两种清除法测定低密度脂蛋白胆固醇的临床评价

目的对表面活性剂清除法 (SUR法 )和过氧化氢酶清除法 (CAT法 )两种低密度脂蛋白胆固醇 (LDL C)均相测定法进行临床评价。方法将上述两种方法与聚乙烯硫酸沉淀法 (PVS法 )进行比较 ,分析各自方法的精密度、准确性、特异性和干扰因素。结果两种清除法与PVS法 (X)具有良好的相关性 ,SUR法 (Y1) :Y1=0 .9311X +0 .10 2 2 ,r =0 .980 1;CAT法 (Y2 ) :Y2 =0 .94 0 1X +0 .0 991,r=0 .9832。高、中、低三种LDL C浓度混合血清所测定结果表明两种方法均具有良好的精密度 ,总CV值SUR法 3.4 5 - 3.89% ,CAT法 3.5 1- 3.99% ,均达到临床满意的程度。两法线性范围均较宽 (线性均至 8.2 2mmol/L) ,最低检测浓度均为 0 .12mmol/L ,平均回收率SUR法为 98.0 % ,CAT法为 97.6 %。TG <14 .2mmol/L ,Hb <5g/L ,HDL C <3.88mmol/L ,胆红素 <4 5 0 μmol/L对两法基本无影响。 结论两种LDL C清除法测定结果的准确度和精密度均符合临床要求 ,适宜自动分析 ,值得在临床推广应用。     

769例教职工血清脂质含量的分析

目的 :检测不同年龄段教职工血清甘油三酯 (TG)及血清总胆固醇 (TC)含量 ,并对各年龄段血脂含量进行分析比较。方法 :将 769例教职工分为 60岁以上、50～ 59岁、40～ 49岁、30～ 39岁、30岁以下五个年龄段组 ,分别用COP -PAP法和CHOD -PAP法测定其血清TG和TC水平。结果 :60岁以上的教职工TG、TC含量显著高于 60岁以下组 (P <0 .0 5) ;30～ 39岁组男性TG、TC含量分别高于同组女性 (P <0 .0 1 ) ,且此组男性TG、TC含量分别高于(除 60岁以上年龄组外 )其它各男性组 ;总体男性TG、TC含量高于总体女性 ,差异有高度显著性 (P <0 .0 1 )。结论 :60岁以上组教职工高血脂发病率明显高于 60岁以下教职工 ;男性教职工高血脂发病率明显高于女性教职工 ;TG、TC含量及高血脂的发病率随年龄增加呈渐进性增高     

卡维地洛对冠心病患者血浆氧化修饰低密度脂蛋白的影响

目的 :观察临床应用卡维地洛能否降低冠心病患者血浆氧化修饰低密度脂蛋白 (Ox LDL)水平。方法 :选择确诊冠心病患者及年龄、性别相匹配的正常对照组各 30例。冠心病组卡维地洛平均用量为 (10± 2 .5 )mg/d ,共 4个月 ,于服药前、服药后2个月及 4个月 ,分别采集清晨空腹血 ,以检测Ox LDL ,丙二醛 (MDA)。结果 :冠心病组的Ox LDL、MDA水平显著高于对照组 ,在用药后 2及 4个月冠心病组Ox LDL较用药前有显著降低 (P <0 .0 5 ) ,MDA显示出类似的趋势 (P <0 .0 1)。结论 :卡维地洛具有抗氧化作用 ,可以降低冠心病患者血浆Ox LDL水平。     

High-density lipoprotein subfractions,apolipoproteins and antipyrine clearance in normal subjects

Summary Serum high density lipoprotein (HDL) subfractions HDL₂ and HDL₃, apolipoproteins, and plasma antipyrine clearance (AP-CL) rate, an index of liver microsomal enzyme activity, were determined in 21 healthy subjects. High HDL cholesterol and HDL₂ cholesterol concentrations and HDL cholesterol/cholesterol and HDL₂/HDL₃ cholesterol ratios were associated with high AP-CL. Phenobarbital enhanced antipyrine elimination and increased the apolipoprotein A-I/A-II ratio. Subjects who had high AP-CL had a more antiatherogenic HDL subfraction and apolipoprotein profile than those with low AP-CL.     

Cholesterol atheromatous embolism: an increasingly recognized cause of acute renal failure

BACKGROUND.: Cholesterol atheromatous embolism is a systemic disease resultingfrom cholesterol crystal embolization to many organs, includingthe kidney. Vascular surgery, vascular radiology investigationsand anticoagulation have been identified as inciting factors. METHODS.: Fifteen patients with extensive atherosclerosis, presentingwith simultaneous occurrence of acute renal failure and peripheralischaemic changes were diagnosed as having acute renal failuredue to cholesterol atheromatous embolism. RESULTS.: The patients, 12 men and three women, had an average age of65 years. In one patient, spontaneous occurrence of the diseasewas observed. An inciting factor was identified in 14 patients:aortography in 10, aortic surgery in two, and thrombolysis intwo. Clinical course of acute renal failure was quite variable.Four patients required dialysis; 11 were conservatively managed.All patients had concomitant skin lesions, including digitalmottling, cyanosis and gangrene of the toes, and livedo reticularisof the lower limb and abdomen. Eosinophilia was the most commonlaboratory abnormality. The diagnosis of cholesterol atheromatousembolism was confirmed by tissue examination in eight; in threeit was based on the finding of retinal cholesterol emboli; infourpatients it was made on clinical grounds. Seven patientsdied within 36 months. Death was most commonly from cardiaccauses. CONCLUSIONS.: Since the population at risk for cholesterol embolism is growingand the disease is iatrogenic in origin, we should expect todetect cholesterol embolism with greater frequency as causeof acute renal failure in the future.     

