Serum total cholesterol, HDL-C and LDL-C concentrations significantly correlate with the radiological extent of disease and the degree of smear positivity in patients with pulmonary tuberculosis

BACKGROUND: Low serum total cholesterol (TC) concentrations in patients with pulmonary tuberculosis (PTB) have been demonstrated. It was shown that a cholesterol-rich diet might accelerate the sterilization rate of sputum cultures in PTB patients. It is known that smear positivity might be related to the radiological extent of disease (RED) in PTB patients. OBJECTIVE: We hypothesized that there might be a relationship between initial serum TC concentrations; the degree of RED (DRED) and the degree of smear positivity (DSP) in PTB patients. METHOD: Eighty-three PTB patients and 39 healthy controls were included in the study. Serum TC, TG, HDL-C, VLDL-C and LDL-C concentrations were determined in all subjects. PTB patients were classified for their chest X-ray findings as minimal/mild, moderate and advanced. Correlations between serum lipid concentrations, DRED and DSP (0, 1+, 2+, 3+, 4+) were investigated. PTB patients and controls were also compared for serum lipid concentrations. RESULTS: Significant differences between PTB patients and controls were detected for serum TC, HDL-C and LDL-C concentrations. On stepwise logistic regression analysis, DRED was found as one of the significant independent predictors of serum TC levels. We also found significant correlations between DRED and serum HDL-C concentrations (r=-0.60, p=0.0001) and between DRED and serum LDL-C concentrations (r=-0.28, p=0.011). There were also significant correlations between DSP and serum lipid concentrations. CONCLUSION: Our study suggests that serum TC, HDL-C and LDL-C concentrations are generally lower in patients with PTB than those in healthy controls. In addition, changes in these parameters might be related to DRED and DSP in PTB patients.     

高脂血对不同方法测定血清高密度脂蛋白胆固醇的影响

目的　观察不同浓度血清三酰甘油 (TG)对高密度脂蛋白胆固醇 (HDL C)测定的影响 ,在临床实验室内寻找可靠的HDL -C测定方法以满足临床诊治需求。方法　采用全自动生化分析仪检测血清TG、TC、HDL C以及LDL C并与沉淀法和电泳法测定HDL C进行分组比较。结果　当血清TG <1.6 9mmol/L时 ,3种方法测定值之间无差异 ;当血清TG为 1.6 9～ 4 .0mmol/L范围时 ,各方法测定HDL -C有显著差异 ,但相关性良好。当TG >4 .0mmol/L ,各方法之间的差异程度不一致。结论　对高TG标本HDL C的测定电泳法、沉淀法和直接法之间有显著差异 ,有条件的实验室应尽可能采用电泳法测定高TG标本HDL C。     

冠心病患者血脂与CRP和Hcy水平的临床研究

目的 联合检测总胆固醇(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)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)等对冠心病危险因素的影响.方法 测定166例冠心病造影阴性者作为健康对照组,总结和分析了120例冠心病阳性者(病例组)血清TC、TG、HCL-L、LDL-C、CRP、Hcy的水平与冠心病发生之间的关系.比较TC、TG、LDL-C、HDL-C、CRP和Hcy对不同年龄病例组和对照组之间的关系.结果 病例组TC、TG、LDL-C、CRP和Hcy明显高于对照组;差异均有统计学意义(P<0.01),而HDL-C差异无统计学意义(P>0.05).多元回归分析研究表明:TC、TG,、LCL-L、CRP、Hcy年龄与冠心病发生独立相关.结论 早期干预高TC、TG、LCL-L、CRP和Hcy血症有益于预防冠心病及急性冠脉事件的发生.     

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.     

