女性冠心病患者的危险因素分析及与冠脉病变严重程度的关系

目的:了解女性冠心病患者的危险因素及与冠脉病变严重程度的关系。方法:随机选取本院2012年至2014年心血管科住院治疗的疑似冠心病女性患者150例,经冠脉造影确诊冠心病患者105例,非冠心病患者45例。对患者的临床资料和冠脉病变严重程度进行单因素和多因素分析。结果:冠心病患者高血压与糖尿病百分比、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)及纤维蛋白原水平均高于非冠心病患者,而高密度脂蛋白(HDL-C)和血红蛋白水平均低于非冠心病患者(P0.05);年龄、高血压与糖尿病百分比、血脂上升百分比(高TC、高TG、低HDL-C、高LDL-C)、高尿酸百分比和纤维蛋白原水平均随冠状动脉病变支数及Gensini积分的增加而增加(P0.05);多因素分析发现女性冠心病的影响因素分别为高LDL-C、糖尿病、低HDL-C、TG和高血压,其中高LDL-C的影响最为显著(P0.05)。结论:高血压、糖尿病史、血脂水平为女性冠心病的影响因素,其中高LDL-C的影响最显著,各影响因素均与冠脉病变程度紧密相关。     

蝇蛆壳聚糖对实验性糖尿病大鼠脂代谢的影响

目的测定实验糖尿病大鼠血脂,探讨蝇蛆壳聚糖改善脂代谢以降低血糖的机制。方法用全自动生化分析仪测定各组大鼠血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)的含量。结果经蝇蛆壳聚糖治疗后,高剂量组TC,TG含量明显低于模型对照组(P<0.01),其中TG含量与拜糖平组相比有明显差异(P<0.05)。中剂量组TC含量明显低于模型对照组(P<0.01),TG含量低于模型对照组(P<0.05)。低剂量组HDL含量最高,与模型对照组相比有显著差异(P<0.01)。结论蝇蛆壳聚糖有改善实验糖尿病大鼠血脂的作用。     

瑞舒伐他汀对兔动脉粥样硬化斑块及血清PAPP-A的影响

目的:探讨瑞舒伐他汀对兔动脉粥样硬化斑块及血清妊娠相关血浆蛋白(PAPP-A)的影响.方法:新西兰家兔18只,随机分为正常对照组(Normal组,n=6)、动物粥样梗化模型组(AS组,n=6)和瑞舒伐他汀治疗组(RSV组,n=6).于治疗前、治疗后,检测血清总胆固醇(TC)、三酰甘油(TG)、血清低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)含量,酶联免疲吸附法(ELISA)检测血清PAPP-A水平.同时,用血管内超声检查(IVUS)测定病变部位的血管外弹力膜面积(EEMA)、管腔面积(LA)和斑块面积(PA),计算管腔面积狭窄百分率(LAS%).结果:治疗前,AS组和RSV组兔的血清TC、TG、LDL-C及PAPP-A的水平较Normal组高(P<0.01),HDL-C的水平较Normal组低(P<0.01);治疗后,RSV组兔的血清TC、TG、LDL-C及PAPP-A比AS组低(P<0.01).HDL-C的水平比AS组高(P<0.01),且RSV组兔的血清TC、TG、LDL-C及PAPP-A的水平较治疗前低(P<0.01),HDL-C的水平较治疗前高(P<0.01).血管内超声检查结果显示,治疗后,RSV组兔的LAS%(30.87%±5.27%)比AS组低(37.42%±6.12%)(P<0.01).结论:瑞舒伐他汀能改善对AS兔血脂,减少AS斑块形成及降低血清PAPP-A水平.     

冠心病患者数量皮纹学特征波动性不对称的研究

本文研究了宁夏汉族男性256例(正常: 128例; 冠心病患者: 128例) 双手数量皮纹学特征及其波动性不对称, 比较了其均值的差异性。结果表明: 1)冠心病患者组与正常对照组相比较, 指纹嵴线数、指纹总嵴线数及a-b嵴线数均值均低于正常对照组; 2)冠心病患者组双手atd角及a-b间距均值均高于对照组, 双手atd角表现为显著增高(P<0.05), 右手a-b嵴线数均值表现为患者组低于对照组, 有显著性差异(P<0.01); 3)冠心病患者组数量皮纹性状波动性不对称水平与对照组在FAⅡ(a-b嵴线数, P<0.01)及FAⅤ(atd角, P<0.05)两项上表现出显著增高; 冠心病患者组a-b嵴线数FA分布在|R-L|≥7组显著增高(P<0.05)。     

