男性冠心病患者性激素与血脂的变化及相关分析

以男性冠心病患者（４４例）为对象，用３８例健康男性作对照，分别观察了性激素、血脂的变化，结果显示男性冠心病患者血清睾酮、高密度脂蛋白胆固醇明显降低（Ｐ＜００１），血清雌二醇与睾酮比率、脂蛋白（ａ）明显增高（Ｐ＜０．０１），血清睾酮与高密度脂蛋白胆固醇呈显著正相关（Ｐ＜００１），与脂蛋白（ａ）呈显著负相关（Ｐ＜００５）。提示睾酮下降引起的性激素失衡是男性冠心病的相关危险因素。     

茶色素（心脑健）对正常人的作用

正常男、女各１０人，内服茶色素３７５ｍｇ（低剂量组）或５００ｍｇ（剂量组）。服药一个月后，未发现任何毒副作用，对血脂［血总胆固醇、甘油三酯、高密度脂蛋白固醇及血清脂蛋白（ａ）］、血浆纤维蛋白原、血液粘度及血液凝固性无影响。     

单纯性肥胖小儿血脂、脂蛋白及载脂蛋白的研究

检测５９例单纯性肥胖小儿血脂、脂蛋白及载脂蛋白的含量。与健康儿童比较，其血总胆固醇、甘油三脂、低密度脂蛋白－胆固醇、极低密度脂蛋白－胆固醉及载脂蛋白Ｂ１００的浓度均明显升高（Ｐ＜０．０１），高密度脂蛋白－胆固醇、载脂蛋白ＡＩ明显降低（Ｐ＜０．０１），脂蛋白（ａ）浓度无明显变化（Ｐ＞０．０５），血脂异常随肥胖加重而加重。结果表明肥胖小儿有明显的脂质代谢紊乱，积极预防和治疗对预防成人冠心病的发生有重要意义。     

茶色素（心脑健）对高脂血症动物血脂含量的影响

茶色素（心脑健）对高脂食物喂饲的动物血清总胆固醇含量无明显影响（Ｐ＞０．０５），高剂量茶色素能显著降低高脂鹌鹑血清中甘油三酯、低密度脂蛋白胆固醇含量（Ｐ＜０．０５），同时又能显著升高血清中高密度蛋白胆固醇含量（Ｐ＜０．０５），能减轻主动脉脂质斑块的形成，以及减轻高脂动物的体重。     

降粘胶囊治疗高粘滞血症的临床研究

目的：观察降粘胶囊治疗高粘滞血症的疗效。方法：高粘滞血症患者３９４例随机分为治疗组１９８例和对照组１９６例。将口服降粘胶囊治疗组和口服茶色素胶囊对照组作比较。结果：治疗组治疗后血液流变学指标较治疗前明显改善（Ｐ＜０．０５～０．０１）。治疗组总有效率为９４．９％，对照组为８５．２％，治疗组疗效明显优于对照组（Ｐ＜０．０５）；治疗组治疗后总胆固醇、甘油三酯和血糖较治疗前明显下降（Ｐ均＜０．０１），高密度脂蛋白则明显上升（Ｐ＜０．０１）。结论：降粘胶囊具有降低血脂、血糖、血液粘稠度及改善微循环、防止动脉硬化等作用，是预防和治疗高粘滞血症的有效药物。     

老年冠心病患者脂蛋白（a）的检测及其临床意义

分析了不同类型老年冠心病（ＣＨＤ）患者４４例和正常健康老年人３０例血清脂蛋白（ａ）〔ＬＰ（ａ）〕、血脂和载脂蛋白的血清含量的变化。结果：显示ＣＨＤ患者ＬＰ（ａ）水平（３２３．６５±３３２．９７ｍｇ／Ｌ）明显高于对照组（１１０．７７±８０．１２ｍｇ／Ｌ，Ｐ＜０．０１），呈正偏态分布；而且，老年ＣＨＤ组中ＬＰ（ａ）与其它血脂和载脂蛋白测定值，除总胆固醇（ＴＣ）外，均较对照组有显著差异；ＬＰ（ａ）与ＣＨＤ的其它危险因子无相关性，但与低密度脂蛋白（ＬＤＬ）和ＴＣ有一定相关性。提示ＬＰ（ａ）是ＣＨＤ的危险因素之一，可作为ＣＨＤ严重性的判断指标。     

