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.     

血脂及部分血脂比值对冠心病的诊断价值

目的 分析探讨血脂及部分血脂比值对冠心病的诊断价值.方法 对210例患者行冠状动脉造影,根据造影结果分为对照组(冠状动脉无狭窄者)和冠心病组,冠心病组再根据Gensini评分分为轻度、中度和重度组,测定血脂水平并对其单项血脂和部分血脂比值与冠脉狭窄程度进行比较分析.结果 冠心病组的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)高于正常对照组,载脂蛋白A1(ApoA1)和高密度脂蛋白胆固醇(HDL-C)低于正常对照组(P均＜0.05).冠心病组的TC/HDL-C、TG/HDL-C、LDL-C/HDL-C高于正常对照组,ApoA 1/ApoB低于正常对照组(P均＜0.05).随着冠脉病变程度增加,TG/HDL-C、TC/HDL-C、LDL-C/HDL-C值升高,ApoA1/ApoB值降低(P＜0.05).结论 血脂和血脂比值异常对冠心病的诊断及其严重程度的判断上具有一定意义,血脂比值较单项血脂有更好的临床价值.     

帕金森病及帕金森综合征病人血脂水平的临床分析

目的探讨帕金森病(Parkinson’s disease,PD)及帕金森综合征(PDS)病人血脂水平情况。方法回顾性分析纳入的82例PD、62例PDS病人及80例对照组的血脂水平,研究指标包括血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)及脂蛋白(a)[LP(a)]。结果PD组及PDS组的ApoA1、ApoB、LDL-C、TG水平均低于对照组,差异有统计学意义,3组间HDL-C、TC、LP(a)无统计学意义。结论低水平的ApoA1、ApoB、LDL-C、TG可能是PD及PDS的危险因素。     

首诊老年高血压患者血脂水平分析

目的:探讨老年高血压患者的血脂水平特点。方法:首诊老年高血压患者常规化验总胆固醇(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)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB),以健康体检老年人为对照组,两组进行比较。结果:高血压组TC、TG、LDL-C、ApoB水平较对照组显著升高(P<0.05~<0.001),ApoA1、HDL-C较对照组显著降低(P<0.05~<0.001)。高血压组的血脂水平不受年龄、性别和高血压分级的影响。结论:老年高血压患者血脂水平存在明显异常,但血脂水平与年龄、性别、血压无关。     

1型糖尿病患者血流变学、血脂、载脂蛋白和脂蛋白(a)水平检测的临床意义

我们检测了1型糖尿病无并发症及并发肾功能损害患者的血流变学、血脂[甘油三脂(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)]、载脂蛋白[载脂蛋白AI(ApoAI)、载脂蛋白B(ApoB)]、脂蛋白(a)[Lp(a)]水平变化,旨在探讨其临床意义。 资料与方法:A组为132例健康查体者B_1组为97例按     

脂类测定与老年动脉粥样硬化及冠心病的相关性研究

目的探讨血清中血脂、脂蛋白及载脂蛋白(Apo)与老年动脉粥样硬化及冠心病的相关性。方法采用贝克曼DXC-600全自动生化分析仪,对60例老年冠心病和60例健康人血脂及Apo进行检测。结果冠心病组三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)与对照组比较,差异有统计学意义(P<0.05);高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)水平低于对照组,差异有统计学意义(P<0.05);两组总胆固醇(TC)比较,差异无统计学意义(P>0.05)。冠心病组LDL-C/HDL-C、ApoA1/ApoB、LDL-C/ApoB、HDL-C/ApoA1比值与对照组比较,差异有统计学意义(P<0.05)。结论 HDL-C、LDL-C、ApoB及HDL-C/TC、ApoA1/ApoB比值的异常统称为老年动脉粥样硬化及冠心病的危险因子,可以作为临床诊断老年动脉粥样硬化及冠心病的重要参考指标之一。     

