妊娠并发甲减患者血清脂蛋白相关磷脂酶A2水平与母婴预后的相关性分析

目的　探讨血清脂蛋白相关磷脂酶A2（LP-PLA2）水平在妊娠并发甲减患者中的表达,并分析其与母婴预后的关系。方法　选取2018年7月~2020年7月妊娠并发甲减患者105例作为研究对象,其中妊娠并发临床甲减46例作为临床甲减组,妊娠并发亚临床甲减59例作为亚临床甲减组,另选取同期产检健康者50例作为对照组。采用酶联免疫吸附法检测血清LP-PLA2水平,采用全自动生化分析仪检测血清三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平,并记录母婴结局。采用Pearson检验分析妊娠并发甲减患者血清LP-PLA2与血脂水平的相关性;采用ROC曲线分析血清LP-PLA2及血脂水平对妊娠并发甲减患者母婴不良结局的预测价值。结果　三组患者血清LP-PLA2,TG,TC和LDL-C和HDL-C水平比较,差异均有统计学意义（F=31.177,97.170,18.242,25.286和9.423,均P＜0.05）;血清LP-PLA2,TG,TC,LDL-C水平由高到低为临床甲减组、亚临床甲减组、对照组,血清HDL-C水平由高到低为对照组、亚临床甲减组、临床甲减组,两两比较差异均有统计学意义（均P＜0.05）。妊娠并发甲减患者血清LP-PLA2与TG,TC,LDL-C水平均呈正相关（r=0.504,0.481和0.552,均P＜0.05）,与HDL-C水平呈负相关（r=-0.433,P＜0.05）。亚临床甲减组和临床甲减组患者总母婴不良结局发生率分别为69.49%和78.26%,均明显高于对照组（32.00%）,差异有统计学意义（均P＜0.05）。母婴不良结局组患者血清LP-PLA2,TG,TC和LDL-C水平均明显高于母婴正常结局组（t=4.389,4.072,2.662,3.099,均P＜0.05）,血清HDL-C水平明显低于母婴正常结局组（t=3.131,P＜0.05）。血清LP-PLA2水平预测妊娠并发甲减患者母婴不良结局的价值（曲线下面积0.942,敏感度和特异度分别为85.50%和96.40%）高于血脂指标。结论　妊娠并发甲减患者血清LP-PLA2水平升高,可作为评估母婴不良结局的血清指标。     

Contribution of non-traditional lipid profiles to reduced glomerular filtration rate in H-type hypertension population of rural China

Background: Despite current interest in the unfavourable impact of non-traditional lipid profiles on cardiovascular disease, information regarding its relations to reduced glomerular filtration rate (GFR) in H-type hypertension population has not been systemically elucidated.

Methods: Analyses were based upon a cross-sectional study of 3259 participants with H-type hypertension who underwent assessment of biochemical, anthropometric and blood pressure values. Reduced GFR was considered if meeting estimated GFR <60?ml/min/1.73 m².

Results: A stepwise multivariate regression analysis indicated that non-traditional lipid parameters remained as independent determinants of estimated GFR (all p?Conclusions: The relative independent contribution of non-traditional lipid profiles, as indexed by TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C, towards reduced GFR putting research evidence at the very heart of lipoprotein-mediated renal injury set a vital example for applying a clinical and public health recommendation for reducing the burden of chronic kidney disease.

• KEY MESSAGES

• Non-traditional lipid profiles has been linked with the occurrence of cardiovascular disease, but none of the studies that address the effect of non-traditional lipid profiles on reduced GFR risk in H-type hypertension population has been specifically established.

• A greater emphasis of this study resided in the intrinsic value of TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C that integrate atherogenic and anti-atherogenic lipid molecules to predict the risk of reduced GFR among H-type hypertension population and provide insight into the pathophysiology of subsequent cardio-cerebrovascular outcomes.

