老年冠心病患者餐后血脂变化及其对血小板活性的影响

目的　探讨老年冠心病 (CHD)患者餐后血脂代谢特点以及对血小板活性的影响。方法　对 48例老年冠心病 (CHD)患者 (冠心病组 )和 3 0例老年健康自愿者 (对照组 )均禁食 12h后 ,分别接受脂肪餐负荷试验 ,于空腹及餐后 4h测定血清甘油三酯(TG)、总胆固醇 (CH)、高密度脂蛋白 (HDL -C)、低密度脂蛋白 (LDL -C)水平 ,并同时于空腹状态及餐后 4h采用生物活性法测定血小板衍生生长因子 (PDGF)、用酶联免疫标测法 (ELISA)检测血管性假血友病因子 (vWF)浓度。结果　冠心病组餐前及餐后 4hTG(P<0 0 1)、CH(P <0 0 5 )、LDL -C(P <0 0 1)、PDGF(P <0 0 1)、vWF(P <0 0 1)值均显著高于对照组 ,HDL -C(P <0 0 1)显著低于对照组。餐后 4h与餐前比较 ,TG、CH、LDL -C值明显上升 ,而HDL -C下降幅度无明显差异。冠心病组PDGF、vWF值在餐后 4h上升幅度存在显著性差异 (P <0 0 5 )。结论　老年冠心病人存在血脂代谢异常。餐后血脂更能反映老年人的代谢水平。餐后血脂代谢异常对血小板活化起促进作用 ,血小板反复活化可能参与了冠状动脉硬化早期病变

The Changes of Postprandial Plasma Lipoproteins and Platelets Activity in the Elderly Patients with Coronary Heart Disease

Objective To study the parameters of the postprandial plasma lipoproteins metabolism and the platelet activity change in the elderly patients with coronary heart disease(CHD). Methods 48 elderly patients with CHD (CHD group) and 30 healthy elderly subjects (control group) were enrolled in this study. The levels of plasma lipoproteins including TG, CH, LDL-C and HDL-C, plama PDGF bioactivity, and vWF plasma concentration were measured at 12 hours after fasting and 4 hours after a fat-rich meal. Results The plasma levels of pre-prandial and postprandial TG, CH, LDL-C, PDGF and vWF in the CHD group were significantly higher than those in the control group, while plasma HLD-C level in the CHD group was significantly lower than that in the control group. Compared with fasting state, the levels of plasma TG, CH and LDL-C in the postprandial state significantly increased, but plasma HDL-C level did not significantly decreased. The plasm PDGF and vWF values of CHD group in the postprandial state significantly elevated. Conclusion These data suggested that the plasma lipoproteins metabolism of the elderly patients with CHD was abnormal, and the platelets activation in the elderly patients with CDH was correlated with the changes of postprandial plasma lipoproteins metabolism.