西藏高原地区藏族人群血脂水平分析

目的 比较分析藏族和世居拉萨汉族健康人群血脂水平和血脂异常变化状况.方法 用全自动生化分析仪检测拉萨市13 037名成年健康体检人群(藏族8 163名,汉族4 874名)空腹血脂水平(TC、TG、HDL-C、LDL-C);比较分析藏族与世居拉萨汉族不同年龄组(藏族:＜25岁组298名、25岁～组1 136名、35岁～组2 039名、45岁～组2 119名、55岁～组1 580名、65岁～组905名、≥75岁组86名,汉族:＜25岁组307名、25岁～组1 254名、35岁～组1 874名、45岁～组1 022名、55岁～组272名、65岁～组129名、≥75岁组16名)、不同性别组(藏族:男4 505名、女3 658名,汉族:男2 976名、女1 898名)之间血脂水平差异.结果 藏族TC、HDL-C和LDL-C分别为(5.07±1. 10)、(1.54±0.49)和(3.33±1.31)mmol/L,世居拉萨汉族分别为(4.60±0.98)、(1.45±0.44)和(2.85±1.08)mmol/L,藏族各年龄组均高于世居拉萨汉族(t值分别为24.78、10,53和21.46,P均＜0.05);TG藏族为1.38(0.20～2.99)mmol/L,世居拉萨汉族为1.54(0.20～2.99)mmol/L,世居拉萨汉族各年龄组均高于世居拉萨藏族(F=224.88,P＜0.05).藏族总高血脂率为75.32%,世居拉萨汉族总高血脂率为69.02%;男性为78.56%,女性为65.42%.民族、性别间差异均有统计学意义(x2分别为9.678、44.138,P均＜0.05).结论 藏族人TC、LDL-C水平和高血脂率高于长期生活在拉萨地区的汉族人群.     

两种试剂盒测定三酰甘油的差异及其对低密度脂蛋白胆固醇计算结果的影响

目的探讨去游离甘油法与不去游离甘油法[甘油磷酸氧化酶（GPO）-过氧化物酶（POD）]测定部分脂蛋白代谢可能紊乱的患者血清与生化质控血清中三酰甘油（TG）的差异及由此带来的计算法低密度脂蛋白胆固醇（LDL-C）与直接法测定结果的差异。方法分别采用去游离甘油法与GPO-POD法测定单纯高TG血症、糖尿病、肝胆疾病、肾病综合征、冠状动脉综合征患者及妊娠患者（各30例）的TG，并测定总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C），按Friedwald公式计算LDL-C，将其与直接法的测定结果进行比较。同时，测定卫生部2006年和2007年第1次常规化学室问质评样本中的TG，比较两法测定结果的差异。结果2种方法测定6组患者的TG水平差异均有统计学意义；GPO-POD法测定结果计算出的LDL-C与直接法结果相比，单纯高TG患者显著偏低，而肝胆疾病患者明显偏高；其余4组患者无差异。而去游离甘油法计算出的LDL-C与直接法结果相比，单纯高TG患者显著偏低，而糖尿病、肝胆疾病、肾病综合征患者显著偏高，冠状动脉综合征与妊娠组无差异。两法测定不同品牌、不同批次的卫生部室间质评样本TG结果可相差数倍。结论2种方法测定血清TG可能对TG的水平划分发生误判：若采用计算法由此确定单纯高TG、肝胆疾病等部分患者的LDL-C水平很不可靠。部分品牌的生化质控血清含大量的游离甘油，两法的结果可出现明显差异。     

肥大细胞在动脉粥样硬化斑块形成和破裂中的意义

肥大细胞,作为炎症细胞参与了人类动脉粥样硬化病变的早期和后期机制。体外研究表明,活化的即有免疫学活性的肥大细胞既可以水解低密度脂蛋白3使胆固醇在细胞内积累,又可以水解高密度脂蛋白使细胞内胆固醇流出减少,从而促进巨噬细胞和平滑肌细胞转成泡沫细胞;它能够激活基质金属蛋白酶、降解细胞外基质,还能抑制平滑肌细胞增生、诱导平滑肌细胞凋亡、抑制胶原合成和促进新血管形成而使斑块倾向破裂。以上这些作用使它在斑块形成和斑块破裂中起着重要作用。     

Pitavastatin: efficacy and safety in intensive lipid lowering

Pitavastatin, (+)-monocalcium bis(3R,5S,6E)-7-(2-cyclopropyl-4-[4-fluorophenyl]-3-quinolyl-3,5-dihydroxy-6-heptenoate), is a totally synthetic statin developed in Japan with a molecular weight of 880.98. Pitavastatin achieves its potent pharmacologic action by strongly binding and inhibiting the active site of 3-hydroxy-3-methyl-glutaryl-CoA reductase, and has potent low-density lipoprotein-cholesterol-lowering effects similar to atorvastatin and rosuvastatin. One other characteristic of the agent is that pitavastatin is minimally metabolized by the cytochrome P450 isozymes; it undergoes glucuronidation and is converted to the inactive lactone form, and, therefore, the incidence of any drug interactions is reduced. Due to the promising results observed in clinical trials, it has the potential to be an excellent addition to the worldwide lipid management market.     