• In a large Chinese H-type hypertension adults, the relative independent contribution of non-traditional lipid profiles, as indexed by TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C, towards reduced GFR putting research evidence at the very heart of lipoprotein-mediated renal injury set a vital example for applying a clinical and public health recommendation for reducing the burden of CKD.

     

部分血脂比值检测在冠状动脉硬化性心脏病患者中的临床价值

目的探讨部分血脂比值在冠状动脉硬化性心脏病患者中的临床价值。方法测定冠心病组和正常对照组患者的血中总胆固醇（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）含量,计算TG/HDL-C、TC/HDL-C、LDL-C/HDL-C、ApoA1/ApoB比值,并作统计分析。结果冠心病组的TG、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C显著高于正常对照组,HDL-C、ApoA1、ApoA1/ApoB显著低于正常对照组;冠心病组的单项血脂及血脂比值异常率：ApoA1/ApoB（71%）、LDL-C/HDL-C（67%）、TG/HDL-C（62%）、TC/HDL-C（56%）、TG（34%）、ApoA1（27%）、HDL-C（21%）、ApoB（19%）、TC（16%）、LDL-C（15%）,各血脂比值的异常率均高于单项血脂的异常率。结论血脂比值对冠心病的早期预防和诊断有较大的临床价值,优于各单项血脂指标。     

Changes in lipid measures and incident coronary heart disease: Tehran Lipid & Glucose Study

BackgroundData on the impact of changes in lipid measures on subsequent coronary heart disease (CHD) outcomes are not consistent.MethodsStudy was conducted in 4459 adults, aged ≥ 30 years, free of cardiovascular disease at baseline who attended two consecutive examinations first in 1999–2001 and second in 2001–2003, and were followed up until March 31, 2010. Multivariate Cox proportional hazard regression adjusted for baseline lipid measures and other risk factors was calculated for a 1 standard deviation (SD) change in total cholesterol (TC), log-transformed triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) (calculated using modified Friedewald formula), non-HDL-C, TC/HDL-C and log-transformed TG/HDL-C. Effect of change in dyslipidemia (TC ≥ 6.21 mmol/L or TG ≥ 2.26 mmol/L or HDL-C < 1.03 mmol/L or non-HDL-C ≥ 4.91 mmol/L) on incident CHD was examined, considering those with no dyslipidemia at baseline and follow-up as the reference group.ResultsDuring a mean follow-up of 9.5 years, 303 cases of CHD occurred. A 1-SD increase in TC, TG, non-HDL-C, TC/HDL-C and TG/HDL-C was associated with 14, 20, 19, 16 and 14% increase in risk of CHD event, respectively (all p values < 0.05); the corresponding risk for LDL-C was [1.12 (0.99–1.27), P = 0.07]. Participants with maintained dyslipidemia during follow-up had a significant risk for incident CHD [HR: 1.67(1.21–2.49)] compared to those with no dyslipidemia at baseline or follow-up.ConclusionChanges in TC, TG, and non-HDL-C, TC/HDL-C, TG/HDL-C were independent predictors of CHD events. Furthermore, maintained dyslipidemia was a strong predictor for CHD events.     

女性高血压患者绝经前后血脂和血尿酸含量分析

目的:探讨女性高血压患者绝经前后及绝经年限与血脂和血尿酸变化的关系。方法:女性高血压患者181例,分绝经前组(61例)及绝经后组(120例),测晨起空腹静脉血中甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(UA),进行组间比较,分析绝经年限与血脂、血尿酸水平相关性,并与103名健康对照组比较。结果:绝经前高血压组TC、LDL-C、UA显著高于对照组。绝经后高血压组TG、TC、LDL-C、UA均显著高于对照组,HDL-C则低于对照组。高血压绝经后组TG、TC、LDL-C、UA显著高于绝经前组,HDL-C低于绝经前组,TC、LDL-C与绝经年限量显著正相关。结论:女性高血压绝经后TG、TC、LDL-C、UA增高,TC、LDL-C与绝经年限量显著正相关,而HDL-C降低。     

