原发痛风的临床特点及高危因素分析

 目的对原发痛风的临床特点及高危因素进行分析.方法病例选自2002年1月～2004年12月在痛风门诊就诊的165例新患者,资料处理采用条件Logistic回归分析.结果发病年龄范围24～72岁,男163例,女2例.首发部位以第1跖趾关节最常见138例(86.3%).原发痛风的独立危险因素:高血压及家族史、冠心病及家族史、目前收缩压和舒张压、BMI、尿酸排泄分数、急性痛风关节炎发作部位的外伤史、痛风家族史、TG、TC、LDL、VLDL的升高及HDL2-C的降低.结论国人对于原发痛风的危险因素应早期预防.     

原发性痛风危险因素的研究

 目的 探讨原发性痛风的危险因素。方法 病例-对照研究1996年1月～2000年1月专科门诊132名新患者,资料处理采用条件Logistic回归分析。结果 原发痛风的独立危险因素：职业、外向性格、饮酒、高嘌呤膳食、高血压及家族史、冠心病及家族史、目前收缩压和舒张压、体质指数(BMI)、尿酸清除分数、急性痛风关节炎发作部位的外伤史、痛风家族史、甘油脂(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL)、极低密度脂蛋白胆固醇(VLDL)的升高及高密度脂蛋白胆固醇2(HDL2C)的降低。结论 国人对于原发痛风的危险因素应早期预防。     

老年前期与老年期原发性高血压患者血脂的变化及临床意义

目的探讨老年前期和老年期原发性高血压患者血脂变化及其临床意义。方法将160例原发性高血压患者分为老年前期与老年期两组,测定晨起空腹静脉血中总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C),将各指标与健康对照组以及高血压患者老年前期与老年期对比分析。结果高血压组TC、TG和LDL-C显著高于对照组,差异均有统计学意义(P<0.05),而HDL和HDL-C/TC则明显低于对照组,差异均有统计学意义(P<0.05)。高血压老年期组TC、TG和LDL-C水平高于老年前期组(P<0.05),而HDL-C和HDL-C/TC则低于老年前期组,差异均有统计学意义(P<0.05)。结论老年原发性高血压患者TC、TG和LDL-C增高,而HDL-C和HDL-C/TC降低,且老年期变化更为明显,提示老年原发性高血压患者应注意追踪观察血脂的变化。     

原发痛风的家系一级亲属血清胰岛素水平及β细胞功能的研究

 目的 研究原发痛风的家系一级亲属血清胰岛素水平及β细胞功能.方法 23个原发痛风患者的核心家庭成员42人,正常人41例口服葡萄糖耐量试验(OGTT)后2 h血糖(2 Hpg)、胰岛素(2 hIns)及胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、血尿酸(UA)的测定.空腹、餐后2 h血糖、胰岛素并计算胰岛素抵抗指数(HOMA-IR),进行对照分析.结果 原发痛风一级亲属组血尿酸、胆固醇、三酰甘油水平明显高有于对照组;胰岛素、胰岛素抵抗指数明显高于对照组,且差别有统计学意义.结论 原发痛风患者一级亲属中存在高胰岛素血症.     

糖尿病合并冠心病患者血脂检测结果比较

 目的 探讨血脂异常对糖尿病和冠心病患者的诊疗意义.方法 306例经冠脉造影后分为单纯糖尿病72例,冠心病81例,糖尿病合并冠心病60例,健康对照组94例,检测其血脂水平,并比较组间差异.结果 糖尿病患者血清HDL,Apo A1水平较对照组降低,而糖尿病合并冠心病组的HDL,Apo A1水平均低于对照组和糖尿病组,糖尿病组LDL,TG,Apo B水平较对照组增高,糖尿病合并冠心病组的LDL,TG,Apo B水平较对照组和糖尿病组高.结论 糖尿病合并冠心病患者血脂水平明显增高,应强化降脂治疗.     