冠状动脉病变程度与血脂及其亚组分、超氧化物歧化酶关系的研究

目的：探讨血脂、脂蛋白及超氧化物歧化酶（ＳＯＤ）与冠状动脉病变程度的关系。方法：选择冠状动脉造影患者３０例，分为正常组（１１例）、单支组（１０例）和多支组（９例）；测定胆固醇、甘油三酯、脂蛋白及其亚组分和ＳＯＤ含量。结果：３组患者间血清甘油三酯和胆固醇水平相近；多支组高密度脂蛋白胆固醇／低密度脂蛋白胆固醇（ＨＤＬＣ／ＬＤＬＣ）比值低于正常组（Ｐ＜０．０５）。单支组和多支组ＨＤＬＣ均低于正常组（Ｐ均＜０．０１），而ＬＤＬＣ均高于正常组（Ｐ＜０．０５或Ｐ＜０．０１）。正常组ＳＯＤ为（２０３．４±５７．７）ｋＵ／Ｌ，高于单支组〔（１２９．４±７１．６）ｋＵ／Ｌ，Ｐ＜０．０５〕和多支组〔（９５．９±５３．３）ｋＵ／Ｌ，Ｐ＜０．０１〕。ＳＯＤ与ＬＤＬ呈中度负相关（ｒ＝－０．４４８，Ｐ＜０．０５），ＳＯＤ与ＨＤＬ（ｒ＝０．６９６，Ｐ＜０．０１）和ＳＯＤ与ＨＤＬＣ（ｒ＝０．３９９，Ｐ＜０．０５）均呈正相关。结论：血脂、脂蛋白、脂蛋白亚组分及ＳＯＤ与冠状动脉病变程度有一定的联系，ＨＤＬ、ＨＤＬＣ、ＬＤＬ、ＬＤＬＣ和ＨＤＬＣ／ＬＤＬＣ是预测冠状动脉粥样硬化性心脏病发病的重要易患因子。     

单纯性肥胖症脂蛋白（a）测定及其临床意义

测定１４４例单纯性肥胖症患者（ＳＯ）的脂蛋白（ａ）［ＬＰ（ａ）］及载脂蛋白Ａ１、Ｂ（ＡＰＯＡ１、ＡＰＯＢ）、总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白胆固醇（ＨＤＬＣ），并计算其ＨＤＬＣ与ＴＣ之比值（Ｈ／Ｃ）。ＬＰ（ａ）的ＳＯ全组与９２例正常对照组比较明显增高（Ｐ＜０．０１），每１０岁分一组与相应的对照组比较，３０岁以上各组增高（Ｐ＜０．０５）。其他脂质的ＳＯ各分组对应比较，ＡＰＯＢ、ＴＧ、ＴＣ较对照组增高，ＡＰＯＡ１、ＨＤＬＣ、Ｈ／Ｃ０降低（Ｐ＜０．０１）。ＬＰ（ａ）的增高及各脂类的异常是动脉粥样硬化及心、脑血管病变的危险因素。强调对ＳＯ早期防治十分重要。     

慢性肾功能不全的脂质代谢变化

测定５７例慢性肾功能衰竭（ＣＲＦ）和３０例正常人血清总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、载脂蛋白（ＡＰＯ）及脂蛋白〔ＬＰ（ａ）〕的含量。结果显示：与对照组相比，ＣＲＦ患者的ＴＧ、ＡＰＯ、ＬＰ（ａ）等均有显著异常（Ｐ＜０．０１）。提示：ＣＲＦ时脂代谢发生紊乱，并且脂代谢紊乱是促进动脉粥样硬化、并发缺血性心血管损害的重要因素     