血清脂蛋白（a）水平及其对低密度脂蛋白测定值的影响

为了解国人血清脂蛋白（ａ）分布情况，调查了１０３２名５０岁以上干部的血清脂蛋白（ａ）［Ｌｐ（ａ）］水平，着重观察Ｌｐ（ａ）对低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）测定值的影响。由于目前所用ＬＤＬ－Ｃ测定法的结果都包含Ｌｐ（ａ）胆固醇［Ｌｐ（ａ）－Ｃ］在内，故以测定值减去０．３Ｌｐ（ａ）作为ＬＤＬ－Ｃ校正值。本组Ｌｐ（ａ）的平均值为１７４ｍｇ／Ｌ，中位数１０５ｍｇ／Ｌ，，实测范围１０～１２００ｍｇ／Ｌ，呈明显正偏态分布。Ｌｐ（ａ）－Ｃ平均占ＬＤＬ－Ｃ实测值的４．３３％，校正后ＬＤＬ－Ｃ平均下降０．１３ｍｍｏｌ／Ｌ，Ｌｐ（ａ）＞３００ｍｇ／Ｌ时半数标本Ｌｐ（ａ）－Ｃ占ＬＤＬ－Ｃ的１０％以上，在ＬＤＬ－Ｃ较低而Ｌｐ（ａ）较高时对ＬＤＬ－Ｃ的影响更大，此时Ｌｐ（ａ）－Ｃ可占ＬＤＬ－Ｃ的２０％～３０％。单因素相关分析示Ｌｐ（ａ）与校正后ＬＤＬ－Ｃ之间无明显相关，因为两者都是冠心病的重要危险因素，比较这两项指标对评价冠心病危险的贡献大小时，最好对ＬＤＬ－Ｃ值进行校正。     

Highly significant negative correlations between erythrocyte aggregation value and serum concentration of high density lipoprotein cholesterol in a sample from a normal population and in patients with coronary heart disease

Abstract. In a previous clinical study it was found that patients with coronary heart disease and diabetics with peripheral artery disease often have an elevated erythrocyte aggregation value (AW) and that there is a positive correlation between AW and the number of risk factors found in a subject. In the present investigation we studied the relationship between AW and the serum concentration of high density lipoprotein cholesterol (HDL-C), which is known to be inversely associated with coronary heart disease (CHD) incidence. We found highly significant negative correlations between AW and HDL-C both in a subsample of the study population of a cross-sectional epidemiologic study on CHD risk factors (First Survey of the MONICA Project Augsburg) and in male patients with angiographically confirmed CHD. Correlation coefficients were –0·233 for normal men ( P < 0·01, n = 136), –0·261 for normal women ( P < 0·01, n = 117), and –0·745 for CHD patients ( P < 0·01, n = 14). The results support the concept that the erythrocyte aggregation value as an indicator of cardiovascular risk is consistent with established risk factor associations.     

精神分裂症患者服用抗精神病药物前后血清LDL-C、TG、TC水平变化及其临床意义

目的分析与探讨精神分裂症患者服药前后血脂水平的变化。方法回顾性分析63例于2014年8月至2016年8月在北京回龙观医院接受药物治疗的精神分裂症患者的临床资料。结果观察组患者服药8周后的低密度脂蛋白胆固醇(LDLC)、三酰甘油(TG)、总胆固醇(TC)水平与服药前相比均明显升高,差异有统计学意义(P0.05);对照组患者服药8周后的各项指标水平与服药前相比,差异无统计学意义(P0.05)。服药后1个月,观察组与对照组服药后进行阳性与阴性症状量表(PANSS)和日常生活活动能力(ADL)评分比较,观察组的不同症状评分以及一般精神病理和总分均显著低于对照组(P0.05),进行生活质量SF-36健康问卷评分和比较,观察组各项得分均显著高于对照组(P0.05)。结论研究表明,对精神分裂症患者实施利培酮口腔崩解片联合奥沙西泮治疗可以获得理想的临床效果,提高患者的日常生活能力和生活质量,有效改善患者LDL-C、TG、TC水平,减少各种不良反应的出现,是一种安全高效的治疗方案,值得推广。     

Serum oxidizability, total antioxidant status and albumin serum levels in patients with aneurysmal or arterial occlusive disease

Objectives:

Oxidative stress is involved in the pathophysiology of atherosclerosis. The aim of the present study was to estimate the extent of oxidative stress in patients with aneurysmal and arterial occlusive disease (AAOD) by analyzing the magnitude of serum oxidizability, total antioxidant status and serum antioxidants and to evaluate their potential clinical significance.