The efficacy of ginseng supplementation on plasma lipid concentration in adults: A systematic review and meta-analysis

ObjectiveWe performed a meta-analysis to evaluate the efficacy of ginseng supplementation on plasma lipid concentration.MethodsThe search included PubMed, Scopus, ISI Web of Science, Cochrane library, and Google Scholar (up to April 2019) to identify randomized controlled trials (RCTs) investigating the effect of ginseng supplementation on serum lipid parameters. To estimate the overall summary effect, we used random-effects model.ResultsTwenty-seven studies comprising 35 treatment arms comprising 1245 participants fulfilled the inclusion criteria. The meta-analysis results showed that consumption of ginseng did not significantly change the concentrations of total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL-C). However, subgroup analyses showed a significant lowering effect in high dose ginseng supplementation on TC, LDL-C and TG. Also, the impact of ginseng on TC and TG was significant in long-term interventions.ConclusionFurther RCTs with longer supplementation durations in subjects with dyslipidemia are necessitated for a more robust assessment of the lipid-modulating properties of this plant.     

Association between serum lipids and breast cancer risk in premenopausal women: systematic review and meta-analysis

ObjectiveAssociations between serum lipids and their individual components with premenopausal breast cancer risk are unclear. This meta-analysis summarized the literature on serum lipids and premenopausal breast cancer risk to elucidate their relationship.MethodsEligible studies were identified by searching the PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases until 31 December 2020. Standardized mean difference (SMD) scores with 95% confidence intervals (95%CIs) were used to assess the impact of serum lipids on premenopausal breast cancer risk. The I² statistic was calculated to measure the percentage of heterogeneity, and Egger’s test was performed to measure publication bias.ResultsThirteen studies were included. The SMD scores of triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) were 12.90 (95%CI: 7.19–18.61) and 31.43 (95%CI: 8.72–54.15), respectively. The SMD scores of total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were not significantly different between the groups. The included studies were highly heterogeneous. There were no publication biases found in TC, LDL-C, or HDL-C analyses, whereas publication bias was present in the TG analysis.ConclusionsTG and LDL-C were higher in premenopausal breast cancer patients than in women without breast cancer. However, no significant differences were found in TC or HDL-C levels.     

健康成人左心室重构与血脂比值的独立相关性北大核心CSCD

目的观察健康成人左心室重构与血脂比值的独立相关性。方法收集352名接受心脏MR(CMR)检查的健康体检者资料,测量其心脏周围脂肪组织(PAT)体积、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、每搏输出量(SV)、射血分数(EF)和舒张末期左心室心肌质量(LVM)等,计算左心室重构指数(LVRI),即LVM/LVEDV;同时检测其血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C),计算血脂比值TC/HDL-C、TG/HDL-C及LDL-C/HDL-C;观察LVRI与血脂比值的相关性。结果LVRI与TC/HDL-C、TG/HDL-C及LDL-C/HDL-C均呈低度正相关(r=0.414、0.441、0.407,P均<0.05)。分别以TC/HDL-C、TG/HDL-C及LDL-C/HDL-C为自变量,以LVRI为因变量,以校正后的年龄、性别、心率、空腹血糖、收缩压及体表面积各因素建立多元线性回归模型1,结果显示LVRI与TC/HDL-C、TG/HDL-C及LDL-C/HDL-C均呈正相关(β=0.175、0.161、0.181,P均<0.05);在此基础上加入校正后PAT体积建立模型2,结果显示LVRI与TC/HDL-C、TG/HDL-C及LDL-C/HDL-C均呈正相关(β=0.149、0.137、0.167,P均<0.05)。结论健康成人左心室重构与血脂比值呈独立正相关,提示临床需早期防控血脂异常。     

