229例患者。Meta分析显示,在冠心病常规治疗的基础上,血脂康组较安慰剂组TC、TG、LDL-C显著降低[(WMD=-1.15,95%CI:-1.67~-0.64,P0.001)、(WMD=-0.51,95%CI:-0.83~-0.20,P=0.002)、(WMD=-0.99,95%CI:-1.38~-0.59,P0.001)],HDL-C明显升高(WMD=0.21,95%CI:0.05~0.38,P=0.01);血脂康组较单纯常规治疗组TC、TG、LDL-C显著降低[(WMD=-1.19,95%CI:-1.45~-0.93,P0.001)、(WMD=-1.19,95%CI:-1.45~-0.93,P0.001)、(WMD=-1.00,95%CI:-1.27~-0.73,P0.001)],HDL-C显著升高(WMD=0.17,95%CI:0.05~0.29,P=0.007)];血脂康与他汀类药物相比TC、TG、LDL-C、HDL-C差异均无统计学意义。结论在冠心病常规治疗的基础上,可有效调节血脂,与他汀类药物作用相当。     

调脂治疗对冠心病患者餐后血管内皮功能的影响

目的　旨在通过高脂餐试验 ,研究调脂治疗对冠心病患者餐后血管内皮功能变化的影响。方法　 5 0例来源于我院心血管内科门诊和住院的冠心病患者。经饮食宣教 4周后 ,开始高脂餐试验和采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能 (FMD)。随后将受试者随机分为常规治疗组和血脂康组。治疗 6周后重复上述检查。结果　治疗前两组高脂餐后 4h的FMD明显受损 (P <0 0 5 ) ,餐后血清甘油三酯 (TG)浓度明显升高 (P <0 0 5 ) ,两组间餐后甘油三酯曲线下面积 (TG AUC)差异无显著性。 6周后血脂康组餐前和餐后FMD有明显改善 (P <0 0 5 ) ,且空腹FMD和餐后FMD差异无显著性 ,而常规治疗组空腹FMD和餐后FMD较治疗前无明显变化 ,餐后FMD仍显著受损 (P <0 0 5 )。相关分析显示餐后TG AUC与餐后 4h内皮依赖性血管舒张功能下降值正相关 (r=0 32 2 ,P <0 0 5 )。治疗后TG AUC的变化与空腹和餐后FMD的变化显著相关 (P <0 0 1)。结论　高脂餐后冠心病患者血管内皮功能受损 ,可能与餐后血脂紊乱有关。提示血脂康调脂治疗有效改善冠心病患者空腹和高脂餐后血管内皮功能。     

中国汉族人群高密度脂蛋白胆固醇水平与冠心病的关系

目的 探讨中国汉族人群高密度脂蛋白胆固醇（HDL-C）与冠心病的关系。 方法 收集2008年8月~2009年8月入住西安交通大学医学院第一附属医院心内科冠心病患者375例,和健康对照者348例,清晨抽取空腹静脉血,检测总胆固醇（TC）、三酰甘油（TG）、HDL-C、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白（Apo）A-I和ApoB,并计算TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和ApoB/ApoA-I比值。通过logistic回归分析和ROC曲线分析各血脂指标与冠心病的关系和诊断价值。 结果 与对照组相比,冠心病组患者TG、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C、ApoB/ApoA-I水平显著增高,而HDL-C、ApoA-I较对照组显著降低。在校正年龄、性别、吸烟史、高血压病史和糖尿病史后,经多变量logistic回归分析,发现TG、HDL-C、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和ApoB/ApoA-I进入回归模型,回归系数分别为:0.222、-1.878、0.258、0.248、0.657和1.566,经ROC曲线分析发现,上述各指标的曲线下面积分别为0.612（P<0.01）、0.717（P<0.01）、0.680（P<0.01）、0.653（P<0.01）、0.661（P<0.01）、0.616（P<0.01）,提示HDL-C水平降低对冠心病的诊断价值最大。 结论 HDL-C水平与中国汉族人群冠心病有相关性。     

Apolipoprotein concentrations during treatment and recurrent coronary artery disease events