老年2型糖尿病患者血小板参数和血清脂质的变化

目的　探讨老年 2型糖尿病患者血小板参数和血清脂质的变化及其意义。方法　选择老年 2型糖尿病患者 4 1例。正常对照 33例。检测血小板数 (PLT)、平均血小板体积 (MPV)、血小板体积分布宽度 (PDW )、大血小板比率 (P LCR)、血清总胆固醇 (TC)、甘油三酯 (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,B(apoA1,apoB)、脂蛋白 (a) [(Lp(a) ]水平 ,观察血小板参数、血清脂质与糖尿病血管并发症及血糖控制水平之间的关系。 结果　老年糖尿病组与正常对照组比较、老年糖尿病不同血管并发症组间比较以及不同血糖浓度组间比较 ,血小板 4项参数测定值差异均无显著性意义均 (P >0 .0 5 ) ;血清TG ,Lp(a)测定值老年糖尿病组明显高于正常对照组 (P <0 .0 5 ) ,P <0 .0 1) ;老年糖尿病合并大血管病变组LDL C明显高于微血管病变组和无血管并发症组 ,差异有显著性意义 (P <0 .0 5 )。结论　血小板 4项参数对老年糖尿病并发血管性病变的诊断可能无明显价值 ,血清LDL C ,TG ,Lp(a)是老年糖尿病患者发生动脉粥样硬化的主要危险因素     

超声造影成像技术评价脑梗死患者颈动脉斑块新生血管与血脂的相关性

目的探讨超声造影成像技术评价急性脑梗死患者颈动脉斑块内新生血管及其与血脂指标的关系。方法选取急性脑梗死伴颈动脉粥样斑块的住院患者106例(脑梗死组),无临床脑梗死表现的颈动脉粥样斑块患者40例(非脑梗死组),经超声造影检查获得斑块的造影参数并进行定量分析,检测两组患者血脂指标包括:三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)并进行比较。结果脑梗死组超声造影增强率为81.1%,明显高于非脑梗死组的40.0%(P<0.01),峰值强度比值(P)、曲线下面积(AUC)明显高于非脑梗死组,达峰时间(Tp)小于非脑梗死组(P<0.05)。两组血脂指标中TG、TC、LDL有统计学差异(P<0.05)。两组中,有增强病例LDL指标均高于无增强病例(P<0.05)。脑梗死组血脂指标与超声造影参数的相关性分析显示,TG与P、Tp、AUC、平均渡越时间(MTT)均明显相关(P<0.01),LDL与P、AUC明显相关(P<0.01),与Tp、MTT无明显相关(P>0.05),TC、HDL与超声造影参数无明显相关(P>0.05)。结论超声造影能方便地检测斑块内新生血管并进行定量分析,可以灵敏、客观地反映斑块的稳定性,对客观地预测和评价脑梗死的发生具有重要的临床价值。     

体外反搏对冠心病患者脂质过氧化物及血脂的影响研究

本文研究观察了体外反搏(ECP)对冠心病(CHD)患者血浆脂质过氧化物(LPO),红细胞内超氧化物岐化酶(SOD)和血脂五项:胆固醇(TC),甘油三酯(TG),高密度脂蛋白(HDL—C),低密度脂蛋白(HDL—C),极低密度脂蛋白(VLDL—C)的影响。结果表明CHD患者红细胞SOD无变化,血浆LPO显著增高(P<0.005),血清TG及VLDL—C水平增高(P<0.01);与5％葡萄糖加丹参静滴对照,ECP可显著降低LPO、TC、TG及LDL—C水平,但不伴有SOD明显变化。提示:ECP是保护缺血心肌的有效抗氧化手段之一。     

子痫前期血脂及凝血指标变化临床价值研究

目的：探讨子痫前期患者血脂及凝血指标变化及其临床价值。方法：选择2011年1月-2013年12月在我院分娩的妊娠妇女96例,分为正常妊娠组44例、轻度子痫前期组20例和重度子痫前期组32例。比较3组血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）,以及凝血酶原时间（PT）、活化的部分凝血酶原时间（APTT）和纤维蛋白原（FIB）等指标。结果：3组血脂及凝血指标存在显著差异（P〈0．05）。其中,重度子痫前期组TC、TG及LDL水平,均显著高于正常妊娠组（P〈0．05）;HDL水平显著低于与正常妊娠组（P〈0．05）。轻度子痫前期组TG水平,显著高于正常妊娠组（P〈0．05）;TC、HDL及LDL水平两组均差异不显著（P〉0．05）。轻度子痫前期组、重度子痫前期组PT、APTT,均较正常妊娠组显著降低（P〈0．05）;FIB较正常妊娠组显著或非常显著升高（P〈0．05,P〈0．01）。结论：血脂及凝血指标变化对于子痫前期早期诊断和防治具有重要临床价值。     