正常妊娠妇女妊娠晚期及产后血脂水平变化分析

目的观察正常妊娠妇女在妊娠晚期及其产后血脂水平的变化。方法收集150例正常妊娠妇女分别在妊娠晚期及产后1周的标本作为实验组,40例健康未孕妇女的标本作为对照组。三酰甘油、总胆固醇采用氧化酶法,高密度脂蛋白胆固醇、低密度脂蛋白胆固醇采用直接测定法,载脂蛋白A(ApoA)、ApoB采用免疫透射比浊法,测定3组标本血清中6项指标的含量,并采用统计学方法比较分析各组血脂水平变化。结果正常妊娠妇女妊娠晚期6项血脂指标均高于其产后血脂水平,差异有统计学意义(P0.05);正常妊娠妇女妊娠晚期和产后期血脂水平均明显高于未孕对照组,差异有统计学意义(P0.01)。结论妊娠晚期孕妇血脂维持在较高水平,但产后1周内脂代谢水平明显下降,因此监测其血脂水平变化对预测产后高脂血症有一定意义。     

青壮年女性四肢瘫痪患者的血脂紊乱特点

目的:通过流行病学调查了解青壮年四肢瘫痪女性血脂浓度的特点,探讨绝对缺乏运动的生活方式对青壮年女性血脂浓度的影响。方法:对中国康复研究中心因脊髓损伤致四肢瘫痪入院进行康复治疗的女性患者100例进行入院状态调查,对其血脂指标甘油三酯(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)浓度进行分析。结果:100例患者TG浓度显著高于女性全国平均水平,HDL浓度显著低于女性全国平均水平;TC、LDL-C平均浓度与女性全国平均水平比较差异无统计学意义。年龄与TG、TC、LDL-C显著正相关(P0.05,0.01);与HDL无显著相关。血脂异常发生率68%,低HDL血症发生率58%。结论:青壮年四肢瘫痪女性患者血脂异常发生率高,与年龄正相关;与病程无相关性;患者均存在心血管健康隐患,有必要给予关注和早期干预。     

北京市部分职业人员血脂水平及血脂异常流行情况

目的:分析2003年北京部分职业人员血脂水平及高脂血症的患病率,并与国内1984～1986年有关血脂研究资料及日本、美国血脂调查结果比较。方法:以16963名体检者为研究对象,对其进行问卷调查、体检及血脂指标检测,血脂包括总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)。结果:由于TC、HDL-C、LDL-C及TG数据呈偏态分布,按百分位数法得出各年龄组的血脂结果,统计血脂异常的不同性别和年龄组的流行率。与20年前相关研究结果比较,男女TC高0.09mmol/L及0.11mmol/L,TG增高明显,男女分别为0.47mmol/L和0.3mmol/L,LDL-C差异无显著性,HDL-C下降0.07mmol/L(男)和0.05mmol/L(女)。高脂血症患病率比20年前明显增高,TC高于合适水平者有27.4%,高TC检出率为14.2%。本统计TC水平比日本低0.55mmol/L,比美国低0.53mmol/L(男)和0.56mmol/L(女),差异均具有显著性(P<0.001)。结论:与20年前资料相比,各型血脂异常检出率明显上升。TG升高幅度较大,而TC水平较稳定。目前我国冠心病血脂危险水平仍低于日本和美国。     

肝病患者血脂水平的变化

目的探讨肝病患者血清总胆固醇（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）的变化情况及其临床意义。方法测定235例肝病患者（其中急性肝炎55例、慢性肝炎59例、肝硬化50例、重型肝炎71例）血清TC、TG、HDL-C、LDL-C水平，并与75名健康人进行比较，同时测定血清总胆红素（TBil）、白蛋白（Alb）、血浆凝血酶原活动度（PTA）。对重型肝炎患者血清TC、TG、HDL-C、LDL-C浓度与其TBil、Alb、PTA进行相关性分析。结果各型肝病患者血清TC、TG、HDL-C、LDL-C水平和对照组比较均有所降低，其中肝硬化和重型肝炎患者以上指标与对照组比较明显下降（P〈0．01或P〈0．05）。重型肝炎组血清TC、TG、HDL-C、LDL-C与TBil呈负相关[P〈0．01]，与Alb呈正相关（P〈0．01），与PTA呈正相关（P〈0．01或P〈0．05）；血清TC与LDL-C呈正相关（P〈0．05）。重型肝炎组中39例死亡患者与32例存活患者的血清TC、TG、HDL-C、LDL—C水平差异均具有统计学意义（P〈0．05）。结论对肝病患者进行定期的血脂水平测定能及时反映体内的脂类代谢状况，对了解肝病患者的肝脏损伤程度、病程进展情况以及重型肝炎的预后判断都有重要价值。     