The effect of untreated total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) as cardiovascular risk factors in both primary and secondary prevention has been extensively investigated. The predictive value of on-treatment lipid and apolipoprotein levels on subsequent cardiovascular events is as yet uncertain. Eight hundred forty-eight patients (675 men and 173 women) with angiographically proven coronary artery disease (CAD) who received effective statin therapy (>/=30% decrease of baseline TC) were studied. We analyzed the predictive value of on-treatment levels of TC, LDL-C, triglycerides (TG), apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB) on subsequent myocardial infarction (MI) and all cause mortality. On-treatment LDL-C levels were 2.55+/-0.55 mmol/L and 2.58+/-0.62 mmol/L for men and women respectively. Age-adjusted Cox regression analysis showed that only on-treatment apoA-I was predictive for future CAD events in both men and women, whereas on-treatment HDL-C was exclusively predictive in women. On-treatment apoB levels were predictive for recurrent CAD events in the total population but not after separate analysis for men and women. On-treatment levels of TC, LDL-C, and TG did not predict subsequent events. Multivariate analysis showed that on-treatment apoA-I and apoB were the only significant predictors for future cardiovascular events. On-treatment levels of TC, LDL-C, and TG were no longer associated with increased risk of recurrent cardiovascular events in CAD patients treated to target levels, which justifies the current guidelines. However, on-treatment levels of apoB and in particular apoA-I (and HDL-C in women) were significantly predictive for MI and all-cause mortality and may therefore be more suitable for cardiovascular risk assessment in this population.     

血脂康调整血脂对冠心病的二级预防研究

目的:研究血脂康调整血脂对冠心病的二级预防作用。方法:采用双盲、随机、安慰剂对照长期随访临床试验,研究时间从1997年至2003年,对97例血清总胆固醇(TC)水平在4．40～6．47 mmoL／L(170～250 mg/dl)之间、年龄18～75岁,有明确心肌梗死的冠心病患者分为血脂康组(49例),安慰剂组(48例),主要终点为冠心病事件(包括非致死性心肌梗死和冠心病死亡)。次要终点为总死亡。同时观察血脂变化。结果:冠心病事件和总死亡在血脂康组发生率分别为4．25％和6．12％,在安慰剂组发生率分别为18．75％与20．83％。两组冠心病事件和总死亡率分别比较,差异均有统计学意义,P<0．05。调脂治疗后,血脂康组TC、甘油三酯(TG)、低密度脂蛋白胆固醇分别降低19．04％、13．76％、25．52％;对照组TC、TG、低密度脂蛋白胆固醇分别降低3．21％、4．57％、1．21％;血脂康组高密度脂蛋白胆固醇升高4．35％,安慰剂组升高1．77％,两组间各指标比较均有统计学差异。在临床不良反应和实验室指标异常方面,血脂康组和安慰剂组间差异无统计学意义。结论:与安慰剂组比较,血脂康能显著降低冠心病心肌梗死患者的冠心病事件与总死亡的发生率。     

Association of the apolipoprotein B/apolipoprotein A-I ratio and low-density lipoprotein cholesterol with insulin resistance in a Chinese population with abdominal obesity

The aim of this study is to assess the relationships among the apolipoprotein B/apolipoprotein A-I ratio (apoB/apoA-I ratio), low-density lipoprotein cholesterol (LDL-C) and insulin resistance (IR) in a Chinese population with abdominal obesity. This is a population-based, cross-sectional study of 3,945 men and 2,141 women with abdominal obesity. Individuals were referred to a primary health service and recruited for analysis. IR was measured using a homeostasis model assessment of insulin resistance (HOMA2-IR) with a HOMA2 calculator. Metabolic syndrome (MetS) was diagnosed using International Diabetes Federation (IDF) criteria. Comparing the apoB/apoA-I ratio and lipid indices using the HOMA2-IR showed that the ratio, LDL-C, total cholesterol level (TC) and triglyceride level (TG) were higher; and the high-density lipoprotein cholesterol level (HDL-C) was lower in the fourth than in the first quartile in both sexes (p????0.001). After adjustment for age, HOMA2-IR was positively correlated with the apoB/apoA-I ratio, LDL-C, TC and TG; and negatively correlated with HDL-C in men (all p?<?0.0001). HOMA2-IR was also positively correlated with the apoB/apoA-I ratio, LDL-C, TC and TG; and negatively correlated with HDL-C in women (all p?<?0.01). After adjustment for age and LDL-C, HOMA2-IR was found to be correlated with the apoB/apoA-I ratio in both men and women (r?=?0.066 and 0.116, p?<?0.0001). After adjustment for age and the apoB/apoA-I ratio, HOMA2-IR was correlated with LDL-C in men and women (r?=?0.063 and 0.044, p?<?0.0001 and p?=?0.0431, respectively). Gender, age, LDL-C, BMI, HOMA2-IR and apoB/apoA-I were the covariates independently associated with presence of the MetS (Odds ratio, OR: 2.183, 1.034, 1.013, 1.157, 1.726 and 1.570, respectively; all p?<?0.05). In conclusion, the study showed that the apoB/apoA-I ratio and LDL-C were positively correlated with IR. Excluding reciprocal interactions, the apoB/apoA-I ratio and LDL-C were still significantly correlated with IR, but the apoB/apoA-I ratio showed a greater correlation with IR than LDL-C in women with abdominal obesity, compared with men with abdominal obesity. Both LDL-C and apoB/apoA-I were independent risk factors of MetS, and the apoB/apoA-I ratio was stronger in this regard than LDL-C for this obese population.     

