血脂、血糖与脑血流联合分析在惊恐障碍中的应用

目的探讨惊恐障碍患者的血脂、空腹及餐后2h血糖水平、脑血流的变化。方法将首诊于综合性医院急诊科惊恐障碍患者60例分成有自杀意念和没有自杀意念两组,并和30名正常对照进行上述四组指标比较。结果单因素方差分析显示惊恐障碍伴自杀意念者血浆总胆固醇（TCh）、低密度脂蛋白胆固醇（LDL）明显低于惊恐障碍不伴自杀意念者及正常对照组（P〈0．05）,前者餐后2h血糖（2hBS）明显高于后者及正常对照组（P〈0．05）。经颅多普勒（TCD）检查发现：惊恐障碍伴自杀意念者左大脑中动脉（LMCA）平均峰、左大脑前动脉（LACA）平均峰、右大脑中动脉（RMCA）平均峰明显低于惊恐障碍不伴自杀意念者和健康对照（P〈0．05）。将上述检查结果中有统计学意义的TCh、LDL、餐后2hBS、LMCA平均峰、LAcA平均峰、RMCA平均峰进行多分类Logistic回归分析,结果显示LDL、LMCA平均峰、RMCA平均峰惊恐障碍伴自杀意念者明显低于惊恐障碍不伴自杀意念者（P〈0．05）,TCh、餐后2hBS、LACA平均峰两组无统计学意义（P〉0．05）。结论低LDL、脑血流量改变可能是惊恐障碍的神经生物学指标之一。     

糖化血红蛋白、血脂及超敏C反应蛋白在冠心病患者检测的临床意义

[目的]检测糖化血红蛋白（HbAlc）、血脂（血清总胆固醇、甘油三脂、高密度脂蛋白及低密度脂蛋白）及超敏c反应蛋白（hs—CRP）在冠心病患者中的表达情况，探讨其临床意义。[方法]选取我院诊治的152例冠心病患者作为观察组，50例正常体检成人作为对照组，检测血清中HbAlC、血脂及hs—CRP的含量。[结果]观察组HbAlc、血清总胆固醇、甘油三脂、低密度脂蛋白及hs—CRP的表达量明显高于对照组，高密度脂蛋白的表达量明显低于对照组。HbAlc、血清总胆固醇、甘油三脂、低密度脂蛋白及hs—CRP的表达量随着冠心病病变分支的增加而表达增加，而高密度脂蛋白表达随着病变分支的增加相应下降。[结论]HbAlc、血清总胆固醇、甘油三脂、低密度脂蛋白及hs—CRP的高表达可能促进冠心病的发生发展，高密度脂蛋白高表达可能延缓冠心病的发展。临床中联合检测其在血清中的表达量可能与冠心病患者的病变程度有关。     

2型糖尿病患者non—HDL—C和hs—CRP联合检测分析

目的探讨2型糖尿病（T2DU）患者血清非高密度脂蛋白胆固醇（non—HDL—C）和高敏C-反应蛋白（hs—CRP）水平的变化。方法分别测定102例2型糖尿病患者和95例正常对照组的血清非高密度脂蛋白胆固醇、高敏C-反应蛋白、总胆固醇（TCHO）、三酰甘油（TG）、空腹血糖（FBG）,高密度脂蛋白胆固醇（HDL—C）的水平。结果2型糖尿病组与正常对照组比较非高密度脂蛋白胆固醇水平有极显著性差异（P〈0．01）,总胆固醇、高密度脂蛋白胆固醇有显著差异（P〈0．05）,三酰甘油无统计学意义;2型糖尿病患者血清高敏C-反应蛋白水平呈极显著高于正常对照者（P〈0．01）,而且2型糖尿病患者血清高敏C-反应蛋白水平与血糖及非高密度脂蛋白胆固醇水平呈正相关趋势。结论2型糖尿病病人血清非高密度脂蛋白胆固醇水平明显高于正常对照组．2型糖尿病患者血清高敏C-反应蛋白水平也明显增高,二者都是评估糖尿病并发症风险的重要指标。     

冠心病与血清胆红素浓度关系的探讨

目的探讨低浓度胆红素（Bil）与冠心病（CHD）的关系。方法检测60例CHD患者和60名正常人血清总胆红素（TBil）、直接胆红素（DBil）、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）水平,并对两组结果进行比较。结果CHD组血清TBil和DBil浓度均降低,与正常对照组比较差异均有统计学意义（P〈0.01）。结论血清Bil降低是CHD的又一危险因素。     