Design and methods:

The study was conducted on 47 patients with AAOD and 49 healthy individuals. Oxidative stress was assessed by: a) copper-induced lipid oxidation described in terms of “lag-time” (t_LAG) and “maximal rate of accumulation of absorbing products” (RA) and b) the measurement of serum total antioxidant status (TAS) and hydrophilic serum antioxidants (albumin, uric acid, transferrin, bilirubin). LDL-cholesterol and HDL-cholesterol were also estimated.

Results:

A decrease of t_LAG and albumin levels in patients as compared to controls was observed. t_LAG was negatively correlated with RA in both patients and controls. RA and LDL-cholesterol did not differ between the two groups. HDL-cholesterol was decreased in patients in comparison to controls. There is statistically significant evidence that low albumin serum levels are associated with increased risk of AAOD.

Conclusions:

The results support the involvement of oxidative stress in AAOD. Significant alterations in serum oxidizability were found in patients with AAOD and low albumin serum levels were correlated with the disease. Clinical evaluation of both findings needs further investigation.     

血清小而密低密度脂蛋白胆固醇水平对冠心病患者心血管不良事件的预测价值

目的分析冠心病(CAD)患者血清小而密低密度脂蛋白胆固醇(sdLDL-C)的水平,并评估sdLDL-C对CAD患者主要心血管不良事件(MACE)发生风险的预测价值。方法检测93例急性冠状动脉综合征(ACS)、48例稳定性CAD(SCAD)患者和123例健康对照者的血清sdLDL-C水平。计算CAD患者的Gensini积分,随访CAD患者1年内MACE的发生情况。采用Spearman相关和多元线性回归分析CAD患者血清sdLDL-C水平与Gensini积分的关系。采用多元Logistic回归分析血清sdLDL-C评估CAD发生风险的预测价值。采用Cox回归分析血清sdLDL-C评估CAD患者MACE发生风险的预测价值。结果ACS组血清sdLDL-C水平高于对照组(P<0.001)和SCAD组(P=0.038)。CAD患者血清sdLDL-C水平与Gensini积分独立相关(β=0.315,P=0.017,校正R^2=0.083)。多因素Logisitic回归分析显示,血清高sdLDL-C水平与ACS发生风险密切相关(OR=7.895,95%CI:2.344~26.589,P=0.001),且对ACS和SCAD的区分具有统计学意义(OR=5.948,95%CI:1.158~30.558,P=0.033)。随访1年内,CAD患者的MACE发生率为22.70%;发生MACE的CAD患者血清sdLDL-C水平高于未发生MACE的CAD患者(P=0.001)。多因素Cox回归分析显示,血清高sdLDL-C水平与CAD患者MACE的发生风险密切相关(HR=5.326,95%CI:1.623~17.483,P=0.006)。结论ACS患者血清sdLDL-C水平升高;血清sdLDL-C可望作为评估CAD患者MACE发生风险的预测指标。     

Influence and interaction of diabetes and lipoprotein (a) serum levels on mortality of patients with peripheral artery disease