低密度与高密度脂蛋白胆固醇比值对冠心病的诊断价值

目的 探讨低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)浓度的比值与冠心病(CHD)的相关性。方法 对68例胸痛患者行冠状动脉造影,并同时测定其血脂成分。结果CHD组总胆固醇(TC)、血清甘油三酯(TG)、LDL-C、TC/HDL-C、TG/HDL-C、LDL-C/HDL-C高于对照组,HDL-C(低于对照组。LDL-C/HDL-C与CHD的相关性最强(OR=3.79,OR95％Cl=1.88-6.14)。结论 CHD患者存在多种血脂异常,LDL-C/HDL-C是一项有较好使用价值的CHD预测指标。     

冠心病患者血清中25羟维生素D3、内皮型一氧化氮合酶水平及意义

目的：检测25羟维生素D3[25-(OH)D3]、内皮型一氧化氮合酶（eNOS）在冠心病（CHD）患者血清中的表达情况,探讨二者在CHD患者发病程度中的关系及作用。方法：选取2017年9月至2019年6月在本院收治的CHD患者96例作为研究对象,按照冠状动脉病变狭窄的严重程度将其分为病变Ⅰ级（22例）、病变ⅠⅠ级（29例）、病变ⅠⅠⅠ级（25例）和病变Ⅳ级（20例）,选取同期健康体检者100例作为对照。分别采集CHD患者和健康体检者外周血并分离出血清,利用酶联免疫吸附法（ELISA）检测血清中25-(OH)D3、eNOS的表达水平,使用全自动生化分析仪分析血脂指标总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）以及高密度脂蛋白胆固醇（HDL-C）水平,并分析CHD患者血清中25-(OH)D3、eNOS水平与TC、TG、LDL-C、HDL-C的相关性。结果：与对照组相比,CHD组患者血清中25-(OH)D3、eNOS和HDL-C水平均明显降低,TC、TG、LDL-C均明显升高（P＜0.05）;随着CHD患者冠状动脉病变狭窄的加重,CHD组患者血清中25-(OH)D3、eNOS表达水平和HDL-C水平均明显降低,TC、TG、LDL-C均明显升高（P＜0.05）;CHD患者血清中25-(OH)D3、eNOS的表达水平与TC水平均明显负相关（P＜0.05）,与HDL-C水平均明显正相关（P＜0.05）,与TG水平负相关均不明显（P＞0.05）,此外,25-(OH)D3水平与LDL-C水平明显负相关（P＜0.05）,eNOS的表达水平与LDL-C水平负相关不明显（P＜0.05）。结论：CHD组患者血清中25-(OH)D3、eNOS表达均明显下调,其表达水平均随着CHD组患者冠状动脉病变程度的加重而下调,且与血脂指标关系密切,可作为CHD诊断、治疗和预后的分子标志物。     

静息心率与老年冠心病关系的研究

目的探讨静息心率对冠心痛发生的预测价值及临床意义。方法选择老年冠心病患者429例为冠心病组,另选同期体检的非冠心病患者60例为非冠心病组。2组患者均测量血压及生化指标检测,并行12导联心电图检查,分析静息心率与冠心病发生是否存在相关性。结果冠心病组的收缩压、TC、TG、LDL-C、静息心率明显高于非冠心痛组(P<0.05,P<0.01)。logistic回归分析显示,校正了舒张压、TC、HDL-C、LDL-C、空腹血糖等因素后,静息心率、收缩压、TG是冠心病的独立危险因素(OR=1.046,95%CI:1.005～1.088,P<0.05)。结论静息心率是冠心病发病的独立危险因素。     