佛山市禅城区机关单位工作人员血脂水平分析

目的：了解本地区机关单位工作人员血脂水平,为临床血脂研究及心血管疾病预防提供依据。方法：随机收集2013年机关单位健康体检人员1292例,采用罗氏P800全自动生化仪对标本进行TC、TG、HDL-C、LDL-C进行检测,判断标准参照我国“血脂异常防治建议”并参考美国“ATPⅢ指南”,利用SPSS17.0对结果进行分析。结果：男性中年组TC、LDL-C明显比青年组、老年组高,而HDL-C低于青年组、老年组;TG随着年龄的增加而逐渐降低;女性TC、LDL-C随着年龄增加而逐渐升高,但中年组TG、HDL-C高于青年组、老年组。同年龄段青年组、老年组不同性别间TC、HDL-C、LDL-C比较,有统计学意义（P〈0.05）;而TG无统计学意义（P〉0.05）;中年组不同性别间除HDL-C有统计学意义（P〈0.05）外;TC、TG、LDL-C都无统计学意义（P〉0.05）。本地区机关工作人员高胆固醇血症约50%,高甘油三酯血症将近30%。青年组与中年组血清TC、TG、LDL-C浓度在合适范围比较,有统计学意义（P〈0.05）;与老年组TC、LDL-C浓度之间有统计学意义（P〈0.05）。结论：禅城区机关工作人员血脂水平处于较高水平,明显增加了心血管疾病的发生,防治血脂异常有利于心血管疾病的预防。     

肝病病人血脂水平检测及其价值

目的探讨肝病病人血脂水平变化及其临床价值。方法对212例不同类型肝病病人与80例健康人的血脂水平进行检测,包括血清三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL—C）、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）,同时检测肝功能指标,包括总胆红素（TBiL）、谷丙转氨酶（ALT）、清蛋白（ALB）。结果急性肝炎组血清TC、HDL-C、ApoA1水平显著低于正常对照组,慢性肝炎组TC、TG、HDL—C、LDL—C、ApoA1、ApoB水平均显著低于正常对照组,重症肝炎及肝硬化组各血脂检测指标均显著降低,肝癌组TG、HDL—C、ApoA1水平显著降低（F=2．37～53．01,q=5．83～17．58,P〈0．05、0．01）。肝炎病人TC、LDL-C、ApoA1与TBiL水平呈负相关（r=-0．324～-0．387,P〈0．05、0．01）;TG与ALT水平呈负相关（r=-0．426,P〈0．01）;TC、LDL—C、ApoB、HDL-C与ALB呈正相关（r=0．301～0．393,P〈0．05、0．01）。结论血脂检测对判断肝病的程度和预后有重要意义。     

Soy milk: A functional beverage with hypocholesterolemic effects? A systematic review of randomized controlled trials