BACKGROUND: Diabetes mellitus is a risk factor for early complications and mortality in patients with peripheral artery disease. Lipoprotein (a) [Lp(a)] is also suggested to be a marker of increased cardiovascular risk. We investigated the association and interaction between diabetes mellitus, lipoprotein(a) and mortality in high risk patients with peripheral artery disease (PAD). METHODS: We studied 700 consecutive patients [median age 73 years, interquartile range (IQR) 62-80, 393 male (56%)] with PAD from a registry database. Atherothrombotic risk factors (diabetes, smoking, hyperlipidaemia, arterial hypertension) and Lp(a) serum levels were recorded. We used stratified multivariate Cox proportional hazard analyses to assess the mortality risk at a given patient's age with respect to the presence of diabetes and Lp(a) serum levels (in tertiles). RESULTS: Patients with Lp(a) levels above 36 mg dL(-1) (highest tertile) and insulin-dependent type II diabetes had a 3.01-fold increased adjusted risk for death (95% confidence interval 1.28-6.64, P = 0.011) compared to patients without diabetes or patients with non-insulin-dependent type II diabetes. In patients with Lp(a) serum levels below 36 mg dL(-1) (lower and middle tertile), diabetes mellitus was not associated with an increased risk for death. CONCLUSION: Insulin-dependent type II diabetes mellitus seems to be associated with an increased risk for mortality in PAD patients with Lp(a) serum levels above 36 mg dL(-1). PAD patients with non-insulin-dependent type II diabetes, and patients with diabetes and Lp(a) levels below 36 mg dL(-1) showed survival rates comparable to PAD patients without diabetes.     

缺血性脑卒中患者血清氧化脂蛋白(a)水平升高

摘要：目的：观察血清氧化脂蛋白(a)［ox-Lp(a)］水平及其与缺血性脑卒中（CIS）严重程度间的关系。 方法：分别检测93例CIS患者［按美国国立卫生研究院卒中量表（NIHS）评分分为轻型48例,重型45例］,脑出血患者30例和体检健康者48例血清ox-Lp(a)、Lp(a)水平并进行统计学分析。 结果：CIS轻型、重型患者血清ox-Lp(a)（t分别为-2.147、-5.082,P均＜0.05）、Lp(a)（t分别为-2.347、-4.187,P均＜0.05）水平均高于体检健康者,CIS重型患者血清ox-Lp(a)、Lp(a)水平均高于轻型组（t分别为-2.700、-0.231,P均＜0.05）和脑出血组（t分别为4.205、-2.180,P均＜0.05）。CIS患者血清ox-Lp(a)与Lp(a)水平呈正相关（r=0.429,P＜0.01）,与HDL-C水平呈负相关（r=-0.149,P＜0.01）;NIHSS与血清ox-Lp(a)、Lp(a)水平呈正相关（r分别为0.324、0.299,P均＜0.01）。多元线性回归分析显示血清ox-Lp(a)、Lp(a)共同决定了13.6%的NIHSS变化［β分别为0.246、0.243,P均＜0.05;决定系数（R²）=0.136)］。多元Logistic回归分析显示,校正年龄、性别和血脂水平等因素后,高ox-Lp(a)水平是CIS重型组的危险因素［风险比（OR）=1.209,95%可信区间（CI）=1.033~1.414］。 结论: CIS患者血清ox-Lp(a)水平升高,并与疾病严重程度相关。     

The relationship of serum total sialic acid with serum acute phase proteins and lipoprotein (a) in patients with severe hypertriglyceridaemia

Abstract. Total serum sialic acid (TSA), recently shown to be a cardiovascular risk factor, was measured in 15 patients with severe hypertriglyceridaemia (fasting triglyceride > 2·3 mmol l^-1) and 15 age and sex matched normal control subjects.
To test the hypothesis that serum TSA is related in some way to serum acute phase proteins we also measured five acute phase proteins, namely alpha-1-antichymotrypsin (ACT), alpha-1-acid-glycoprotein (AGP), alpha-2-macroglobulin (AMG), C-reactive protein (CRP) and haptoglobin (HAP) in both groups.
Of note was the significantly elevated serum TSA in the severely hypertriglyceridaemic group as compared to normal subjects. Serum TSA being 71·9 ± 11·7 mg dl^-1 and 59·6 ± 10·2 mg dl^-1 respectively ( P < 0·01 Mann-Whitney test).
Serum CRP was significantly elevated in the type IV patients as compared to controls (6·4 ± 4·5 mg l^-1 vs. 3·3 ± 1·9 mg l^-1 P <0·05 Mann Whitney test) as was serum AMG (2·1 ± 0·89 g l^-1 vs. 1·5 ± 0·53 g l^-1 P < 0·05 Mann Whitney test).
There was no correlation between serum TSA and lipoprotein (a) in either the normal or severely hypertriglyceridaemic subjects. We suggest that serum TSA could in part be related to hypertriglyceridaemia and serum acute phase proteins but that its property as a cardiovascular risk factor is not related to serum lipoprotein (a) concentrations.     