Low-density lipoprotein subfraction profiles in dialysis patients

Summary: Uraemic dyslipidaemia is a major risk factor for cardiovascular disease in end-stage renal failure patients. In patients without renal failure, high levels and qualitative abnormalities of low-density lipoprotein (LDL) are known to be atherogenic. Recently, LDL subfraction analysis has associated premature coronary artery disease with a high prevalence of small, dense LDL particles characterizing the LDL subclass phenotype B. We therefore examined the lipid profiles, LDL subfraction distribution and phenotypes in our population of haemodialysis (HD; n = 30) and peritoneal dialysis patients (PD; n = 17), and compared them to 40 asymptomatic, non-uraemic volunteers. Dialysis patients had significantly higher triglyceride and VLDL cholesterol concentrations and lower HDL cholesterol and smaller LDL peak particle diameters. PD patients had significantly higher total cholesterol, glycated haemoglobin and fasting blood glucose levels with smaller LDL peak particle diameters (24.4 [0.1] vs 24.8 [0.1 nm] than HD. Both groups showed significant negative correlations between plasma triglyceride and LDL peak particle diameter, and positive correlations between HDL cholesterol and LDL peak particle diameter. All the PD patients expressed the B phenotype (LDL peak diameter ± 25.5 nm) compared to 73% of HD patients. This study demonstrates that HD and especially PD patients have atherogenic lipid profiles which are associated with a predominance of small dense LDL particles and the highly atherogenic LDL subclass phenotype B.     

Cultured human granulosa cells as a model for corpus luteum function: relative roles of gonadotrophin and low density lipoprotein studied under defined culture conditions.

In primates, corpus luteum development involves both gonadotrophin stimulation and exposure to low density lipoprotein (LDL) delivered through vascularization of the granulosa cell-derived layer. These regulatory influences were modelled in vitro using granulosa cells obtained during in-vitro fertilization (IVF) cycles controlled with gonadotrophin releasing hormone (GnRH) analogue, human menopausal gonadotrophin (HMG) and human chorionic gonadotrophin (HCG). Granulosa cells were cultured in defined medium on extracellular matrix. Without gonadotrophin or LDL in the medium, progesterone production declined progressively. With LDL alone, there was a short-lived elevation of progesterone output which subsequently declined. Culture with HCG alone resulted in a relatively unchanged rate of steroid production over 5 days despite morphological development. This contrasted with a marked and sustained increase in progesterone output over the same time when granulosa cells were cultured with combined HCG/LDL. Cultures were challenged with combined HCG/LDL on day 5. Where initial incubation included HCG, the challenge resulted in a recovery of progesterone output to values comparable to those of granulosa cells exposed to continuous HCG/LDL. Initial incubation without gonadotrophin led to a reduced response. Results suggest that LDL delivery to granulosa cells of the early corpus luteum causes a short-lived period of progesterone production. Sustained luteinization of granulosa cells and maintenance of gonadotrophin responsiveness requires continued exposure to gonadotrophin in the luteal phase.     

接触一氧化碳工人血清LDL—C,HDL—C及脂质过氧化物含量的研究

本文对长期接触一氧化碳(CO)的工人血清高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三脂(TG)及脂质过氧化物(LPO)含量进行了研究。结果表明,长期接触低浓度CO者的血清TG、LPO及HbCO含量与对照组比较,有极显著性差异(P<0.001)。     

Intakes and major dietary sources of cholesterol and phytosterols in the British diet

Cholesterol intakes in Britain have been re-estimated by analysing Total Diet samples taken in 1991 and from 1993 National Food Survey records. The Total Diet samples contained only 284 mg/day compared with 319 mg/day in 1987 and 337 mg/day in 1981, while the National Food Survey showed intakes had fallen to 238 mg/day from 259 mg/day in 1990 and 405 mg/day in 1970-75. More details of the intakes by adults in 1986/87 are given, and compared with the results from the other methods. Daily intakes of eight phytosterols were also estimated, the main ones being β-sitosterol, campesterol, stigmasterol and 57-stigmastenol whose intakes were 104, 49, 10 and 4 mg/day, respectively, in 1991. These intakes had increased since 1981, reflecting the rising consumption of vegetable oils.     

延边地区警察人群血脂水平

目的了解延边地区警察人群的血脂水平。方法将382例（男350例，女32例；朝鲜族165例，汉族217例）延边少数民族自治州公安局职工作为观察组，将100例健康人群作为对照组，应用日立7600生化分析仪分别测定甘油三酯（TG）、总胆固醇（CHO）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C），并进行对比分析。结果观察组检出血脂异常者220例，占58．9％；对照组28例，占28％，两者差异有统计学意义（Х^2=27．78，P〈0．01），观察组明显高于对照组。此外，观察组中朝鲜族与汉族的血脂异常率差异无统计学意义（P〉0．05），但男女差异显著（P〈0．01）。结论延边地区警察人群的血脂代谢异常率明显高于普通人群，无民族差异，提示该人群应及早加强健康教育和其他预防措施。