冠心病患者不同剂量血脂康降脂疗效及其安全性的临床评估

目的　探讨不同剂量血脂康治疗合并有脂质代谢异常的冠心病患者的量效关系及其安全性。方法　将 2 5 5例冠心病患者随机分为 5个剂量组记录服药前及服药后第 1、3、6个月服药反应与化验指标 ,同时观察各剂量组中CHD患者TC、LDL—C和TC的达标率情况。结果　 ( 1 )血脂康可显著降低合并有脂质代谢异常的冠心病患者TC、LDL—C和TG水平并显著升高HDL—C水平。同一剂量血脂康治疗时随着时间的延长效应逐渐增大 ,并多在第 3个月达高峰。 ( 2 )除个别情况外 ,在第 1、3、6个月时不同剂量组间CHD患者TC、LDL—C和TG的达标率均有显著差异 ,且不同时间的达标率与对数剂量呈显著的正相关 ,TC、LDL—C的达标率随服药时间的延长而显著增高 ,而TG的达标率则在第 3个月时达到高峰后随服药时间的延长未再显著增高 ;( 3 )副反应发生率为 1 2 1 0 % ( 3 8/ 3 1 4)。结论　 ( 1 )血脂康胶囊治疗脂质代谢异常疗效显著、并呈现出明显的剂量—效应关系 ;( 2 )不同剂量血脂康治疗后的最大疗效出现在治疗后的第 3个月这一时段上 ,此时段可作为疗效判断及调整治疗的时间窗 ;( 3 )血脂康治疗有较好的安全性。     

血脂康和辛伐他汀治疗高脂血症的疗效比较

目的：比较血脂康与辛伐他汀对高脂血症的疗效。方法：60例高脂血症患者随机分为两组，血脂康组30例，口服血脂康0.6g，早晚各1次。辛伐他汀组30例，服辛伐他汀20mg，晚餐后顿服，疗程均为4周。结果：两组患者治疗后TC、TG、LDL－C下降，HDL－C升高；组间无差别（P＞0.05)；两组均无明显不良反应。结论：血脂康与辛伐他汀疗效相似，均为安全、有效的降脂药物，但血脂康比辛伐他汀价廉。     

A comparison of pravastatin and gemfibrozil in the treatment of dyslipoproteinemia in patients with non-insulin-dependent diabetes mellitus

The effects of pravastatin (pravachol) compared with gemfibrozil on cholesterol-rich and trigylceride-rich lipoproteins were evaluated in this multi-centered trial. Following an 8-12 week prerandomization phase, 136 patients with NIDDM and hypercholesterolemia were randomized to receive either pravastatin 40 mg or gemfibrozil 1200 mg daily for 16 weeks. The reduction of total cholesterol (TC), betaquant LDL and LDL cholesterol (LDL-C) was significantly greater in patients treated with pravastatin than with gemfibrozil. However, gemofibrozil treatment resulted in a significantly greater reduction of triglyceride (TG) levels than did treatment with pravastatin. Pravastatin reduced the concentration of apoB (-19.3%, P<0.001) and cholesterol-rich Lp-B (Lp-B+Lp-B; E) particles (-19%, P<0.001) to a significantly greater extent (P<-0.001) than gemfibrozil (-4.1 and -1%, respectively). Both gemfibrozil and pravastatin reduced the concentrations of trigylceride-rich Lp-Bc (-12.2 and -13.3%, respectively) and Lp-A-II;B;C;D;E (-19 and -12.7%, respectively) particles and their characteristic apoC-III constituent (-10.0 and -7.0%, respectively). In contrast, gemfibozil has a greater lowering effect compared with pravastatin on TG levels (-29.6 vs. -6.3%, respectively). Both pravastatin and gemfibrozil significantly increased the levels of apoA-I and, with both drugs, the elevated concentrations of apoA-I were due to significantly increased levels of Lp-A-I;A-II particles. By decreasing both cholesterol-rich Lp-B and triglyceride-rich Lp-Bc particles and increasing HDL-C and Lp-A-I;A-II particles in addition to proven efficacy in decreasing coronary events in NIDDM patients, pravastatin appears to be an appropriate choice for monotherapy in a broad range of diabetic patients with Type IIA and Type IIB hyperlipoproteinemias. These results also showed that direct measurement of lipoprotein family of particles provides important information not only about the composition but also the type and number of apoA- and apoB-containing lipoprotein particles.     