Raloxifene与利维爱对去卵巢大鼠血脂的影响

目的 观察Raloxifene(EVISTA)和利维爱（Livial）用于治疗去卵巢大鼠骨质疏松时对血脂的影响。方法 32只4月龄雌性SD大鼠随机分为 4组：假手术组、模型组、Raloxifene组及利维爱组,每组8只,用药60天,采血分离血清,测定血清总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白（HDL－C）、低密度脂蛋白（LDL－C）,对各组血脂测定值进行比较。结果 大鼠去卵巢75天后,模型组血脂已有变化,表现为TC增高,HDL－C降低,TG、LDL－C差异无显性;两药物组与模型组比较血脂改善,但调脂结果各不相同;利维爱与Raloxifene均有降低TG、升高HDL－C的作用,前降低TC强于后,对LDL－C无明显影响;后升HDL－C强于前,同时还有降低LDL－C作用;二对TG均无明显作用;结论 大鼠去卵巢后将发生血脂紊乱,Raloxifene、利维爱均有调脂作用。     

Lipoprotein and lipid profiles of elite athletes in Olympic sports

The aim of this work was to obtain an insight into the influence exerted upon plasma lipid parameters by high quality physical training in different specialties of nine Olympic sports. We compared the concentrations of serum cholesterol (TC), total lipids (TL), triglycerides (TG), HDL, LDL, VLDL, and % distribution of HDL, LDL, and VLDL of elite athletes (n = 127, age = 22.0 +/- 3.2 yrs) participating in regular training for over 3 years (2-4 h/day), separated into 11 groups of athletic specialties, with those obtained from a group of selected sedentary controls (n = 26, age = 25.3 +/- 4.5 yrs). We also compared the lipoprotein ratio factor (RF) values TC/HDL and LDL/HDL. The athletic disciplines examined were football, basketball, volleyball, boxing, wrestling, judo, sailing, skiing (slalom), track (two groups), and throwing-jumping. Football, volleyball, judo, SD and LD running, and the total sum of athletes had significantly higher HDL than the controls. Football, basketball, volleyball and all the disciplines taken together showed significantly lower LDL. Boxing, judo, and LD running had significantly lower VLDL and volleyball, SD, and LD running significantly lower %VLDL. Volleyball had significantly lower TL, boxing and volleyball lower TC, while judo, boxing, SD and LD running had lower TG. Sailing had significantly lower %HDL and higher %LDL and TL than the controls; wrestling, skiing, and throwing-jumping did not differ. In all the athletes taken together, VO2 max or relative body weight, with respect to HDL and TC/HDL, were found to be slightly correlated (r = 0.30, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)     

卒中后抑郁患者载脂蛋白H与血脂的相关研究

目的了解卒中后抑郁（PSD）患者载脂蛋白H（ApoH）和血脂水平特点,进一步探讨Aport对PSD的影响。方法①检测血清中甘油三酯（TG）、总胆固醇（Tc）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）水平。②应用实时荧光定量PCR技术检测Aport水平。结果①PsD组AportmRNA表达量低于脑卒中组,差异具有统计学意义（P〈0．05）。@PSD组血清TG水平高于脑卒中组和对照组,差异具有统计学意义（P〈0．05）。血清TC、HDL、LDL水平在各组间差异均无统计学意义（P均〉0．05）。结论载脂蛋白H结合甘油三酯可以作为PSD临床疗效评价的参考指标。     

大肠癌患者血清脂蛋白、血脂、癌胚抗原分析

目的：观察大肠癌患者术前术后血清脂白、血脂、癌胚抗原的变化。方法：对４６例大肠癌病人和４０例正常人检测血清ＴＣ、ＴＧ、ＨＤＬ－Ｃ、ＬＤＬ－Ｃ、ＣＥＡ术前术后的改变。结果：术前大肠癌血清ＴＣ和ＨＤＬ－Ｃ水平明显低于正常组,ＣＥＡ水平明显高于正常组,差异非常显著（Ｐ〈０．０１）;术后大肠癌血清ＴＣ、ＨＤＬ－Ｃ、ＣＥＡ水平与正常组对照有显著差异（Ｐ〈０．０５）,大肠癌恶性程度高则血清ＴＣ和ＨＤＬ－Ｃ水平     