冠心病患者血尿酸水平相关性分析

目的探讨高尿酸水平与冠心病（CHD）的关系。方法检测80例CHD患者和80例正常人血清尿酸（UA）及总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低高密度脂蛋白胆固醇（LDL-C）水平,并对两组结果进行比较。结果CHD组血清尿酸及总胆固醇（TC）、低高密度脂蛋白胆固醇（LDL-C）水平均升高,高密度脂蛋白胆固醇（HDL-C）水平均降低,与正常对照组比较差异均有统计学意义（P〈0.05）。血清UA水平与冠心病（CHD）呈显著正相关。结论血清高尿酸水平与动脉粥样硬化密切相关,可能是导致CHD的重要因素。     

血液透析患者血清脂联素瘦素与脂代谢异常的相关性研究

目的探讨血液透析患者血清脂联素、瘦素与脂代谢异常的相关性。方法2010年1月至2012年1月,分别检测110例血液透析患者和60例健康体检者血清中总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、脂联素和瘦素水平变化。结果血液透析组血清甘油三酯、脂联素和瘦素水平明显高于对照组（P〈0．05）,两组总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平比较,差异无统计学意义（P〉0．05）。血液透析患者血清脂联素与甘油三酯、瘦素呈显著正相关（P〈0．05）,瘦素与甘油三酯、脂联素呈显著正相关（P〈0．05）。结论血液透析患者血清脂联素、瘦素明显升高,与脂代谢紊乱密切相关,对预测和预防心血管并发症的发生具有重要的临床意义。     

男性冠心病患者血清性激素和血脂水平的临床研究

目的探讨男性冠心病（CHD）患者血清性激素与血脂水平的临床意义。方法采用电化学发光免疫分析和生物化学分析测定106例男性CHD患者和41名正常对照组血清雌二醇（E2）、睾酮（T）、总胆固醇（TC）、甘油三脂（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）和载脂蛋白B（apoB）。结果与正常对照组比较,CHD组E2增高、T降低（P〈0．05）,CHD组E2／T比值为42．39±7．33,较正常对照组（21．04±6．73）增高（P〈0．01）。CHD组血清TC和apoB水平增高、HDL-C和LDL-C水平降低（P〈0．05）;TG和apoA1差异无统计学意义（P〉0．05）。结论男性CHD患者E2增高、T降低,TC和apoB增高,HDL—C和LDL—C降低,代谢紊乱是CHD患者的典型特征。     

阿昔莫司对老年代谢综合征患者胰岛素抵抗与游离脂肪酸的影响

目的观察老年代谢综合征（MS）患者胰岛素抵抗（IR）和游离脂肪酸（FFA）的变化及阿昔莫司对其影响。方法选取40例老年代谢综合征患者给予阿昔莫司治疗8周,采用放射免疫法和酶比色法测定治疗前后空腹血清胰岛素和FFA水平,并测定空腹血糖、甘油三酯、胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇,应用稳态模型计算胰岛素抵抗指数（Homa-IR）,选取40例正常老年人作对照组。测量两组的体重、身高、腰围、臀围,计算体重指数（BMI）、腰臀比（WHI。结果老年MS组Homa-IR和FFA水平较对照组明显升高,（P〈0．01,P〈0．05）。经阿昔莫司干预治疗后,高密度脂蛋白胆固醇明显升高（P〈0．01）,甘油三脂、低密度脂蛋白胆固醇、FFA、Homa—IR均明显下降（P〈0．01,〈0．01,0．05,0．01）。结论阿昔莫司能明显降低老年MS患者血清甘油三脂、FFA水平,明显升高高密度脂蛋白胆固醇水平,改善胰岛素抵抗,其机制可能与降低血清FFA水平有关。     