山楂籽油降血脂作用研究

采用不同剂量山楂籽油对小鼠进行灌胃试验,研究其对血脂水平的影响。结果表明山楂籽油组小鼠的血清甘油三酯(TG),总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C)和动脉硬化指数(AI)均不同程度(P<0.05或P<0.01)低于高脂模型组,而高密度脂蛋白胆固醇(HDL-C)却明显(P<0.01)高于高脂模型组,说明山楂籽油确具显著(P<0.05)降低小鼠血脂作用。     

川芎嗪注射液对冠心病心绞痛患者血脂相关指标的影响及其临床疗效分析

目的:探讨川芎嗪注射液治疗冠心病心绞痛的临床疗效。方法:选择2014年5月-2016年5月在我院接受治疗的冠心病心绞痛患者79例,根据治疗方法不同分为对照组(37例)和研究组(42例)。对照组患者给予常规治疗,研究组患者在对照组基础上给予川芎嗪注射液治疗。观察并比较两组患者的临床疗效。结果:治疗前,两组患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P0.05);治疗后,两组患者总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)水平均显著降低,差异具有统计学意义(P0.05);治疗后,研究组患者总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)水平均低于对照组,差异具有统计学意义(P0.05);治疗后,两组患者高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P0.05)。研究组患者治疗总有效率(92.86%)高于对照组(81.08%),差异具有统计学意义(P0.05)。结论:川芎嗪注射液治疗冠心病心绞痛的临床疗效显著,能够降低血脂相关指标水平,改善临床症状,值得临床推广应用。     

胰岛素对大鼠肝脏和血浆脂质代谢的影响

正常大鼠皮下注射胰岛素后血清总胆固醇(TC)、高密度脂蛋白-胆固醇(HDL-C)和甘油三酯(TG)显著下降(P<0.01、P<0.001和P<0.01),(血清HDL-C)/(血清TC)和(血清HDL-C)/(血清TC-(HDL-C))无变化,离体灌流肝脏分泌TC和TG显著增加(P<0.001,P<0.05)。这些结果提示:(1)胰岛素使血清HDL-C和较低密度脂蛋白[极低密度脂蛋白(VLDL) 低密度脂蛋白(LDL)]-胆固醇同等比例下降。(2)胰岛素促进正常大鼠肝脏合成分泌TG(VLDL-TG)增加和血浆TG(VLDL-TG)清除增加,可能以后一作用为主。(3)胰岛素促进正常大鼠肝脏合成分泌胆固醇增加和血浆胆固醇清除增加,可能以后一作用为主。(4)胰岛素使正常大鼠血清HDL-C下降,可能是由于激活LDL受体促进大鼠HDL通过LDL受体途径的分解代谢和/或激活肝内皮脂酶(HEL)促进HDL分解的结果。     

血脂增高的非药物治疗

高脂血症是各种原因导致的血浆胆固醇和/或甘油三酯水平升高的一种疾病,其诊断标准为:近期2次(相隔2周以上)空腹血清总胆固醇(TC)≥6·45 mmol/L,甘油三酯(TG)≥1·53 mmol/L或高密度脂蛋白-胆固醇(HDL-ch)男≤1·04mmol/L,女≤1·17 mmol/L。高脂血症是人体脂质代谢障碍,是引发和加重动脉粥样硬化的病理基础及导致动脉硬化、心绞痛、心肌梗死、脑梗死、肾损害等动脉栓塞性疾病的独立危害因素。无并发症的高脂血症是治疗的最佳时期,最简单的方法是:饮食疗法及适度活动和配合治疗,如果盲目服药,或不采取有效措施控制,将会引发严重病变。…     

磁处理水对家兔血脂影响的实验研究

目的:探讨饮用磁处理水时间的长短与降低家兔血脂的关系。方法:72只家兔平均分四组A组基础饲料组,饮自来水;B、C、D高脂饲料组,B组对照组饮自来水;C组治疗1组,30天后饮磁处理水,治疗30天后采耳血,分别测血清TC、TG、HDL-c、LDL-c水平。D组治疗2组,30天后饮磁处理水,治疗100天后采耳血,分别测血清TC、TG、HDL-c、LDL-c水平。结果:B组家兔血清TC、TG、HDL-c、LDL-c水平显著高于A组,(P<0.01);C组家兔TC、LDL-c水平显著低与B组(P<0.01);,但也显著高于A组(P<0.01);TG、HDL-c水平与B组相比无显著差异(P>0.05)。D组家兔血清TC、TG、LDL-c水平与B组相比均有明显下降(P<0.01),与A组比较差异无显著性(P>0.05),而HDL-c水平与A组比较明显上升(P<0.01)。结论:长期饮用磁处理水可以显著降低家兔血清高胆固醇含量,并恢复到正常状态。     