茶色素（心脑健）降血清脂蛋白（a）作用的研究

用茶色素治疗血清脂蛋白（ａ）升高（＞３０ｍｇ／ｄｌ）者６８例，每日三次，每次１２５ｍｇ，疗程１个月，并与血清脂蛋白（ａ）ｂｅ ｎｔｇ （＜３０ｍｇ／ｄｌ）者４２例对照。结果证明，茶色素对血清Ｌｐ（ａ）升高有明显的降Ｌｐ（ａ）作用，总有效率为７５％，而对血清脂蛋白（ａ）阴性者无降低Ｌｐ（ａ）作用，提示茶色素对冠心病与动脉粥样硬化有防治作用。     

茶色素对SHRSP血脂和高血压靶器官结构的影响

目的　探讨茶色素对卒中易感型自发性高血压大鼠血脂和高血压靶器官结构的影响。方法　治疗组大鼠用大剂量茶色素 [6 0 0mg/(kg·d) ]或小剂量茶色素 [3 0 0mg/(kg·d) ]灌胃 ,对照组用同体积 1%盐水灌胃。每 2周进行一次尾动脉血压测量。实验 8周后 ,进行血脂测定 ,然后断头处死动物 ,观察心、脑、肾结构的变化。结果　茶色素对SHRSP血压和体重无显著影响 ,但它能够显著降低血浆胆固醇和甘油三酯水平 ,升高高密度脂蛋白水平 ;显著降低大鼠心脏和大脑的脏器系数和卒中率 ,显著改善大鼠主动脉、心肌和脑基底动脉的结构。结论　茶色素能够减缓SHRSP高血压的发展过程。     

非诺贝特治疗高脂血症40例疗效观察

目的：观察非诺贝特对高脂血症的疗效。方法：对４０例高脂血症患者使用非诺贝特，每日３００ｍｇ，疗程６个月；治疗前后检测血清总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、低密度脂蛋白胆固醇（ＬＤＬＣ）、高密度脂蛋白胆固醇（ＨＤＬＣ）和载脂蛋白Ａ１（ａｐｏＡ１）、载脂蛋白Ｂ（ａｐｏＢ）等。结果：ＴＧ平均降低了４５．２％，ＴＣ平均降低了２０．５％，ＨＤＬＣ平均上升了１５．４％，ＬＤＬＣ平均降低了２５．５％，ａｐｏＡ１平均上升了２．０％，ａｐｏＢ平均下降了３０．０％。结论：非诺贝特具有降低ＴＧ、ＴＣ、ＬＤＬＣ、ａｐｏＢ和升高ＨＤＬＣ、ａｐｏＡ１作用，从而可减少冠状动脉粥样硬化性心脏病的发病率和病死率     

弹性酶与脂必妥对糖尿病高脂血症及微量蛋白尿的疗效观察

目的：探讨弹性酶与脂必妥对糖尿病高脂血症及对早期糖尿病肾病的疗效。方法：８４例非胰岛素依赖型糖尿病患者随机分为弹性酶组和脂必妥组,比较２种药物对糖尿病高脂血症及微量蛋白尿的治疗效果。结果：总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白胆固醇（ＨＤＬＣ）在弹性酶组治疗６周末分别下降了１０％、１９％和上升了８％（Ｐ均＜０．０１）;脂必妥组６周末分别下降了１１％、１６％和上升了７％（Ｐ均＜０．０１）。尿蛋白排泄率在脂必妥组平均上升了２．４％（Ｐ＞０．０５）,弹性酶组平均下降了２５．７％（Ｐ＜０．０１）。结论：弹性酶与脂必妥对糖尿病高脂血症均有非常显著的疗效,而对尿蛋白排泄率（ＵＡＥＲ）的影响弹性酶优于脂必妥。     

The effect of wet cupping on serum lipid concentrations of clinically healthy young men: a randomized controlled trial