ObjectiveCurrent guidelines have highlighted the role of diet in conjunction with drug therapy in the management of dyslipidemia. Over the last two decades, the effect of soy milk, a derivative of soybean, on blood lipids has been the focus of nutritional researches. The present study aimed to provide a comprehensive review of clinical trials investigating the effect of soy milk on blood lipids.MethodsAn electronic database searching including PubMed, EMBASE, Scopus, and CENTRAL was performed to extract all the records that were published up to May 2018 using MeSH terms and relevant keywords. Randomized clinical trials that had evaluated the effect of soy milk consumption on serum lipids including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were eligible for inclusion to this systematic review.ResultsEight eligible trials comprising a total of 263 subjects were included in this review. Three studies reported no significant improvement in any of the serum lipid parameters following soy milk consumption. A significant decrease in serum TG, TC, and LDL-C was reported by 1, 1 and 3 trials. Also, 1 trial found that soy milk consumption was accompanied by a significant increase in HDL-C.ConclusionEvidence from clinical trials regarding the hypolipidemic effect of soy milk is limited and controversial. More well-designed clinical trials with large sample size and longer duration are warranted.     

The Effect of Anastrozole on the Lipid Profile: Systematic Review and Meta-analysis of Randomized Controlled Trials

PurposeWe aimed to investigate the impact of anastrozole administration on the traditional components of the lipid profile (ie, total cholesterol [TC], LDL-C, HDL-C, and triglycerides [TGs]) by means of a systematic review and meta-analysis of randomized controlled trials.MethodsWe searched the PubMed/Medline, Scopus, Embase, and Web of Science databases for relevant randomized controlled trials published in the English language until January 18, 2022. The weighted mean difference (WMD) and 95% CIs were calculated using a random-effects model (DerSimonian and Laird methods).FindingsAnastrozole administration significantly lowered TC concentrations when the treatment duration was ≤3 months (WMD = ?2.73 mg/dL; 95% CI, ?5.09 to ?0.38 mg/dL; P = 0.02) and when the baseline TC concentration was ≥200 mg/dL (WMD = ?3.64 mg/dL; 95% CI, ?6.30 to ?0.98 mg/dL; P = 0.007). HDL-C levels decreased after anastrozole administration when the treatment duration was >3 months (WMD = ?1.67 mg/dL; 95% CI, ?3.24 to ?0.10 mg/dL; P = 0.03). Anastrozole administration had no impact on TG or LDL-C values.ImplicationsAnastrozole administration in humans can decrease TC and HDL-C levels but has no effect on LDL-C or TG concentrations.     

高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及其比值检测在中老年冠心病患者诊断和临床治疗中的意义

目的 探讨血清高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、LDL-C/HDL-C检测在中老年冠心病(CHD)患者中的意义.方法 分析经冠状动脉造影确诊为冠状动脉粥样硬化(药物治疗组)83例、CHD(支架植入组)163例及冠状动脉造影阴性(对照组)44例中老年病例的血清HDL-C、LDL-C、LDL-C/HDL-C比值与冠状动脉病变程度之间的关系.并比较各组间男女血脂水平的差异.结果 药物治疗组、支架植入组与对照组总胆固醇(T()、LDL-C、LDL C/HDL-C比值水平差异有统计学意义(P＜0.05或＜0.01).支架植入组TC、LDL-C、TC/HDLC比值水平明显高于药物治疗组及对照组(P＜0.05或＜0.01).支架植入组HDL-C显著低于药物治疗组及对照组(P＜0.05).药物治疗组女性HDL-C水平高于男性(P＜0.05),但女性TC/H DL-C比值、LDL-C/HDL-C比值低于男性(P ＜0.05).支架植入组女性TC和HDL-C高于男性(P＜0.05).对照组女性TC、HDL-C高于男性(P＜0.05),但女性TG/HDL C、LDLC/HDL-C低于男性(P＜0.05).结论 血清HDL-C、LDL-C、LDL-C/HDL-C比值与冠状动脉病变相关,对中老年CHD患者的诊断及临床治疗有使用价值.     