双歧杆菌对高胆固醇饮食小鼠血脂影响的研究

目的了解双歧杆菌对高胆固醇饮食水平异常的动物个体血脂及脂蛋白代谢的影响.方法将高胆固醇饮食小鼠分为2组,一组饮用双歧杆菌菌液,另一组常规饮水.经28 d喂养后,将全部动物处死,并立即取血,取上清液测定血脂及脂蛋白各项指标:血清总胆固醇(TC)、甘油三酯(TG)和高密度脂蛋白(HDL-C).结果高脂饮食 双歧杆菌组TG、TC水平显著低于高脂饮食组(P<0.01),HDL-C/TC显著高于高脂膳食组(P<0.01).结果表明灌胃双歧杆菌,小鼠血清中TC、TG浓度较高脂饮食显著降低(P＜0.01),同时HDL-C浓度有所增加.结论饮用双歧杆菌能显著改善高胆固醇饮食小鼠血脂及脂蛋白代谢状况.     

Effects of dietary sea squirt (Halocynthia roretzi) on lipid metabolism in rats

The effect of dietary sea squirt ( Halocynthia roretzi) on lipid metabolism in rats was investigated. Rats were fed sea squirt muscle (Experiment 1); sea squirt muscle, defatted sea squirt muscle and its hexane extract (Experiment 2); and whole body sea squirt and its parts as muscle or viscera (Experiment 3). All of the diets contained the same levels of protein (20%) and lipid (7%). In experiment 1, serum total cholesterol (T-Ch), very-low-density lipoprotein plus low-density lipoprotein (VLDL+LDL)-Ch, triglyceride (TG), phospholipid (PL) and nonesterified fatty acid (NEFA) levels were reduced by 20% dietary sea squirt muscle ingestion; steroid excretions into feces were enhanced by the same diet. In experiment 2, serum T-Ch, (VLDL+LDL)-Ch, TG, PL and NEFA levels were significantly reduced and steroid excretions into feces were significantly enhanced by ingestion of the sea squirt muscle hexane extract. Ingestion of defatted sea squirt muscle also reduced these serum lipid levels, but not as much as did that of whole sea squirt muscle. In experiment 3, serum T-Ch and HDL-Ch levels were significantly elevated by the 10% sea squirt viscera ingestion.     

原发性肾病综合征高脂血症发生机制的研究进展

原发性肾病综合征高脂血症主要表现为血浆总胆固醇（Ch）和低密度脂蛋白胆固醇（LDL—Ch）明显升高,甘油三酯（TG）和极低密度脂蛋白胆固醇（VLDL—Ch）升高。高密度脂蛋白胆固醇（HDL—Ch）浓度可降低或不变,但HDL的亚型分布异常,即HDL3增加而HDL2减少。这提示我们HDL3转变为富含CH的HDL2成熟障碍。不过,关于高脂血症在肾病综合征的发生机制较为复杂,还不十分清楚。但是目前有关该机制的观点主要集中在（1）低白蛋白血症刺激肝脏合成胆固醇、甘油三酯、脂蛋白增加,（2）外周脂蛋白的清除障碍,（3）高密度脂蛋白（HDL）的成熟障碍,本文就此做一综述。     

原发性肾病综合征高脂血症发生机制的研究进展*

摘要：原发性肾病综合征高脂血症主要表现为血浆总胆固醇（Ch）和低密度脂蛋白胆固醇（LDL-Ch）明显升高,甘油三酯（TG）和极 低密度脂蛋白胆固醇（VLDL-Ch）升高。高密度脂蛋白胆固醇（HDL-Ch）浓度可降低或不变,但HDL的亚型分布异常,即HDL3 增 加而HDL2 减少。这提示我们HDL3 转变为富含CH的HDL2 成熟障碍。不过,关于高脂血症在肾病综合征的发生机制较为复杂, 还不十分清楚。但是目前有关该机制的观点主要集中在（1）低白蛋白血症刺激肝脏合成胆固醇、甘油三酯、脂蛋白增加,（2）外周 脂蛋白的清除障碍,（3）高密度脂蛋白（HDL）的成熟障碍,本文就此做一综述。     