比较不同剂量血脂康对急性冠脉综合征患者血脂水平及炎症因子的影响

目的比较不同剂量血脂康与普伐他汀治疗急性冠脉综合征(ACS)对血脂水平及血清炎症因子的影响,探讨ACS患者早期应用血脂康的临床意义。方法96例ACS患者随机分为血脂康1.2g/d组(n=32)、血脂康2.4g/d组(n=32)及对照组普伐他汀20mg/d(n=32)。测定治疗前、治疗8周时血脂水平及血清hsCRP、IL-6水平。结果(1)三组治疗8周时与治疗前比较,TC、LDL-C、TG水平均显著降低(P<0.05或P<0.01);hsCRPI、L-6水平降低也有显著性差异(P<0.05或P<0.01)。(2)三组治疗8周时组间比较,hsCRP、IL-6水平血脂康1.2g/d组较普伐他汀20mg/d对照组降低明显有显著性差异(P<0.05);血脂康2.4g/d组较1.2g/d组降低明显有显著性差异(P<0.01)。结论急性冠脉综合征患者早期给予血脂康1.2~2.4g/d调脂作用与普伐他汀20mg/d无明显差异,但降低炎症因子作用强于普伐他汀20mg/d。     

血脂康改善冠心病患者餐后高甘油三酯血症

目的 :观察冠心病患者高脂餐后血脂的变化以及 6周血脂康对餐后血脂水平的影响。　　方法 :5 0例病情稳定的冠心病患者随机分为两组 ,分别在常规治疗的基础上服用血脂康 (每日 12 0 0mg ,血脂康组 ,n =2 5 )和安慰剂 (常规组 ,n =2 5 )。所有患者在治疗前和治疗后各接受 1次高脂餐 (总热量 80 0千卡 ,脂肪 5 0克 ) ,采集空腹 12h、餐后 2、 4、 6h静脉血备测血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇 (LDL C)和高密度脂蛋白胆固醇(HDL C)浓度。　　结果 :5 0例患者治疗前餐后 2、 4、 6h与空腹状态比较 ,血清甘油三酯浓度显著升高 (P <0 0 5 )。血脂康组治疗后较治疗前空腹血清甘油三酯、总胆固醇、LDL C浓度显著降低 ,HDL C浓度显著升高 ,均有极显著差异 (P均 <0 0 0 1) ;血脂康组治疗后较治疗前的餐后 2、 4和 6h血清甘油三酯浓度和甘油三酯曲线下面积明显下降 (P <0 0 5 )。常规组的空腹和餐后血脂水平较治疗前无显著变化。　　结论 :血脂康能有效降低冠心病患者空腹血脂浓度和高脂餐后升高的血清甘油三酯浓度。     

Effects of menopause on intraindividual changes in serum lipids, blood pressure, and body weight--the Chin-Shan Community Cardiovascular Cohort study

In Taiwan, the Chin-Shan Community Cardiovascular Cohort (CCCC) was assessed prospectively to determine whether the changes in cardiovascular risk factors for women age 45--54 years are due to menopause. The average paired percentage changes that occurred between baseline (1990-1991) and follow-up (4 years later) in fasting serum lipids were compared in three groups of women including groups of 59 and 224 who were pre- and postmenopausal, respectively, and a group of 118 who had spontaneously stopped menstruating. Postmenopausal women had the least gain in body mass index (BMI), whereas, mainly premenopausal women had increased systolic blood pressure (P<0.05). All women had elevated total cholesterol (TC) levels, with the greatest elevation in women transitioning into menopause (P<0.001). Low-density lipoprotein cholesterol (LDL-C) levels increased before and during the transition to menopause, but decreased after menopause (P<0.01). Age had significant association with changes in TC, triglyceride (TG) and LDL-C levels, whereas BMI had significant association with changes in TG, LDL-C, and high-density lipoprotein cholesterol (HDL-C) levels (P<0.05). After controlling for age and BMI, only differences in TC remained significant, with the greatest gain in women who stopped menstruating (12.9%) followed by pre- (6.5%) and postmenopausal women (4.8%). Changes in both systolic and diastolic blood pressures, and TG and HDL-C levels were not significantly different, but HDL-C levels declined between 11.5 and 14.7% in all groups. This study suggests an unfavorable effect of menopause on lipid metabolism, especially on the TC level, which was predominantly elevated during the transition to menopause. The decline of HDL-C is of concern.     