血清C-反应蛋白测定在2型糖尿病中的临床应用

目的探讨血清C-反应蛋白（CRP）测定在2型糖尿病中的临床就用。方法采用奥林巴斯AU2700对健康对照组40例、2型糖尿病患者88例（分为伴大血管并发症组44例和不伴大血管并发症组44例）分别进行血清CRP、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）和低密度脂蛋白胆固醇（LDL—C）水平测定。测定结果用SPSS10．0统计软件进行处理,组间比较采用配对资料￡检验。结果2型糖尿病伴大血管并发症组和不伴大血管并发症组的血清CRP水平较健康对照组明显增高（P〈0．05）,2型糖尿病伴大血管并发症组血清CRP水平较不伴大血管并发症组的血清CRP水平高,但差异无统计学意义（P〉0．05）。结论血清CRP对2型糖尿病及其大血管病变的发生、发展和预后有重要的预测价值。     

血脂特征对冠状动脉病变程度影响的研究

目的:探讨冠心病患者血脂特征对冠脉病变严重程度的影响。方法:住院患者322例行冠脉造影,冠脉造影正常者68例(21%),确诊冠心病患者254例(79%),其中单支病变组75例(30%),2支病变组83例(32%),3支病变组96例(38%);依据造影结果采用Gensini积分系统对冠脉病变程度进行评分。造影前常规测定总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三脂。对所得数据资料用SPSS10.0统计软件进行单因素方差分析和多元线性逐步回归法和logistic回归法分析。结果:冠心病组的高密度脂蛋白胆固醇水平明显低于正常组,低密度脂蛋白胆固醇水平高于正常组,差异有统计学意义。各组的总胆固醇、甘油三酯差异无统计学意义。多元线性回归和Logistic回归分析显示高密度脂蛋白胆固醇和低密度脂蛋白胆固醇进入回归方程,高密度脂蛋白胆固醇的OR值较大。结论:低密度脂蛋白胆固醇增高和高密度脂蛋白胆固醇降低是冠状动脉病变及病变程度加重的主要危险因素,其中高密度脂蛋白胆固醇对冠脉病变的影响程度可能强于低密度脂蛋白胆固醇。     

妊娠期肝内胆汁淤积症患者血脂水平与新生儿血气分析值的相关性分析

目的:探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)患者血脂水平与围生儿预后的关系。方法:选择ICP晚期妊娠60例,正常晚期妊娠25例,测定母体血总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)浓度及围生儿出生即刻脐动脉血气分析值[pH值、血氧分压(PO2)、二氧化碳分压(PCO2)],并进行相关性分析。结果:ICP孕妇血TC、TG、LDL值明显升高,HDL值明显降低,ICP孕妇TC、TG、LDL值与PCO2呈正相关,与pH值及PO2呈负相关,HDL值与pH值及PO2呈正相关,与PCO2呈负相关。结论:ICP孕妇血脂水平与围生儿预后具有相关性,血脂检测应列为ICP的常规。     

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     

Lipoproteins and apolipoproteins in human pleural effusions.

We investigated the lipoproteins and apoproteins in human serum and pleural effusions of different origin: transudates, inflammatory exudates, and malignant exudates. Transudates had a low cholesterol content of 35 +/- 12 mg/dl (mean +/- SD) because of low levels of low-density lipoprotein (LDL) cholesterol--representing 16% of serum levels--whereas inflammatory exudates (cholesterol 92 +/- 26 mg/dl) and malignant exudates (cholesterol 86 +/- 6 mg/dl) exhibited high levels of LDL, with 67% and 69% of serum levels. Apolipoprotein (apo) B level corresponded with LDL and presented with multiple split-products in sodium dodecyl sulfate-polyacrylamide gel electrophoresis in exudative effusions. LDL levels in effusions correlated with serum levels in exudates but did not correlate with those in transudates. In contrast, lipoprotein(a) appeared in all effusions from patients with detectable serum levels. The isoforms were similar as demonstrated by immunoblotting. Differences were found in the composition of the high-density lipoprotein (HDL) fraction: transudates had cholesterol-rich HDL when compared with serum. HDL particles of malignant exudates were poor in cholesterol, and isoelectric focusing demonstrated more sialized apolipoprotein E. A strongly abnormal HDL level with accumulation of cholesterol was found in a long-standing tuberculous effusion. In conclusion, cholesterol in acute effusions is bound to lipoproteins and derived from the blood. The difference in total cholesterol levels between transudates and exudates is based on the lack of LDL in transudates. Transudates show the lipoprotein characteristics of interstitial fluid. Alterations of lipoproteins occur in chronic inflammation and in malignancy with possible de novo synthesis of apolipoprotein E by tumor cells. Lipoprotein(a) accumulates independently from LDL in the pleural space, a finding that supports the view that the physiologic function of lipoprotein(a) is located in the interstitial space.     