2型糖尿病患者血脂水平与心脑血管并发症的相关性分析

目的：探讨2型糖尿病患者血脂水平与其心脑血管并发症的相关性。方法：选择中国医科大学附属盛京医院2011年3月～2012年5月就诊的2型糖尿病患者236例和同期200例健康体检者为研究对象,检测和比较其空腹血糖（FBG）、胆固醇（CH）、甘油三酯（11G）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）水平。结果：2型糖尿病组患者FBG、血清CH、TG、LDL的含量与对照组比较均显著升高（P〈0．01）,而HDL的含量较对照组显著降低（P〈0．01）;在2型糖尿病组中,有心脑血管并发症的患者血清CH、TG、LDL的含量显著高于无并发症者（P〈0．01）;而血清HDL含量显著低于无并发症者（P〈0．01）。相关性分析结果显示,2型糖尿病患者CH、TG和LDL的含量与其合并心脑血管并发症均存在正相关（r=0．337,P〈0．05;r==0．514,P〈0．05;r=0．438,P〈0．05）,而HDL的含量与其合并心脑血管并发症存在显著负相关（r=-0．237,P〈0．05）。结论：2型糖尿病患者存在显著的糖脂代谢紊乱,且血脂水平与心脑血管并发症的发生密切相关,检测并控制2型糖尿病患者的血脂水平有助于预防其心脑血管病变的发生。     

冠心病患者血清HN、CTRP3与血脂及病情严重程度的关系研究

摘要 目的：分析血清抗凋亡多肽（HN）、补体C1q肿瘤坏死因子相关蛋白因子3（CTRP3）与冠心病（CHD）患者血脂及病情严重程度的关系。方法：选取2017年1月至2018年12月期间西安医学院第二附属医院收治的CHD患者360例（CHD组）,另选取同期健康体检者100例作为对照组（NC组）,比较两组血清HN、CTRP3、血脂水平及基线资料;根据CHD患者病变支数分为单支病变组（n=131）、双支病变组（n=119）、多支病变组（n=110）,根据冠状动脉造影结果测定Gensini积分,采用Pearson相关分析HN、CTRP3与血脂及Gensini积分的相关性。结果：CHD组患者吸烟史比例、收缩压、空腹血糖、总胆固醇（TC）、甘油三酯（TG）及低密度脂蛋白（LDL-C）水平均高于NC组（P<0.05）,血清HN、CTRP3和高密度脂蛋白（HDL-C）均低于NC组（P<0.05）;CHD双支病变组和多支病变组患者吸烟史、空腹血糖、TC水平以及Gensini积分均高于单支病变组,CTRP3和HDL-C水平均低于单支病变组,多支病变组收缩压高于单支病变组,多支病变组吸烟史、空腹血糖和Gensini积分均高于双支病变组,且多支病变组CTRP3低于双支病变组（均P<0.05）;Pearson相关分析结果显示：CHD患者血清HN水平与HDL-C水平呈正相关性,CHD患者血清CTRP3水平与Gensini积分呈负相关（P<0.05）。结论：CHD患者血清中HN、CTRP3水平均显著降低,HN与HDL-C水平呈正相关,CTRP3降低程度与CHD患者病情严重程度有关,临床可考虑将其作为评估CHD患者病情严重程度的辅助血清学指标。     

Apolipoprotein E polymorphism in Northern Indian patients with coronary heart disease: Phenotype distribution and relation to serum lipids and lipoproteins

Apolipoprotein E (apo E), a genetic determinant of plasma lipid levels and coronary heart disease (CHD) needs to be investigated in Asian Indians since they have a propensity to develop dyslipidemia and accelerated atherosclerosis. We studied apo E phenotypes and plasma lipid levels in 52 Northern Indian male patients (aged 38–71 years) with angiographically proven CHD, and compared them to 50 healthy blood donors taken as the control group. High levels of Lp(a), (p < 0.05), and a definite trend towards lower levels of HDL-C (p < 0.05), was observed in the CHD patients as compared to the control subjects. The frequency of apo E allele 3 was 0.86 and 0.862, and 4 allele was 0.12 and 0.08 in the patients and controls, respectively. However, a lower frequency of the E2 allele was observed in the patient group (2 = 0.02) as compared to the controls (2 = 0.06) (p = ns). In individuals with apo E3/E3 phenotype, significantly lower HDL-C levels was observed in the CHD patients as compared to the control subjects (p < 0.05). A positive correlation was observed between apo E phenotypes and Lp(a) levels in the CHD subjects as compared to the controls (p < 0.05), the level being significantly high in CHD subjects with at least one E4 allele. To conclude, in this sample of Northern Indian subjects with CHD, there is a significant correlation between apo E3/E3 phenotype and low levels of HDL-C as compared to the control subjects. Further, apo E phenotype is positively correlated with high Lp(a) levels in the CHD subjects having at least one E4 allele. However, these relationships need to be explored in a larger sample of subjects.     