OBJECTIVE: The aim of this study was to determine if a reduction in serum lipoproteins, especially LDL cholesterol, is a preventive approach against atherosclerosis. Phlebotomy has been a recommended method to reduce serum lipoprotein levels. The present study was conducted to investigate the effects of wet cupping on serum lipoprotein concentrations. SUBJECTS AND METHODS: In this randomized controlled trial, 47 men (18 to 25 years old), without chronic disease or a history of hyperlipidemia and antihyperlipidemic drug consumption were randomly assigned into control (N = 24) and treated (N = 23) groups. Men in the treated group were subjected to wet cupping, whereas men in the control group remained untreated. The serum concentrations of lipids, collected from brachial veins, were determined at the time of wet cupping and then once a week for 3 weeks. Data were analyzed using a repeated measure ANOVA. RESULTS: A substantial decrease in LDL cholesterol (p < 0.0001) and in the LDL/HDL ratio (p < 0.0001) was found in the treated group compared to the control. There were no significant changes in serum triglyceride between groups (p > 0.05). Although there were no statistically significant variations in total cholesterol and HDL cholesterol (p > 0.05), a 7% decrease in total cholesterol and 3% increase in HDL cholesterol may be clinically important. CONCLUSIONS: Wet cupping may be an effective method of reducing LDL cholesterol in men and consequently may have a preventive effect against atherosclerosis.     

Lipid effects of celiprolol, a new cardioselective beta-blocker, versus propranolol

The metabolic effects of celiprolol, a new beta-adrenoceptor blocking agent with intrinsic sympathomimetic activity and alpha 2-blocking properties, were evaluated in a series of patients with hypertension, both with and without hyperlipidemia. Propranolol was tested as the reference drug in a randomized double-blind trial. Of the 35 patients of both sexes who completed the study, 17 were hyperlipidemic (low-density lipoprotein cholesterol greater than or equal to 170 mg/dl) and 18 were normolipidemic. Both drugs exerted a similar hypotensive effect after gradual dose adjustment; however, propranolol reduced heart rate to a higher extent (-20.5%) than celiprolol (-7.7%). Propranolol determined a significant rise of total and very low-density lipoprotein (VLDL) associated triglyceridemia, whereas high-density lipoprotein cholesterol (HDL cholesterol) levels and the total cholesterol/HDL cholesterol ratios were significantly depressed, particularly in hyperlipidemic patients. Celiprolol, in contrast, slightly decreased triglyceridemia (significantly in the hyperlipidemic group at week 12) and caused a 5% increase of the HDL cholesterol levels. The total cholesterol/HDL cholesterol ratio was reduced by celiprolol at week 16 in both hyperlipidemic and normolipidemic patients. The effects of the two beta-adrenoceptor blockers on HDL cholesterol and triglyceride levels differed significantly after 12 and 16 weeks of treatment, which confirm the divergent metabolic effects of the two agents.     

糖尿病患者尿GPDA与血清脂质变化的关系

目的　探讨糖尿病患者尿甘氨酰脯氨酸二肽氨基肽酶 (GPDA)与血清脂质变化的关系。方法　选择糖尿病患者 2 1 1例 ,正常对照组 98名 ,检测尿GPDA和血清脂质的水平 ,对其相互关系进行分析。结果　糖尿病患者组尿GPDA水平显著高于正常对照组 (t=4 .2 5 5 5 ,P <0 .0 0 1 ) ,血清胆固醇 (TC)、三酰甘油 (TG)、低密度脂蛋白胆固醇 (LDL C)、TC/高密度脂蛋白胆固醇比值 (TC/HDL C)、LDL C/HDL C比值、载脂蛋白B(ApoB)、脂蛋白 (a) [Lp(a) ]水平均高于正常对照组 (P <0 .0 0 1 ) ,而HDL C、载脂蛋白Al(ApoAl)、ApoAl/ApoB比值则明显低于正常对照组 (P <0 .0 1 )。糖尿病患者分组比较 ,血清TC、TG、LDL C、TC/HDL C、LDL C/HDL C、ApoB、Lp(a)随尿GPDA排泄量增多呈增高趋势 ,而HDL C、ApoAl、ApoAl/ApoB比值呈下降趋势。 结论　糖尿病患者伴有脂代谢紊乱 ,并与尿GPDA的升高、肾功能的损害相平行     