Effects of two lipid-lowering,carotenoid-controlled diets on the oxidative modification of low-density lipoproteins in free-living humans

This study compares the effects of two lipid-lowering diets [a diet enriched in MUFAs (monounsaturated fatty acids) and a HCLF (high-carbohydrate/low-fat) diet] with a controlled carotenoid content on risk factors for coronary heart disease, including in vitro copper-induced LDL (low-density lipoprotein) oxidation and serum lipid levels. A randomized crossover dietary intervention study, with two diets each consumed for 14-16 days, was conducted in 18 women and 13 men aged 20-70 years, recruited via personal contacts and advertisements in newspapers. Both diets (MUFA-enriched diet and HCLF diet) contained the same basic foods and had a controlled carotenoid content, high in lycopene. The in vitro copper-induced oxidation of isolated LDL showed a longer lag phase (mean difference 7.4 min in women and 7.34 min in men) after the MUFA-enriched diet compared with the HCLF diet. Serum total cholesterol, LDL cholesterol and carotenoid levels were similar after the two diets. Serum triacylglycerol levels were significantly lower and those of HDL (high-density lipoprotein) cholesterol were significantly higher at the end of the MUFA-enriched diet compared with the HCLF diet. It is concluded that the significantly longer lag phase for oxidation of LDL, the higher HDL cholesterol level and the lower triacylglycerol level in subjects following a carotenoid-controlled, MUFA-enriched diet may decrease the risk of coronary heart disease.     

Effect of ileal exclusion on lipoprotein sitosterol in familial hypercholesterolaemia

A plant sterol, sitosterol, was quantitated in very low density lipoproteins (VLDL), low density lipoproteins (LDL) and high density lipoproteins (HDL) and related to faecal steroids and cholesterol absorption in heterozygous familial hypercholesterolaemia patients with (n = 7) and without ileal bypass (n = 6). The latter had resulted in severe bile acid malabsorption but fractional cholesterol absorption was within low control limits. Serum total and LDL cholesterol and apoprotein B levels were reduced, whereas HDL cholesterol, apoprotein A-I, VLDL and HDL sitosterol concentrations were increased by the ileal exclusion, and the increase in LDL and serum total sitosterol levels was insignificant. In terms of mmol/mol of cholesterol or apoprotein B, however, the LDL and total sitosterol contents were higher in the subjects who had undergone operation. For an unknown reason the sitosterol content increased gradually within the lipoprotein particles from the lighter to the heavier lipoproteins, and the enrichment was similar in the two groups. Dietary sitosterol intake, indicated by faecal sitosterol excretion, was similar in the two groups. The contents of serum total and LDL sitosterol were positively correlated with the dietary sitosterol intake in both groups, and with the fractional cholesterol absorption only in the group not subject to operation. These associations were less consistent for sitosterol contents in other lipoproteins. We conclude that normally the serum sitosterol content reflects cholesterol absorption efficiency even in patients with familial hypercholesterolaemia, provided the dietary sitosterol intake is quite constant. In addition, for unknown reasons ileal exclusion leads to an increased lipoprotein sitosterol content.     