Serum sphingomyelin levels are related to the clearance of postprandial remnant-like particles

It is known that sphingomyelin (SM) content is higher in apolipoprotein B-containing particles (BLps) than in high density lipoproteins and that BLp levels, including chylomicrons and their remnant particles, are positively related to atherosclerosis. To evaluate the relationship between serum SM and postprandial remnant particle levels, we determined SM, triglyceride (TG), and cholesterol levels in serum and in remnant-like particles (RLPs) before and 3, 5, 7, and 10 h after a high-fat meal in 31 healthy subjects. We found that serum SM, like serum TG, was increased to its maximum 3 h after fat loading and then gradually decreased to basal levels after 10 h. More important, we determined that SM and TG levels in RLPs were parallel. Serum SM was positively correlated with serum TG (P <0.001), RLP SM (P <0.001), RLP TG (P <0.001), and RLP cholesterol (P <0.001) levels. It is our conclusion that serum SM is a marker for the clearance of RLPs.     

冠心病患者的血脂、胆红素、UA及Fib水平变化及临床意义

目的:研究冠心病(CHD)患者的血脂、胆红素、血尿酸(UA)及纤维蛋白原(Fib)水平变化及临床意义。方法:选取2014年4月到2015年4月我院收治的CHD患者110例(研究组),另选取同期健康体检者110例(对照组),检测两组受检者血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、直接胆红素(DBIL)、间接胆红素(IBIL)、总胆固醇(TBIL)、UA以及Fib水平。结果:研究组TC、TG、LDL-C、UA以及Fib水平均显著高于对照组,两组比较差异具有统计学意义(P0.05);研究组HDL-C、DBIL、IBIL以及TBIL均显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论:血脂水平异常,胆红素水平降低,UA以及Fib水平增高与CHD的发病有关。     

性腺甾体激素对雌,雄大鼠下丘脑血管升压素mRNA水平的影响

实验用１０－１１周龄经阉割的雌、雄Ｓｐｒａｇｕｅ－Ｄａｗｌｅｙ大鼠进行。以３末端异羟基洋地黄毒甙标记的２６个碱基长的寡核苷酸作为检测探针,用核酸斑点杂交技术检测大鼠下丘脑血管升压素ｍＲＮＡ水平。在假手术对照组,雄性大鼠下丘脑ＡＶＰｍＲＮＡ水平经雌性大鼠高４５％（Ｐ〈０．０５）,血浆渗透压高于雌性大鼠（Ｐ〈０．０５）。摘除卵巢的大鼠下丘脑ＡＶＰｍＲＮＡ深恶痛绝经假手术组雌性大鼠高３０％（Ｐ〈０．０５     

Plasma triglyceride/HDL-cholesterol ratio,insulin resistance,and cardiometabolic risk in young adults

Studies in mature adults suggest that the plasma concentration ratio of triglyceride (TG)/HDL-cholesterol (HDL-C) provides a simple way to identify apparently healthy individuals who are insulin resistant (IR) and at increased cardiometabolic risk. This study extends these observations by examining the clinical utility of the TG/HDL-C ratio and the metabolic syndrome (MetS) in 2,244 healthy college students (17–24 years old) of Mexican Mestizo ancestry. The TG/HDL-C ratio separating the 25% with the highest value was used to identify IR and increased cardiometabolic risk. Cardiometabolic risk factors were more adverse in men and women whose TG/HDL-C ratios exceeded 3.5 and 2.5, respectively, and approximately one third were identified as being IR. The MetS identified fewer individuals as being IR, but their risk profile was accentuated. In conclusion, both a higher TG/HDL-C ratio and a diagnosis of the MetS identify young IR individuals with an increased cardiometabolic risk profile. The TG/HDL-C ratio identified a somewhat greater number of “high risk” subjects, whereas the MetS found a group whose risk profile was somewhat magnified. These findings suggest that the TG/HDL-C ratio may serve as a simple and clinically useful approach to identify apparently healthy, young individuals who are IR and at increased cardiometabolic risk.