老年抑郁症认知功能与血清同型半胱氨酸及血脂水平的相关性

目的 研究老年抑郁症患者血清同型半胱氨酸(Hcy)、血脂水平与认知功能之间的关系。方法 选取60例老年抑郁患者为研究组,以60例健康志愿者为对照组,测定两组血清Hcy、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)水平。用汉密尔顿抑郁量表（HAMD）评定病情严重程度,蒙特利尔认知评估量表(MoCA)评估患者的认知功能。结果 与对照组比较,研究组MoCA评分明显低于对照组（P＜0.05）,血清Hcy明显高于对照组（P＜0.05）,血清HDL C水平明显低于对照组（P＜0.05）。相关分析显示,研究组认知功能损害程度与病情严重程度呈正相关（r=0.327,P＜0.01）,认知功能评估中注意与集中、记忆、执行功能评分与血清Hcy水平呈负相关（r=-0.402,P=0.01）,其中执行功能评分与HDL C水平成正相关（r=0.562,P=0.008）。结论 老年抑郁症患者的认知功能损害与血清高水平Hcy和低水平HDL C水平有关,血清高水平Hcy和低水平HDL C可能是老年抑郁症患者的危险因素。     

Coronary heart disease incidence in NIDDM patients in the Helsinki Heart Study.

OBJECTIVE--To determine coronary heart disease (CHD) incidence among dyslipidemic subjects with non-insulin-dependent diabetes mellitus (NIDDM) and to assess the effect of lipid-modifying treatment on serum and lipoprotein lipids and the CHD incidence in these patients. RESEARCH DESIGN AND METHODS--Of the 4081 men participating in the Helsinki Heart Study, a coronary primary prevention trial with gemfibrozil in middle-aged men with high non-high-density lipoprotein (HDL) cholesterol (greater than 5.2 mM; 200 mg/dL), 135 had NIDDM at entry. The incidence of definite myocardial infarction and cardiac death and changes in serum and lipoprotein lipids were determined during the 5-yr trial in the NIDDM patients and compared with those observed in nondiabetic trial participants. RESULTS--Compared with nondiabetic subjects, NIDDM patients had lower HDL cholesterol (P less than 0.001), higher triglyceride concentration (P less than 0.0001), and greater body mass index (P less than 0.001), there were more hypertensive patients (P less than 0.001) among them. The incidence of myocardial infarction and cardiac death was significantly higher among diabetic than nondiabetic participants (7.4 vs. 3.3%, respectively, P less than 0.02). CHD incidence in the gemfibrozil-treated diabetic men (n = 59) was 3.4% compared with 10.5% in the placebo group (NS). In multivariate analysis, diabetes (P less than 0.05), age (P less than 0.0001), smoking (P less than 0.0001), low HDL cholesterol (P less than 0.05), and high low-density lipoprotein cholesterol (P less than 0.005) were independently related to CHD incidence. Gemfibrozil-induced serum and lipoprotein lipid changes in diabetic patients were similar to those observed in nondiabetic subjects. CONCLUSIONS--Compared with similarly dyslipidemic nondiabetic subjects, patients with NIDDM are at markedly increased risk of CHD. This elevated risk can be somewhat reduced by gemfibrozil.     

Efficacy and tolerability of a "suprabioavailable" formulation of fenofibrate in patients with dyslipidemia: a pooled analysis of two open-label trials