重叠综合征患者血脂及脂蛋白变化特点及其可能机制

目的观察重叠综合征(OS)患者血脂及脂蛋白代谢的变化特点及其可能机制。方法健康对照组40例及OS组140例均测定血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及载脂蛋白(Apo)A1、B水平,同时计算ApoB/ApoA1比值,分析OS患者血脂及脂蛋白代谢的变化特点;根据呼吸暂停低通气指数(AHI)及末梢血氧饱和度情况,将OS组分为轻、中度、重度OS组,比较上述指标情况,探讨AHI及末梢血氧饱和度与TC、TG、HDL-C、LDL-C及ApoB/ApoA1的相关性。结果与对照组相比,OS组TC、TG、LDL-C、ApoB及ApoB/ApoA1比值水平明显升高,HDL-C、ApoA1明显降低(P<0.05);与轻度OS组相比,中、重度OS组TC、TG、LDL-C、ApoB及ApoB/ApoA1比值水平显著升高,HDL-C、ApoA1明显降低(P<0.05),其中,重度OS组改变更为明显(P<0.05);TC、TG、LDL-C、ApoB及ApoB/ApoA1与AHI呈正相关,与末梢血氧饱和度呈负相关;HDL-C、ApoA1与AHI呈负相关,与末梢血氧饱和度呈正相关(P<0.05)。结论OS患者存在脂质代谢异常,其血脂代谢异常的严重程度和低氧相关。     

2型糖尿病各期肾病病人载脂蛋白等变化分析

选择健康人40例及我院住院2型糖尿病病人110人,根据24小时尿白蛋白定量分为糖尿病无肾病组(A组)、早期肾病组(B组)及临床期肾病组(C组),全部病人测定血甘油三脂(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB),将各组指标分析比较.结果B组、C组病人血TG较A组病人升高更明显,TC较正常组升高(P＜0.05),A组、B组、C组HDL-C均有下降,而B组、C组下降更有意义(P＜0.01).B组、C组血LDL-C较A组升高,有统计学意义,B组、C组血ApoA1下降,ApoB升高,ApoB/ApoA1升高.结论糖尿病肾病病人血脂及载脂蛋白显著异常,对糖尿病合并早期及临床期肾病病人应严格控制血脂水平.     

载脂蛋白在糖尿病患者中表达水平及临床意义

目的探讨载脂蛋白在糖尿病患者中表达水平及临床意义。方法选取2017年11月—2018年11月该院收治的51例糖尿病患者和同期进行健康体检的60名健康人作为研究对象,以全自动生化分析仪测定患者血清甘油三脂(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)、载脂蛋白A1(ApoA1)及载脂蛋白B(ApoB)水平,比较两组研究对象上述指标水平。结果相比于对照组,观察组研究对象TC、TG、LDL-C水平显著升高,HDL-C水平降低,差异有统计学意义(P0.05);相比于对照组,观察组研究对象Apo A1、ApoA1/Apo B显著降低,ApoB水平升高,差异有统计学意义(P0.05)。结论载脂蛋白ApoA1、ApoB可用于糖尿病的早期诊断,应用价值高。     

表观健康人群血脂分布特点分析

目的观察表观健康人群血脂含量与年龄和性别的关系,分析血脂与载脂蛋白的相关性,为建立血脂参考范围和预防心血管疾病提供科学依据。方法采用贝克曼AU5421全自动生化分析仪对5701名20~60岁的表观健康体检者进行TC、HDL-C、LDL-C、TG、LP(a)、ApoAI和ApoB的测定,同时收集年龄和性别信息,对数据进行趋势检验和相关性分析。结果血脂四项随年龄呈单向变化(P0.01),TC、LDL-C和TG血清含量随年龄递增,HDL-C随年龄递减,在男女分层和总人群中,血脂含量随年龄的变化趋势一致。血脂四项在不同性别间存在显著性差异(P0.01),男性TC、LDL-C和TG血清含量高于女性,HDL-C含量低于女性。相关分析发现,TC、LDL-C和ApoB呈强的正相关(r0.7,P0.01),HDL-C与ApoAI也存在强的正相关(r0.7,P0.01)。结论表观健康人群具有血脂增龄现象,血脂含量在不同性别间存在显著差异,提示临床建立参考范围时应考虑年龄和性别因素的影响。同时发现载脂蛋白与血脂含量具有很强的相关性,载脂蛋白有可能成为心血管疾病发病风险的预测指标。     