Serum levels of pigment epithelium-derived factor (PEDF) are independently associated with procollagen III N-terminal peptide levels in patients with nonalcoholic fatty liver disease

Objectives

Pigment epithelium-derived factor (PEDF) is a glycoprotein that belongs to the superfamily of serine protease inhibitors with complex anti-oxidative, anti-fibrotic, and anti-inflammatory properties, thus being involved in cardiometabolic disorders. Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of the metabolic syndrome as well. However, the pathophysiological role of PEDF in NAFLD remains largely unknown. We studied here the relationship between serum PEDF levels and various clinical markers of NAFLD in humans.

Design and methods

The study involved 194 biopsy-proven NAFLD patients (102 male and 92 female) with a mean age of 51.3 ± 13.8 years. We examined which anthropometric, metabolic and inflammatory variables, and liver steatosis and fibrosis markers are independently associated with serum levels of PEDF.

Results

Mean serum levels of PEDF were 16.4 ± 5.7 μg/mL. Univariate analysis revealed that age (inversely), male, body mass index, waist circumference, numbers of white blood cells and platelets, aspartate aminotransferase, alanine aminotransferase, fasting plasma glucose, glycated hemoglobin, uric acid, procollagen type III N-terminal peptide (P-III-P), subcutaneous fat areas, visceral fat areas and liver to spleen density ratio in computed tomography, the presence of diabetes and medication for hyperlipidemia were significantly associated with serum levels of PEDF. In multiple stepwise regression analysis, age (p < 0.01, inversely), male (p < 0.05), waist circumference (p < 0.01), white blood cell number (p < 0.05), P-III-P (p < 0.05), and the presence of diabetes (p < 0.05) and medication for hyperlipidemia (p < 0.01), were independently correlated to serum levels of PEDF (R² = 0.285).

Conclusions

The present study reveals that serum levels of PEDF are independently associated with P-III-P levels, suggesting that PEDF level is a novel biomarker of liver fibrosis in patients with NAFLD.     

Serum neopterin, tumor necrosis factor-alpha and soluble tumor necrosis factor receptor II (p75) levels and disease activity in Egyptian female patients with systemic lupus erythematosus