Serum lipids and disease severity in children with severe meningococcal sepsis

OBJECTIVE: To evaluate the role of cholesterol and lipoproteins in children with severe meningococcal sepsis. DESIGN: Retrospective observational study. SETTING: A university-affiliated pediatric intensive care unit. PATIENTS: Fifty-seven patients admitted to the pediatric intensive care unit with meningococcal sepsis or septic shock. INTERVENTIONS: Total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) concentrations were measured in serum samples drawn within 6 hrs after admission to the pediatric intensive care unit and 12, 24, 48, 72 hrs, 7 days, and 1-3 months afterward. Standard deviation scores of these variables (sd scores) were calculated to correct for age-related differences. To assess disease severity, the Pediatric Risk of Mortality (PRISM) score, the Sepsis-related Organ Failure Assessment (SOFA) score, and the Disseminated Intravascular Coagulation (DIC) score were determined as well as selected laboratory variables. MEASUREMENTS AND MAIN RESULTS: Ten patients died. Total serum cholesterol on admission was very low in all patients. This hypocholesterolemia was caused by low HDL concentrations but in particular by low LDL cholesterol levels. Eight patients had undetectable LDL levels on admission. Total cholesterol levels were significantly lower in nonsurvivors than in survivors (0.97 vs. 1.60, p = .013), whereas levels of LDL and HDL did not significantly differ between both groups. Total cholesterol sd scores were similar between survivors and nonsurvivors. Within survivors, cholesterol sd score was significantly lower in patients with shock compared with those with sepsis. The total cholesterol, HDL, and LDL levels correlated with clinical variables of disease severity and with levels of cytokines. Total cholesterol, HDL, and LDL levels normalized rapidly in survivors and were completely normal 1-3 months after admission. CONCLUSIONS: Extremely low levels of total serum cholesterol, HDL, and LDL are found in the initial phase of children with severe meningococcal disease. Total cholesterol levels are significantly lower in nonsurvivors than in survivors, but not the sd score. Total cholesterol, HDL, and LDL levels on admission are inversely associated with disease severity. Hypocholesterolism is associated with hypocortisolism. The concentrations of total cholesterol and lipoproteins steadily increase after 24 hrs in survivors and are normalized 1-3 months after pediatric intensive care unit admission.     

血脂、血糖与脑卒中的病因学关系分析

目的:探讨血脂、血糖与脑卒中的病因学关系。方法:选择100例脑卒中患者(脑梗死59例、脑出血41例)作为观察组,选择100例无影响血脂代谢及神经系统疾病健康体检者作为对照组。分别将脑卒中、脑梗死、脑出血患者的总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)水平与对照组患者进行比较。结果:脑卒中及脑出血患者TC、TG、HDL、LDL、ApoB与对照组比较差异有统计学意义(P<0.01),脑梗死患者TC、TG、HDL、LDL、ApoA、ApoB与对照组比较差异有统计学意义(P<0.01,P<0.05)。结论:血脂与脑血管病有一定关系,TG、HDL、LDL是预测脑卒中发病的重要易患因子;高血糖可能与严重脑卒中患者的预后有关。     

Comparison of cholesterol-lowering regimens

Drug therapy should be reserved for patients with marked total cholesterol elevation not amenable to dietary measures. While current guidelines suggest that bile acid sequestrants, such as cholestyramine and colestipol, are first-line drugs for the treatment of hypercholesterolemia, recent studies suggest that lovastatin is a safe, more potent alternative. Gemfibrozil reduces the serum triglyceride level and raises the high-density lipoprotein (HDL) cholesterol level, but has only a moderate effect on the serum cholesterol level. Nicotinic acid lowers serum low-density lipoprotein (LDL) cholesterol and triglyceride levels and raises serum HDL levels, but its use is limited because of troublesome side effects, notably a flushing reaction. Probucol lowers both serum LDL and HDL levels and is a second-line agent for the treatment of hypercholesterolemia.     

无症状人群高尿酸血症与高甘油三酯血症的相关性研究

目的探讨无症状人群高尿酸血症与高甘油三酯血症的相关性,为临床疾病的预防和治疗提供实验基础研究。方法回顾分析2008年5月-2009年5月门诊体检中200名无临床症状高血尿酸者（A组）的血脂检查情况,并与同期200例血尿酸正常者（B组）的血脂检查情况进行比较分析。A组：男121例,女79例;年龄20～60岁,平均43岁。男性患者血尿酸〉420mmol/L,女性患者〉360mmol/L。B组：男115例,女85例;年龄20～60岁,平均41岁。男性患者血尿酸为99～420mmol/L,女性患者为99～360mmol/L。两组性别和年龄差异无统计学意义（P〉0.05）。结果 A组甘油三酯、总胆固醇、低密度脂蛋白、高密度脂蛋白分别为（3.09±0.98）、（4.05±1.07）、（3.38±0.98）、（1.30±0.51）mmol/L;B组为（1.65±0.86）、（3.99±0.99）、（2.97±0.89）、（1.41±0.66）mmol/L。A组甘油三酯较B组比较,差异有统计学意义（P〈0.01）;总胆固醇、低密度脂蛋白、高密度脂蛋白比较,差异无统计学意义（P〉0.05）。经相关性分析,A组血尿酸与甘油三酯呈正相关（r=0.69,P〈0.01）。结论血尿酸代谢与甘油三酯代谢之间有一定的联系。