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。     

高脂血症与血清载脂蛋白含量关系的研究

目的　探讨高脂血症与载脂蛋白的关系。方法　对杭州市 6 6 9名高脂血症患者和 2 6 2名健康人 ,用全自动生化分析仪测定TC、TG、HDL -C、LDL -C、ApoAⅠ、AⅡ、B、CⅡ、CⅢ、E。结果　与健康对照组比较 (1)高胆固醇血症组 ,HDL -C、LDL -C明显升高 (P <0 0 1) ,各类载脂蛋白均升高 ,尤以ApoAⅠ升高最明显。 (2 )高甘油三酯血症组 ,HDL-C低于正常对照组 (P <0 0 1) ,LDL -C无显著性差异 (P >0 0 5 ) ,ApoAⅠ降低 (P <0 0 1) ,ApoB、ApoCⅡ、ApoCⅢ、ApoE均有明显升高 (P <0 0 1)。 (3)混合型高脂血症组 ,LDL -C升高 (P <0 0 1) ,ApoAⅡ、ApoB、ApoCⅡ、ApoCⅢ、ApoE升高最明显 (P <0 0 1)。结论　高脂血症ApoAⅡ、B、CⅡ、CⅢ、E水平均升高 ;高胆固醇血症ApoAⅠ、B和HDL -C、LDL -C可同时升高 ;ApoCⅢ是高甘油三酯的重要影响因素 ;混合型高脂血症高甘油三酯伴LDL -C/HDL -C比值升高 ,可视为CHD的高危人群     

冠心病患者载脂蛋白AV与脂蛋白(a)关系研究

目的:探讨冠心病患者血清载脂蛋白AV(ApoAV)与脂蛋白(a)[LP(a)]之间的关系.方法:入选120例住院患者均接受冠状动脉造影检查,根据造影结果分为冠心病组60例和对照组60例,所有患者均测定空腹血糖(FBG)、血清TC、TG、HDL-C、LDL-C、载脂蛋白A1(ApoAI)、载脂蛋白B(ApoB)与LP(a);同时采用酶联免疫吸附法测定血清ApoAV.所有资料均进行正态性检验.结果:冠心病组血清ApoAV、ApoAI、HDL-C显著低于对照组[(206.76±135.95)μg/L∶(265.33±122.35)μg/L],[(1.09±0.26)g/L∶(1.23±0.25)g/L],[(1.22±0.29)mmol/L∶(1.31±0.21)mmol/L],P<0.01;TG、LP(a)高于对照组[(1.64±1.15)mmol/L∶(1.10±0.37)mmol/L],[(393.03±280.08)mg/L∶(218.37±60.58)mg/L],P<0.01.ApoAV与TG、LP(a)呈负相关,与HDL-C呈正相关.结论:冠心病患者血清ApoAV降低、LP(a)增高.ApoAV与LP(a)对冠心病的发展影响不同.     

Coalition of DNA polymorphisms of ApoB and ApoAI genes is related with coronary artery disease in Kazaks

Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B (ApoB) gene and -75 bp, +83 bp loci of apolipoprotein AI (ApoAI) gene and coronary heart disease (CHD) in Kazaks of Xinjiang Uyghur Autonomous Region, China. Methods These loci were analyzed by PCR-restriction fragment length polymorphism (PCR-PFLP). Two hundred and five patients with CHD and two hundred and thirty six controls were involved. Results There were significant distinctions among low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and the ApoAI/ApoB ratio between the two groups, but no significant distinction among the polymorphism frequencies of the four sites between the two groups. The polymorphism coalition frequency of X--/Ms++/M1+-/M2++ (named Coalition 11) was significantly higher in CHD compared to the control group (14.6% vs. 7.2%, P < 0.05). The level of total cholesterol (TC) in Coalition 11 was significantly higher and the level of the ApoAI/ApoB ratio in Coalition 11 was significantly lower than Coalition 1~10 in CHD patients. The level of the ApoAI/ApoB ratio of Coalition 11 was significantly lower than the Coalition 1~10 in control group. The levels of ApoAI/ApoB ratio of Coalition 3 were significantly higher compared to Coalition 11 in the two groups, respectively. The level of LDL-C of Coalition 3 was significantly lower than in the Coalition 11 in control group. The level of TC of Coalition 5 was significantly higher than Coalition 3 in the CHD group. The level of the ApoAI/ApoB ratio of Coalition 5 was significantly lower than in Coalition 3 or Coalition 1~10 of the two groups, respectively. The level of LDL-C of Coalition 5 was significantly higher than in Coalition 3 in control group. The ratio of ApoAI/ApoB was negatively related to TC, LDL-C and was positively related to HDL-C, both in CHD and control groups. Conclusion Coalition 11 of the 4 loci polymorphisms of the ApoB and ApoAI genes was correlated with CHD in Kazaks, and perhaps the ratio of ApoAI/ApoB was the most diagnostic parameter related with CHD among all lipid parameters. CHD may also be associated with Coalition 5, and, perhaps, Coalition 3 may have been confirmed as a protection factor against CHD, if more samples were enrolled.     