OBJECTIVE: To determine the clinical value of assaying serum levels of neopterin, tumor necrosis factor-alpha (TNF-alpha) and soluble tumor necrosis factor receptor II (p75) (sTNFRII) in patients with systemic lupus erythematosus (SLE), manifested clinically with lupus nephritis (LN), neuropsychiatric lupus erythematosus (NPLE), and/or vasculitis compared with established parameters (complements C3 and C4). PATIENTS AND METHODS: Serum concentrations of neopterin, TNF-alpha and sTNFRII were studied in 40 female patients with SLE at various degrees of disease activity and in 10 healthy controls, matched for age and sex, using an ELISA kit. Disease activity was assessed by the SLE disease activity index (SLEDAI) score. Thirty-five, 30 and 28 of our patients presented with LN, NPLE and/or vasculitis, respectively, as the main clinical manifestation. RESULTS: Serum levels of neopterin, TNF-alpha and sTNFRII were significantly increased, while the TNF-alpha/sTNFRII ratio, C3 and C4 levels of SLE patients were significantly lower than those of healthy controls. Neopterin and sTNFRII were the only parameters that showed significantly higher levels in SLE patients with mild activity compared to normal subjects and were the only parameters that showed a significant elevation in membranous nephritis and in mild NPLE compared to patients without nephritis and NPLE. Patients with vasculitis had significant elevation of serum neopterin, TNF-alpha and sTNFRII levels compared to patients without vasculitis. We found significant correlations between all measured variables and the SLEDAI score. Also, serum neopterin levels showed significant positive correlation with serum TNF-alpha, sTNFRII and TNF-alpha/sTNFRII levels. Serum neopterin and sTNFRII could be used to identify SLE patients from normals with a sensitivity and specificity of 100%. Multivariate linear regression analysis showed that serum sTNFRII was the only significant independent variable among parameters for prediction of SLE disease activity. CONCLUSION: We suggest that serum sTNFRII and neopterin are more sensitive markers of disease activity than TNF-alpha, C3 or C4. However, sTNFRII may be a clinically useful independent marker for prediction of SLE disease activity and to differentiate normal subjects from those having mild SLE.     

N-acetylglucosaminidase,myeloperoxidase and vascular endothelial growth factor serum levels in breast cancer patients

Inflammatory cells surround breast carcinomas and may act promoting tumor development or stimulating anti-tumor immunity. N-acetylglucosaminidase (NAG) has been employed to detect macrophage accumulation/activation. Myeloperoxidase (MPO) is considered a marker for neutrophils activity/accumulation. Vascular Endothelial Growth Factor (VEGF) is as strong pro-angiogenic cytokine. The aim of this study was to measure the systemic inflammatory response by measuring serum levels of NAG, MPO and VEGF in women diagnosed with breast cancer and associate this response to the peritumoral inflammatory infiltrate and to prognostic factors. Serum samples obtained from women with no evidence of disease (n = 31) and with breast cancer (n = 68) were analyzed for the activities of NAG, MPO and VEGF by enzymatic assay. Serum levels of NAG and VEGF were higher in healthy volunteers (P < 0.0001) and serum levels of MPO were higher in patients with breast cancer (P = 0.002). Serum levels of NAG were positively correlated to serum levels of MPO and VEGF (P < 0.0001 and P = 0.0012, respectively) and MPO and VEGF serum levels had also a positive correlation (P = 0.0018). The inflammatory infiltrate was not associated to serum levels of the inflammatory markers, and higher levels of MPO were associated to lymphovascular invasion negativity (P = 0.0175).     

脑血管疾病患者血清胆红素、同型半胱氨酸、超敏C反应蛋白和脂蛋白(a)水平变化分析

目的通过观察脑血管病患者血清超敏C反应蛋白(hs-CRP)水平探讨胆红素对同型半胱氨酸(Hcy)引起脑血管损伤的可能保护作用。方法采用经CT确诊的脑血管病患者共82例,对照组35例。分别取血测定血清总胆红素(TB)、hs-CRP、Hcy、脂蛋白(a)[Lp(a)]水平并比较分析。结果脑血管疾病患者血清Hcy、hs-CRP和Lp(a)水平明显高于对照组(P<0.01),TB水平明显低于对照组;血清TB水平与hs-CRP和Hcy呈负相关,Hcy与hs-CRP呈正相关;血清Lp(a)与TB、Hcy及hs-CRP未见显著相关。结论胆红素对高Hcy引起的脑血管损伤可能具有一定的保护作用。     