烧伤患者外周血高密度脂蛋白变化的临床意义

目的探讨烧伤患者高密度脂蛋白的变化特点及其与感染并发症的关系。方法选取120例伤后24h内入院的18～59岁热力烧伤患者,其中轻中度、重度和特重度烧伤各40例,于入院时和伤后1、2、3、5、7、14、21d空腹采集外周血,检测甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)水平,并监测感染并发症及预后情况。以40例健康体检者作为对照组。结果120例患者中有32例发生医院感染51例次,死亡6例,其中5例与感染有关。轻中度、重度和特重度烧伤患者的感染发生率分别为7·5%、20·0%和52·5%,三者比较差异显著(P<0·001)。TC、HDL、apoA1在伤后1d已明显降低(P<0·05),伤后5d降至最低水平,此三项指标的水平随伤情加重递减,其中以HDL降幅最大。与对照组比较,轻中度、重度和特重度组HDL平均降低33%、45%和70%。TG在伤后7d升至最高水平,其浓度随伤情加重递增,与对照组比较,轻中度、重度和特重度组TG平均升高30%、67%和153%。特重度组40例中有21例发生感染37例次,在入院时和伤后1d,感染者与非感染者血脂水平无显著差别,伤后2d感染者的TC、HDL、apoA1开始低于非感染者,直至伤后21d差别仍具有显著性(P<0·05)。伤后3～21d,感染者TG明显高于非感染者。结论烧伤患者TC、HDL、apoA1、LDL水平降低,TG水平升高,血脂异常程度与伤情及感染并发症有关。     

分化型甲状腺癌患者在左甲状腺素撤药及用药状态下血清甲状腺激素、血肌酶谱和血脂的相关性分析

目的分析分化型甲状腺癌（DTC）患者在左甲状腺素撤药及用药状态下血清甲状腺激素、血肌酶谱、血脂等指标的变化及撤药后的临床表现。方法选取攀枝花市中心医院就诊的DTC患者46例,检测左甲状腺素撤药后4周及服用左甲状腺素后4、8、12周甲功3项[游离三碘甲腺原氨酸（FT₃）、血清游离甲状腺素（FT₄）、TSH]、血肌酶谱[谷草转氨酶（AST）、乳酸脱氢酶（LDH）、α-氢丁酸脱氢酶（α-HBD）、肌酸激酶（CK）、肌酸激酶同工酶（CKMB）]、血脂4项[甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）]水平,计算检验值,勾画指标随时间变化曲线图,记录患者临床症状。选取攀枝花市中心医院体检甲功正常对照者50名,行血肌酶谱、血脂4项检测。将正常对照者与DTC患者撤药后4周的血肌酶谱、血脂4项行独立样本秩和检验。DTC患者撤药后4周FT₃、FT₄与血肌酶谱、血脂行线性相关性分析。结果① DTC患者在左甲状腺素撤药后4周与正常对照者在血肌酶谱（AST、LDH、CK）、血脂4项（TG、TC、HDL、LDL）水平相比较,差异均有统计学意义,其中AST（t=3.888,P < 0.05）、LDH（Z=-3.372,P < 0.05）、CK（Z=-5.913,P < 0.05）、TG（Z=-2.787,P < 0.05）、TC（t=6.166,P < 0.05）、HDL（t=3.041,P < 0.05）、LDL（t=5.372,P < 0.05）; ② DTC患者CK、TG、TC、LDL在服用左甲状腺素后4周恢复至正常范围水平; ③ FT₃与CK、TC呈负相关,FT₄与LDH、α-HBD、CK、CKMB、TG呈负相关; ④ 左甲腺素撤药后4周DTC患者的症状以肌肉酸痛、乏力、肿胀为主要表现的占86.96%。结论① DTC患者撤药后可导致AST、LDH、CK、TG、TC、HDL、LDL异常; ② 撤药后引起血肌酶谱、血脂4项指标的变化是可逆的; ③ 血清FT₃、FT₄是CK异常的影响因素; ④ DTC患者撤药后4周大多数发生甲减性肌病,给予左甲腺素替代治疗后症状明显缓解。     

Changes in blood lipids in humans during long-term ski crossing in the Extreme North]

Serum lipids were measured in the men who made two ski crosses in the Far North during polar night. The first trip, which was to train the athletes, took 17 days and the second took 38 days. In both studies, lipid mobilization and utilization increased, which led to changes in the lipid spectrum: decrease of the concentration of LDL and, in the second trip, of VLDL and HDL3, and increase of the concentration of HDL2 and cholesterol HDL. In the second trip, lipids were most intensively utilized: lipolysis enhanced and free fatty acids declined. This was also indicated by an increase of the capillary-venous difference in terms of the total fraction of LDL and VLDL as well as free fatty acids. At the end of the second trip, the positive capillary-venous difference in terms of LDL and VLDL and, accordingly, the negative capillary-venous difference in terms of HDL2 and HDL3 increased. At the end of both trips the synthesis of transport lipids grew; in the most strenuous second trip, their active utilization in the working organs was stronger.     