外周血血脂水平与老年性白内障相关性研究

目的探讨外周血血脂水平与年龄相关性白内障(age-related cataract,ARC)的相关性。方法采用回顾性病例对照设计,选取2018年1月—2019年12月于复旦大学附属眼耳鼻喉科医院就诊并确诊为ARC的患者280例作为观察组,其中男性140例,女性140例。同时选取同期217例正常健康体检者作为对照组,其中男性109例,女性108例。使用罗氏全自动生化分析仪检测受试者外周血胆固醇(cholesterol,CHOL)、三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(high-densitylipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、载脂蛋白A(apolipoprotein A,Apo A)和载脂蛋白B(apolipoprotein B,Apo B)水平。采用独立样本t检验及二元多因素Logistic回归,分析上述血脂指标在观察组和对照组间的差异及其与ARC的相关性。结果观察组外周血CHOL、TG、HDL-C、LDL-C、ApoA、ApoB水平均高于对照组(P<0.05),并且在男性和女性亚组中均观察到相似的结果。Logistic回归分析显示,观察组CHOL(P=0.002,OR=1.467,95%CI=1.151~1.871)、TG(P<0.001,OR=3.400,95%CI=2.312~5.001)、HDL-C(P<0.001,OR=7.632,95%CI=3.8942~14.958)、LDL-C(P<0.001,OR=6.306,95%CI=4.440~9.011)、ApoB(P<0.001,OR=40.893,95%CI=16.003~104.493)、BMI(P<0.001,OR=1.256,95%CI=1.171~1.348)水平与ARC的发病存在一定相关性;与男性相比,外周血HDL-C(P<0.001,OR=9.180,95%CI=3.317~25.404)、LDL-C(P<0.001,OR=8.652,95%CI=4.965~15.077)和ApoB(P<0.001,OR=75.614,95%CI=19.448~293.990)水平较高的女性患ARC的风险更高。结论ARC患者外周血脂水平升高,CHOL、TG、HDL-C、LDL-C、ApoB升高可能增加中老年人群发生ARC的风险。     

Cord blood lipoprotein-cholesterol: relationship birth weight and gestational age of newborns

Umbilical plasma levels of lipoproteins-cholesterol were measured in 60 premature (less than 37 weeks), 60 small for gestational age (SGA, greater than 37 weeks), and 60 full term newborns (greater than 37 weeks) to ascertain the relationship between gestational age, infant's weight and concentration of plasma lipoprotein cholesterol. Umbilical levels of total cholesterol (TC), unesterified cholesterol (UC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) in premature newborns were significantly higher (P less than .001) than in term infants. The levels of TC, UC, HDL-C and very low density lipoprotein cholesterol (VLDL-C) were substantially higher (P less than .05) in umbilical cord plasma of SGA newborns than in cord plasma of full term newborns. Lecithin:cholesterol acyltransferase activity in cord plasma was indirectly assessed by measuring the ratio of esterified cholesterol to unesterified cholesterol (CE/UC). This ratio was significantly lower (P less than .01) in preterm and SGA than in full term newborns. In addition, plasma TC, UC, LDL-C and HDL-C levels were inversely correlated with gestational age of newborns. By contrast, CE/UC ratio had an inverse correlation with gestational age and HDL-C of the newborns. These findings suggest that the levels of TC in newborns are regulated by the uptake of LDL-C by the fetal adrenal and, additionally, by the lecithin:cholesterol acyltransferase (LCAT) activity of newborn plasma. Only by careful follow-up of hyperlipidemic neonates can the true incidence of familial hyperlipoproteinemia and the value of early diagnosis be assessed.     