冠心病患者血清游离脂肪酸、氧化脂蛋白(a)与冠状动脉病变程度的关系

目的分析冠心病(CAD)患者血清游离脂肪酸(NEFA)和氧化脂蛋白(a)[ox-Lp(a)]水平,探讨CAD患者该两种指标的关系,并评估其与冠状动脉病变狭窄程度的关系。方法选取急性冠状动脉综合征(ACS)患者56例、稳定性冠心病(SCAD)患者62例和健康对照者71例;测定血清NEFA和ox-Lp(a)水平,同时分析血脂水平、冠状动脉病变支数和Gensini积分。结果与健康人对照组相比,血清ox-Lp(a)(t=4.91,P0.01)和NEFA(t=7.77,P0.01)水平在CAD患者中均升高,且ACS患者ox-Lp(a)(t=2.84,P0.01)、NEFA(t=4.22,P0.01)水平高于SCAD患者。CAD患者中,冠状动脉多支病变组血清ox-Lp(a)(t=2.52,P=0.014)、NEFA(t=3.21,P0.01)水平高于单支病变组。CAD患者血清ox-Lp(a)(r=0.193,P0.05)和NEFA(r=0.322,P0.01)水平均与Gensini积分呈正相关。多元线性回归分析显示,冠状动脉病变支数和血清NEFA水平共同决定了Gensini积分34.6%的变化(β分别为0.497和0.225,P均0.01)。多因素Logistic回归分析显示,在校正了年龄、性别和其他血脂水平的影响后,血清高NEFA、ox-Lp(a)水平与ACS[ox-Lp(a),OR=1.159,95%CI=1.075~1.250,P0.01;NEFA,OR=1 118.185,95%CI=78.979~15 831.200,P0.01]、SCAD[ox-Lp(a),OR=1.082,95%CI=1.010~1.158,P0.05;NEFA,OR=65.007,95%CI=5.628~750.837,P0.01]的发生密切相关,且对ACS、SCAD的鉴别具有显著意义[ox-Lp(a),OR=1.072,95%CI=1.013~1.134,P0.05;NEFA,OR=17.201,95%CI=3.741~79.091,P0.01]。结论 CAD患者血清NEFA、ox-Lp(a)水平升高,且ACS患者NEFA、ox-Lp(a)水平高于SCAD患者;血清NEFA、ox-Lp(a)水平与冠状动脉病变狭窄程度密切相关。     

冠心病房颤患者不同伴发病变血清脂蛋白(a)的改变

目的观察冠心病房颤患者不同伴发病变血清脂蛋白 (a) [Lp(a) ]的变化。 方法采用ELISA法检测冠心病患者(44例 ,Ⅰ组 )、冠心病房颤伴发糖尿病 (40例 ,Ⅱ组 )或伴发高血压病 (41例 ,Ⅲ组 )或伴发慢性支气管炎 (慢支 )患者 (37例 ,Ⅳ组 )血清Lp(a)。 结果冠心病房颤伴糖尿病组血清Lp(a)水平显著高于冠心病组、冠心病房颤其他各组及正常对照组 (P <0 .0 1) ;冠心病组、冠心病房颤各组血清Lp(a)水平均显著高于正常对照组 (P <0 .0 1) ,而冠心病组及冠心病房颤伴发高血压病或伴慢支 3组患者血清Lp(a)水平无差异 (P >0 .0 5 )。 结论血清Lp(a)的增高可能是导致冠心病房颤血栓形成及脑梗死等并发症发生的原因之一 ,在冠心病房颤常见伴发病中 ,尤应注意伴发糖尿病时Lp(a)的变化。     

缺氧缺血性脑病患儿血清IL-6、TNF—α和NPY水平检测的临床意义

目的探讨缺氧缺血性脑病患儿血清IL-6、TNF—α和NPY水平检测的临床意义。方法应用放射免疫分析法对32例缺氧缺血性脑病患儿进行了血清IL-6、TNF-α和NPY水平测定,并与35名健康人作比较。结果缺氧缺血性脑病患儿血清IL-6、TNF—α和NPY水平非常显著地高于正常人组（P〈0．01）,且血清IL-6、TNF-α和NPY水平呈正相关（r=0．6045、0．5714．P〈0．01）。结论检测血清IL-6、TNF-α和NPY水平的变化对了解病情、观察预后均具有十分重要的临床价值。