男性冠心病患者血清性激素结合球蛋白水平变化的临床观察

目的探讨性激素结合球蛋白(SHBG)在男性冠心病(CHD)患者中的变化及其临床意义。方法选择住院并接受冠状动脉造影检查的男性患者,并根据冠脉造影结果分为冠脉造影正常组(对照组)33例;冠脉造影异常组(CHD组)52例,同时测定两组患者血清SHBG、睾酮(TT)、血脂、血糖、胰岛素等水平的变化,计算体质指数(BMI)。结果 CHD组和对照组相比hs-CRP、TC、GLU、空腹胰岛素显著增高(P<0.05),HDL-C、SHBG、TT、胰岛素敏感指数显著减低(P<0.05),BMI、LDL-C、TG差异无统计学意义。相关分析显示SHBG与BMI、LDL-C及空腹血糖呈负相关(r=-0.25～0.87,P<0.05),与胰岛素敏感指数呈正相关(r=0.45,P<0.05),但是其与TC、TG、HDL-C及hs-CRP间未见显著的相关关系(r=-0.19～0.02,P>0.05)。结论男性冠心病患者血清SHBG含量降低可能是导致男性冠心病发病率显著升高的重要因素。     

不同剂量辛伐他汀调脂治疗冠心病的疗效及安全性研究

目的　观察冠心病 (CHD)患者中 ,辛伐他汀不同剂量调脂的有效性和安全性。方法　选择确诊为CHD的 114例患者 ,随机 (计算机数字表 )、开放分为辛伐他汀 2 0mg组 (n =5 8)和 10mg组 (n =5 6 ) ,年龄 40～ 86岁 ,平均年龄(6 0 .7± 9.7)岁。均为每晚服药 1次。分别于用药前、用药后第 6、12、2 4周空腹采静脉血清 ,以酶法测定总胆固醇(TC)、低密度脂蛋白胆固醇 (LDL C)、高密度脂蛋白胆固醇 (HDL C)、甘油三酯 (TG)以及肝、肾功能等。结果　 (1)用药第 6周始 ,两组TC和LDL C均比用药前明显下降 ,且一直保持到用药 2 4周末 (P均 <0 .0 5 )。 (2 )第 6、12、2 4周的TC、LDL C水平 ,在 2 0mg组比 10mg组明显低 (P <0 .0 5 )。 (3) 2 4周TC达标率 ,2 0mg组明显高于 10mg组(78.2 %比 5 2 .9% ,P <0 .0 5 )。 (4 )两组间谷丙转氨酶 (ALT)升高等副作用未见明显差异。结论　 2 0mg辛伐他汀能够安全而且更有效地降低TC和LDL C水平 ,使更多的CHD患者的血清胆固醇达到理想标准水平     

冠心病患者高密度脂蛋白胆固醇与冠脉病变的相关性研究

目的探讨血浆高密度脂蛋白胆固醇(HDL-C)水平与冠脉病变的关系。方法选取153例行冠脉造影确诊的冠心病患者,并对冠脉病变程度进行分型,观察其与各项冠心病危险因素相关指标的关系。结果冠心病患者HDL-C比对照组明显降低,而总胆固醇(TC)、体重指数(BMI)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)比对照组明显增加,急性冠脉综合征组(ACS)患者比稳定型心绞痛组(ACS)HDL-C明显降低,TC明显增加P<0.001。HDL-C与冠脉病变类型、病变支数成负相关,TC与之成正相关。结论HDL-C与冠脉病变程度具有负相关关系。血HDL-C水平有可能成为一项有价值的、能预测冠心病事件的检查方法。     

不同类型冠心病患者血清脂联素水平及冠心病危险因素的变化

目的探讨不同类型冠心病患者血清脂联素水平和冠心病危险因素的变化及两者的相关性。方法冠心病患者90例:稳定型心绞痛组(SAP)22例,不稳定型心绞痛组(UAP)32例,急性心肌梗死组(AMI)36例;对照组(CG)30例。测定身高、体重、腰围、臀围、空腹血糖(FPG)、胰岛素(FINS)、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)和血清脂联素(APN)水平,并计算体重指数(BMI)、腰臀比(WHR)及胰岛素敏感性指数(ISI)。结果冠心病组血清APN水平明显降低,且SAP、UAP、AMI三组血清APN水平依次降低。SAP组FINS升高、ISI降低;UAP组FINS、TC、TG升高,吸烟年限长,ISI降低;AMI组BMI、WHR、FINS、TC、TG、LDL-C升高,吸烟年限长,ISI、HDL-C降低。冠心病患者血清APN与BMI、WHR、FINS、TG、LDL-C呈负相关,与ISI、HDL-C呈正相关。结论冠心病患者血清APN水平降低,SAP、UAP、AMI三组血清APN水平依次降低,冠心病危险因素依次增多。冠心病患者血清APN水平与冠心病危险因素密切相关。