BACKGROUND: Newer fibrates such as micronized fenofibrate lower triglyceride (TG) levels, raise high-density lipoprotein cholesterol (HDL-C) levels, and lower fibrinogen levels, in addition to markedly lowering levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). A new microcoated "suprabioavailable" formulation of fenofibrate has demonstrated a superior pharmacokinetic profile compared with micronized fenofibrate 200 mg/d and may effectively reduce cardiovascular risk factors at the lower dose of 160 mg/d. OBJECTIVE: The goal of this study was to assess the efficacy and tolerability of the suprabioavailable" formulation of fenofibrate in patients with type IIa, type IIb, or type IV dyslipidemia. METHODS: This was a pooled analysis of data from 2 unpublished multicenter, open-label trials with a common protocol. After a 4-week washout period, patients with dyslipidemias not corrected by diet alone were assigned to receive microcoated fenofibrate 160 mg/d for 12 weeks. Changes in lipid profiles and safety variables (vital signs, body weight, and laboratory measures) were monitored throughout the study, and adverse events occurring between visits 1 and 5 were recorded by the study investigators. RESULTS: The 2 trials included 375 men and women (mean age, 55.2 years) with type IIa (n = 158), type IIb (n = 195), type IV (n = 21), or other (n = 1) dyslipidemias. At end point. HDL-C levels in patients with type IIa, IIb, or IV dyslipidemia were increased by a respective 10.9% (P < 0.001), 16.1% (P < 0.001), and 12.1% (P < 0.05), whereas TG levels were decreased by a respective 27.7% (P < 0.001), 46.4% (P < 0.001), and 40.2% (P < 0.05). In patients with type IIa or IIb dyslipidemia, TC decreased (-14.3% in each group), LDL-C decreased (-20.6% and -13.2%, respectively), and the LDL-C/HDL-C ratio decreased (-26.7% and -22.0%) (all, P < 0.001). Overall, 121 of 375 (32.3%) patients experienced > or = adverse event (AE) (202 nonserious, 8 serious). Of these, 10.1% were judged to be possibly drug related. The most common nonserious AEs were those affecting the body as a whole (2.7% of patients) and the digestive system (5.3% of patients). No serious AE was considered drug related. CONCLUSIONS: The new "suprabioavailable" microcoated, micronized formulation of fenofibrate appears to maintain the good efficacy and safety profile of micronized fenofibrate. In the study population with moderate dyslipidemia (types IIa and IIb), it promoted beneficial changes in major lipid risk factors for cardiovascular disease.     

Effects of Fixed-dose Combination of Low-intensity Rosuvastatin and Ezetimibe Versus Moderate-intensity Rosuvastatin Monotherapy on Lipid Profiles in Patients With Hypercholesterolemia: A Randomized,Double-blind,Multicenter, Phase III Study

PurposeWe investigated whether the combination therapy of low-intensity rosuvastatin and ezetimibe is an useful alternative to moderate-intensity rosuvastatin monotherapy in patients requiring cholesterol-lowering therapy.MethodsThis was a multicenter randomized, double‐blind study to investigate the safety and efficacy of a fixed-dose combination of rosuvastatin 2.5 mg and ezetimibe 10 mg (R2.5+E10) compared to those of ezetimibe 10 mg monotherapy (E10), rosuvastatin 2.5 mg (R2.5), and rosuvastatin 5 mg monotherapy (R5) in patients with hypercholesterolemia. A total of 348 patients at 15 centers in Korea were screened, and 279 patients were randomized to different groups in the study. Clinical and laboratory examinations were performed at baseline and 4 and 8 weeks after intervention. The primary endpoint was the percentage change of low-density lipoprotein (LDL) cholesterol levels at the 8-week follow-up.FindingsBaseline characteristics were similar among the four groups. There were significant changes in lipid profiles at the 8-week follow-up. A greater decrease in the LDL cholesterol levels (primary endpoint) were found in the R2.5+E10 group (−45.7±18.6%) than in the E10 group (−16.7±14.7%, p<0.0001), R2.5 group (−32.6±15.1%, p<0.0001), and R5 group (−38.9±13.9%, p=0.0003). Similar outcomes were observed regarding the decrease in total cholesterol, non-high-density lipoprotein (HDL) cholesterol, and apolipoprotein B protein. In addition, changes in the triglyceride and HDL levels in the R2.5+E10 group were significantly different compared with those in the E10 group; however, the changes were similar to those in the other treatment groups. In patients with low and moderate risk, all patients achieved the target LDL cholesterol levels in the R2.5+E10 group (100%) compared to 13.0% in the E10 group, 47.6% in the R2.5 group, and 65.2% in the R5 group. Adverse effects were rare and similar in the four groups.ImplicationsFixed-dose combination of low-intensity rosuvastatin and ezetimibe was more effective in lowering LDL cholesterol and achieving LDL cholesterol goals than moderate-intensity rosuvastatin monotherapy. These findings suggest that the combination therapy of low-intensity rosuvastatin and ezetimibe is an useful alternative to moderate-intensity rosuvastatin monotherapy for cholesterol management, particularly in patients with low and moderate risk. ClinicalTrials.gov identifier: NCT04652349.