Heparin-released plasma lipase activities, lipoprotein and apoprotein levels in young adult cyclists and sedentary men

Serum lipid and lipoprotein levels, apolipoproteins A-I and B, and lipolytic enzyme activities were studied in 14 young male cyclists and in 21 age-matched sedentary controls. While there were no significant differences in serum cholesterol between the two groups, the cyclists showed a significant decrease in serum triglycerides (P less than 0.05) and LDL cholesterol (P less than 0.05) and had significantly higher levels of HDL cholesterol (P less than 0.01) and HDL2 cholesterol (P less than 0.001). Significantly lower serum cholesterol/HDL cholesterol (P less than 0.001) and LDL cholesterol/HDL cholesterol (P less than 0.001) ratios and a significantly higher HDL2 cholesterol/HDL3 cholesterol ratio (P less than 0.001) were observed in the athletes. Serum apolipoprotein B was lower and the Apo B/Apo A-I ratio significantly reduced in the athletes. No significant differences emerged between the two groups in plasma post-heparin lipoprotein lipase activity (LPL) and in hepatic triglyceride lipase activity (HTGL), and there were no correlations between HDL cholesterol and lipolytic enzyme activities. In conclusion, this cross-sectional study may indicate that an aerobic training program such as cycling is associated with an advantageous lipoprotein pattern; some factors other than lipolytic activity may contribute to increase the HDL cholesterol levels in physical training.     

Effects of submaximal exercise on high-density lipoprotein-cholesterol subfractions

Acute high-density lipoprotein-cholesterol (HDL) changes were determined in 18 healthy college aged-men completing two-counterbalanced running trials at different exercise intensities: trial 1 at 70 % lactate threshold (LT) (372.5 +/- 28.9 kcal); trial 2 at LT intensity (365.9 +/- 75.9 kcal). For each trial, blood samples were collected at pre-exercise (baseline), 15 min post-exercise (15 m PE) and 24 hours post-exercise (24 h). Serum samples were analyzed for HDL/HDL 2 /HDL 3 subfraction, low density lipoprotein (LDL), very low density lipoprotein (VLDL), total cholesterol (TC), free cholesterol (FC), cholesterol ester, and triglycerides (TG). In addition, capillary blood samples were collected for analysis of blood lactate concentrations during incremental test to determine LT. All samples were corrected for plasma volume changes and compared to pre-exercise (baseline). In assessing the lipid and lipoprotein variables, the significant increase in HDL (p < 0.05) at the 24 h was due to the increase in both HDL 2 and HDL 3. The increase in 15 m PE TC at the LT intensity occurred while the decreases in 24 h TG and VLDL concentrations at the LT intensity occurred at different time periods, respectively. These decreases in the concentrations of TG and VLDL were significantly different, contributing to change in 24 h HDL concentration. No significant difference was determined in changes of HDL over time ratios of FC/CE and HDL 2 /HDL 3. Therefore, the significant increase in 24 h HDL at LT intensity was potentially due to increases in both HDL 2 and HDL 3 subfractions even though 24 h FC was increased significantly. Exercise at LT intensity might favourably alter the lipid profile as demonstrated in 24 h HDL concentration in combination with decreases in TG and VLDL at 24 h post-exercise. Consequently, the LT intensity might appear to be the threshold intensity of acute aerobic exercise (expending 350 kcal) necessary to promote a significant increase in HDL.     

2型糖尿病血管并发症与血脂水平的相关性研究

目的研究2型糖尿病血管并发症与血脂水平的相关性。方法临床入选305例研究对象,按照相关诊断标准分成4组,分别为正常对照组（A组,n=110）、糖尿病无血管并发症组（B组,n=65）、糖尿病微血管并发症组（c组,n=60）、糖尿病大血管并发症组（D组,n=70）,比较分析各组的血脂水平。结果A组的TC、TG、LDL-C及Non-HDL-C水平均较其他3组明显降低,而HDL-C较其他3组明显升高（P〈0．05）;c组的TC、LDL-c及Non-HDL-C水平较B组明显升高,D组的TC、LDL-C及Non-HDL-C水平较c组和B组明显升高（P〈0．05）。结论血清TC、LDL-C及Non-HDL-C均是糖尿病微血管及大血管病变的危险因子,而HDL-C是其重要的保护因子。