Impact of parathyroidectomy on cardiovascular risk in primary hyperparathyroidism: A narrative review

AimsPrimary hyperparathyroidism (PHPT), one of the most frequent endocrine disorders, is not only associated with bone and kidney disorders but also with increased cardiovascular risk. This cardiovascular risk is not part of the indication for surgery owing to discordant evidence of the effects of parathyroidectomy (PTX), especially in mild PHPT which is the most common presentation of PHPT. This literature review focuses on the effects of PTX on the cardiovascular risk in PHPT. The MEDLINE database was searched via the PubMed interface, selecting relevant articles published after 1990 in English.Data synthesisIn the most recent series, PTX appeared to have a positive impact on cardiovascular morbidity and mortality. Surgery improves arterial hypertension, markers of glucose homeostasis, vascular and cardiac remodeling and electrocardiographic impairments due to classical PHPT. However, the results of surgery on mild PHPT are conflicting.ConclusionsPTX seems to improve cardiovascular risk in patients presenting the classical form of PHPT. This improvement is correlated with preoperative serum calcium and/or PTH level, depending on the cardiovascular risk factor. However, many aspects of this improvement are not fully understood. Future studies should assess the effects of PTX on nocturnal hypertension, cardiac morphology and functions. The results for mild PHPT are conflicting owing to the limited size of the cohorts included in studies and the lack of randomized trials. Surgery is not currently recommended for patients presenting mild PHPT based on the cardiovascular risk and more studies are needed to better understand the interest of PTX on cardiovascular outcomes.     

不稳定性心绞痛患者短期应用辛伐他汀治疗对血清C-反应蛋白的影响

目的：观察不稳定性心绞痛患者应用辛伐他汀治疗2周后Ｃ-反应蛋白（CRP）及血脂的变化。方法：将80例临床诊断为不稳定性心绞痛的患者随机分为两组：A组给予辛伐他汀20mg／d，B组给予常规治疗。所有。研究对象均于治疗前及治疗2周后测定CRP及血脂水平。结果：（1）治疗前后两组患者CRP及血脂水平差异无显著性。（2）治疗2周后辛伐他汀组血清CRP均较治疗前明显下降，较常规治疗组下降更为明显。结论：不稳定性心绞痛患者短期应用他汀治疗可明显减轻炎症反应，稳定斑块。     

Comparison of two filter combinations for low-density lipoprotein apheresis by membrane differential filtration: a prospective crossover controlled clinical study

Membrane differential filtration is an accepted procedure for the extracorporeal removal of low-density lipoprotein (LDL). Reduction rates largely depend on the nature of the membranes and are ideally evaluated in a crossover study design. Four patients who had been treated by LDL apheresis for at least 6 months were included. Six consecutive weekly sessions (40 ml plasma/kg body weight) were scheduled per system (Plasmacure PS06/Evaflux Eval 5A [Kuraray] versus Plasmaflo OP05W/Cascadeflo AC1770 [Asahi]). Laboratory measurements indicated reductions of plasma concentrations for fibrinogen (37% [Kuraray] versus 44% [Asahi]), IgG (15% versus 20%), IgA (24% versus 28%), IgM (63% versus 53%), and total protein (11% versus 16%). Total cholesterol was eliminated by 52% versus 49%, LDL by 67% versus 66%, triglycerides by 56% versus 41%, and high-density lipoprotein by 10% versus 20%. Three therapies employing the Asahi filter combination were terminated prematurely due to saturation of the plasma fractionator. In conclusion, despite similar physical properties, the membranes differ significantly concerning selectivity and sensitivity to saturation.     

中国上海人群中胆固醇7α—羟化酶基因多态性与高低密度脂蛋白胆固醇血症的关系研究

目的：探讨上海地区中国人胆固醇7α-羟化酶（CYP7）基因多态性与血低密度脂蛋白胆固醇间的关系。方法：研究包括上海地区中体重指数大于25的肥胖者68例,健康体检的体重正常人92例。以限制性片段长度多态性（RFLP）的方法进行分析CYP7基因翻译起始位点上游278bp处C→A替换多态性,同时检测血清胆固醇,低密度脂蛋白胆固醇和甘油三脂浓度。结果;肥胖和非肥胖者该多态性基因型分布无差异。CC纯合子较AC杂合子有较高的血清LDL-C水平和较高的高LDL-C血症的发生率。结论：CYP7的基因多态性是决定血清LDL-C水平的一个遗传因素。