川崎病患儿血脂代谢与冠状动脉病变的关系

目的探讨川崎病（Kawasaki disease,KD）患儿血脂代谢与冠状动脉病变之间的关系。方法纳入2007年1月2009年10月住院治疗的82例KD患儿,检测治疗前后血总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、极低密度脂蛋白（VLDL-C）、载脂蛋白A1（ApoA1）及载脂蛋白B100（ApoB100）水平。选取50例健康儿童作为对照。KD患儿在治疗前行超声心动图检查,根据超声心动图显示将KD组再分为冠状动脉病变组（CAL组,n=31）和非冠状动脉病变组（NCAL,n=51）。结果治疗前,KD患儿TC、ApoA1、HDL-C降低,TG、LDL-C升高,与正常儿童相比有统计学意义（P〈0.05）。KD患儿CAL组较NCAL组变化更明显,有统计学意义（P〈0.05）。VLDL-C和ApoB100水平KD患儿与正常儿童比较、NCAL组与CAL组比较变化均不明显（P〉0.05）。治疗后与治疗前相比,NCAL组TC、TG、HDL-C、LDL-C、ApoA1恢复正常（P〈0.05））,而CAL组仅TC、LDL-C、ApoA1恢复正常（P〈0.05）。结论 KD患儿存在血脂代谢紊乱,TC、TG、HDL-C、LDL-C、ApoA1与冠状动脉的损害有关,应早期进行干预。     

人血清载脂蛋白M与血脂的相关性研究

目的 探讨血浆中载脂蛋白M(ApoM)水平与总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平的相关关系.方法 用ELISA法检测200例随机人群血清(男101例,女99例)中ApoM水平,酶法检测其TC、TG、HDL-C 和LDL-C水平,分析ApoM与各项目之间的相关性.结果 男女混合分析显示ApoM与TC水平呈正相关(r=0.418,P<0.01),与TG水平呈负相关(r=-0.407,P<0.01)同时与HDL-C呈正相关(r=0.786,P<0.01),与HDL-C/TC呈正相关(r=0.671,P<0.01).结论 血浆中ApoM水平与TC、HDL-C水平呈正相关,与TG水平呈负相关,提示ApoM在血脂代谢中有一定的生理功能.     

孕晚期血脂变化与妊娠高血压综合征关系的研究

目的探讨孕晚期血脂变化与妊娠高血压综合征(妊高征)发生之间的关系。方法比较正常非孕女性组(n=50)、正常妊娠组孕妇(n=50)及妊高征组孕妇(n=45)孕晚期血甘油三酯(TG)、总胆固醇(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-A(Apo-A)、载脂蛋白-B(Apo-B)的变化,分析不同分级的妊高征孕妇血脂的变化;以血脂各指标正常参考值中值为基础,描述正常妊娠组与不同妊高征分级孕妇在各血脂异常区间的样本分布情况,并分析血脂异常程度与妊高征严重程度的相关性。结果与对照组比较,正常妊娠组及妊高征组孕妇孕晚期血TG、TC、LDL-C、Apo-B明显升高(t分别=15.73、7.55、4.42、11.06;19.14、10.55、5.98、14.54,P<均0.05),HDL-C和Apo-A明显降低(t分别=2.78、2.42;4.54、4.38,P均<0.05);与正常妊娠组比较,妊高征组孕妇血TG、TC、Apo-B、LDL-C升高(t分别=5.09、4.33、3.85、2.11,P均<0.05),HDL-C、Apo-A降低(t分别=2.04、2.28,P均<0.05)。妊高征重度组TG、TC、LDL-C、Apo-B较轻度组明显升高(t分别=3.56、4.10、5.90、4.35,P均<0.05);中度组TG、TC、LDL-C、Apo-B较轻度组升高(t分别=2.59、2.15、2.18、2.22,P均<0.05);中度组Apo-A及重度组Apo-A较轻度组下降(t分别=2.52、2.36,P均<0.05);重度组LDL-C则较中度组升高(t=3.33,P<0.05)。TG、TC、LDL-C、Apo-A、Apo-B与妊高征严重程度呈正相关(r分别=0.43、0.52、0.60、0.37、0.47,P均<0.05)。结论妊高征的发生可能与孕期过度异常的血脂代谢相关,血脂异常程度越高,伴发严重妊高征的风险也可能越大。