心血管病患者幽门螺杆菌感染与血脂、一氧化氮水平的关系

目的 :探讨幽门螺杆菌 （HP）感染与血脂、一氧化氮 （NO）水平的关系。方法 :测定心血管疾病患者 192例的血清 HPIg G、总胆固醇 （TC）、甘油三脂 （TG）、载脂蛋白 A1（Apo A1）、载脂蛋白 B（Apo B）、脂蛋白 a[L p（a） ]、高密度脂蛋白胆固醇 （HDL- C）、低密度脂蛋白胆固醇 （L DL- C）、一氧化氮 （NO）、一氧化氮合酶 （NOS）的含量。结果 :HP感染10 8例 ,HP感染组的血清 TG,Apo B,NOs,NO浓度较未感染组明显升高 （P<0 .0 5 ） ,TC,L p（a） ,L DL- C有增高趋势 ,但未达显著水平 .结论 :HP感染可明显升高血清 TG,Apo B,NOS,NO的含量。     

The role of lipid profile in determining the risk of ischemic stroke in the elderly: a case-control study

In this study, we investigated the association of lipids with ischemic stroke and its different subtypes in elderly patients. In particular, lipid parameters not extensively investigated so far in previous case-control studies specifically focused in the old population, such as lipoprotein Lp (a) and Apoproteins AI (ApoAI) and B (ApoB), have been taken into account. Seventy nine patients (mean age 83 +/- 7.4, range 67-99), consecutively admitted to a Geriatric Ward between January 1998 and June 2000 with acute stroke (first event) were studied. A complete clinical and laboratory assessment, including neurological evaluation, head CT scan, carotid ultrasonography and ECG, was employed to define the clinical and etiologic stroke subtype, according to standardized criteria. Fasting blood samples were collected within 48 h from admission, for determination of total cholesterol (TC), triglycerides (TG), High Density Lipoprotein-cholesterol (HDL-C), Lp(a), ApoAI and ApoB; Low Density Lipoprotein-Cholesterol (LDL-C) was estimated by Friedwald formula. Eighty eight age and sex-matched outpatients, referred to the hospital for non-inflammatory disorders of joints and musculoskeletal system, served as controls. Patients showed HDL-C and HDL-C/ApoAI ratio significantly lower than controls, with higher LDL-C/HDL-C ratio. Analysis on quartiles of lipoprotein concentrations showed also a significant increase in odds of stroke for LDL-C concentrations over 100 mg/dl, in absence of a linear relationship between LDL-C levels and risk. Multiple logistic regression, adjusting for non-lipid risk factors for stroke, confirmed the independent association of low HDL-C and HDL-C/ApoAI with all strokes, as well as with each subtype. In conclusion, these data suggest that lipids give some contribution to stroke risk even in the elderly, with a more prevalent role for HDL than LDL, and that lipid profile assessment must be taken into account in estimating the individual risk of stroke.     

辛伐他汀与辅酶Q10联合应用对血脂水平及C-反应蛋白的影响

目的观察辛伐他汀与辅酶Q10联合应用对血脂水平及C-反应蛋白的影响。方法88例高血压性心脏病、冠心病伴高脂血症及C-反应蛋白增高的患者,随机分成对照组43例和试验组45例。对照组患者口服辛伐他汀10mg,每日一次睡前服。试验组辛伐他汀10mg,每日一次睡前服,辅酶Q1010mg,每日3次口服。两组均口服8周。检测指标:总胆固醇、甘油三酯、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、脂蛋白-a(Lp-a)、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)和C-反应蛋白(CRP)。结果试验组治疗前后总胆固醇、甘油三酯、LDL-C、APo-B、CRP明显降低,尤其是LDL-C差异有统计学意义(P<0.01),HDL-C、Apo-A有不同程度的升高,但差异无统计学意义(P>0.05);对照组除LDL-C水平降低外(P<0.05,P<0.01)其余各项指标治疗后较治疗前有不同程度降低,差异无统计学意义。但两组治疗后比较,差异有统计学意义。结论辛伐他汀与辅酶Q10联合应用能增强辛伐他汀降脂及抗炎作用。     

雌激素替代疗法对绝经后冠心病患者及正常妇女的影响

目的观察雌激素治疗绝经后冠心病患及正常妇女体内血脂、血小板聚集率、氧自由基及纤溶活性变化。方法选５３例绝经后妇女冠心病患为冠心病组,４２例绝经后健康妇女为正常对照组,每组病例再单盲随机分为治疗组和安慰剂组,治疗组予尼尔雌醇（每月４ｍｇ／次）治疗６个月,安慰剂组予安慰剂治疗,观察治疗前后患雌激素水平及血脂各项指标、血小板聚集率、氧自由基和纤溶活性变化。结果冠心病组雌激素水平低于正常对照组（Ｐ＜