国产洛伐他汀对高脂血症患者血脂代谢的影响

目的：研究国产洛伐他汀对高脂血症患者血脂代谢的影响。方法：将１２０例患者随机分为洛伐他汀组（ｎ＝８０）及美降之组（ｎ＝４０），分别口服国产洛伐他汀及进口洛伐他汀（美降之），每次２０ｍｇ，每日２次，服用８周。观察用药４周及８周患者血清总胆固醇（ＴＣ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）、高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）、（ＴＣ－ＨＤＬ－Ｃ）／ＨＤＬ－Ｃ、甘油三酯、载脂蛋白ＡⅠ（ＡｐｏＡⅠ）、载脂蛋白Ｂ１００（ＡｐｏＢ１００）及ＡｐｏＡⅠ／ＡｐｏＢ１００变化。结果：服用国产洛伐他汀４周及８周可分别使患者血清ＴＣ降低２３．０％及２７．３％，ＬＤＬ－Ｃ降低２７．９％及３４．１％，高甘油三酯血症患者甘油三酯水平降低２１．６％及２６．２％；ＨＤＬ－Ｃ升高９．１％及１０．１％，（ＴＣ－ＨＤＬ－Ｃ）／ＨＤＬ－Ｃ降低２９．６％及３７．１％。血清ＡｐｏＢ１００降低９．６％及１５．５％，ＡｐｏＡⅠ升高１８．９％及１４．５％，ＡｐｏＡⅠ／ＡｐｏＢ１００升高３９．９％及４４．９％。服药４周即有明显疗效。结论：国产洛伐他汀调血脂作用疗效肯定，与其相应进口产品美降之比较基本相同     

力平脂治疗高脂血症的临床观察

报告对１５３例高脂血症患者以力平脂治疗１００例，潘特生治疗５３例。于服力平脂４和８周后分别检测有关指标，总胆固醇（ＴＣ）分别下降２０％、２３％；甘油三酯（ＴＧ）下降５５％、５９％；低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）下降２０％、２３％；高密度脂蛋白胆固醇（ＨＤＬＣ）升高２８％、３８％；ＴＣＨＤＬ－Ｃ／ＨＤＬ－Ｃ比值下降３１％。前后对比差异非常显著（Ｐ＜０．０１～０．００１）。其中１５例重度高ＴＧ血症（ＴＧ≥５．５ｍｍｏｌ／Ｌ），服力平脂８周后，ＴＧ值下降７．２±３．３ｍｍｏｌ／Ｌ下降率为７４．０％，显示其降ＴＧ尤为显著。服药前ＴＧ值越高，治疗后下降越显著。力平脂还可使载脂蛋白Ａ（ａｐｏ－Ａ１）升高，为１５％（４周）、１８％（８周）；ａｐｏ－Ａ１／ａｐｏ－Ｂ比值分别上升４６％、４８％；ａｐｏ－８分别下降１５％、１７％。力平脂组部分病例的ＡＬＴ轻度升高，但为可逆性，其余尚未发现明显副作用。     

TSH双位点单抗免疫放射测定法的建立及临床应用

采用本所制备及鉴定的二株不同位点的抗ｈ－ＴＳＨ单抗１３Ｂ４和８Ｅ７，建立了高灵敏度、高特异的ｈ－ＴＳＨ免放测定法。其中经饱和硫酸铵和ＰｒｏｔｅｉｎＡＳｅｐｈａｒｏｓｅ亲和层析柱纯化的１３Ｂ４以Ｉｏｄｏｇｅｎ固相法进行碘标，纯化的８Ｅ７（１∶１００稀释度）作塑料管固相抗体。方法学鉴定表明，本法与生理剂量的其他糖蛋白激素ｈ－ＦＳＨ、ｈ－ＬＨ、ｈＣＧ无明显交叉反应，灵敏度达０．０２６ｍＵ／Ｌ（－ｘ±２ｓ），批内ｃｖ为１．２３～７．３０％，批间ｃｖ为１２．３％。稀释度试验示平行线性关系好，ｒ＝０．９９９。初步临床应用结果表明：甲亢６４例，ＴＳＨ值为未测得（ＮＤ）～０．３１ｍＵ／Ｌ，９５％可信限为ＮＤ～０．２６３ｍＵ／Ｌ；甲减２８例，ＴＳＨ范围为６．６～１８２ｍＵ／Ｌ；甲状腺功能正常者９８例ＴＳＨ为１．４５ｍＵ／Ｌ（Ｐ＿（５０）），９５％可信限为０．３２６～６．０５９ｍＵ／Ｌ。本法与瑞士Ｓｅｒｏｎｏ酶免药盒同时测定１２８例，两种结果的相关系数ｒ＝０．８４４（Ｐ＜０．０１）。经上海华山医院等４家医院初步临床试用，结果表明本法与国内外同类型药盒相比，测定方法简便，相关性高，临床符合率好。     

肾上腺髓质素抑制内皮素的促血管平滑肌细胞增殖作用

目的观察肾上腺髓质素ａｄｒｅｎｏｍｏｄｕｌｉｎ，ＡＭ）对血管平滑肌细胞（ＶＳＭＣ）内丝裂素活化蛋白激酶（ｍｉｔｏｇｅｎ－ａｃｔｉｖａｔｅｄｐｒｏ－ｔｅｉｎｋｉｎａｓｅ，ＭＡＰＫ）活性和ＶＳＭＣ增殖的作用。方法测定培养的ＶＳＭＣ内ＭＡＰＫ活性和３Ｈ－ＴｄＲ参入。结果１０－８ＥＴ－１可明显增加培养的ＶＳＭＣｓ内３Ｈ－ＴｄＲ参入（增加６７％，Ｐ＜０．０１）和ＡＰＫ激活（活性增高１１倍，Ｐ＜０．０１），而１０－１０～１０－７ｍｏｌ／Ｌ肾上腺髓质素（１３－５２）［ＡＭ（１３－５２）］与ＥＴ－１（１０－８ｍｏｌ／Ｌ）同时孵育，则可显著抑制ＥＴ－１的上述作用，与１０－８ｍｏｌ／ＬＥＴ－１单独应用时相比，３Ｈ－ＴｄＲ参入和ＭＡＰＫ活性分别减低２２％～５２％（Ｐ值均＜０．０１）和８．１～２９．４％（Ｐ值分别＜０．０５或０．０１）。而单用ＡＭ（１３－５２）对培养的ＶＳＭＣ３Ｈ－ＴｄＲ参入和ＭＡＰＫ活性无明显影响（Ｐ值＞０．０５）。结论ＡＭ（１３－５２）具有抑制ＥＴ所致的ＭＡＰＫ激活和ＶＳＭＣ增殖的作用。ＡＭ与ＥＴ相互作用，参与内皮源的细胞旁分泌调节体系的构成，共同维持循环系统功能的稳态     

甘油三酯／高密度脂蛋白胆固醇比值对老年冠心病诊断价值的 …

探讨甘油三酯／高密度脂蛋白胆固醇（ＴＧ／ＨＤＬ－Ｃ）比值对老年冠心病（ＣＨＤ）的诊断价值。方法：分极３４２例选择性冠状动脉造影（冠脉造影）确诊的老年ＣＨＤ患者（ＣＨＤ组）及９６例冠脉造影阴性老年人（对照组）的ＴＧ／ＨＤＬ－Ｃ比值水平与ＣＨＤ之间的关系。结果：ＣＨＤ组患者的ＴＧ／ＨＤＬ－Ｃ比值水平及异常率均明显高于对照组（２．５４&;#177;１．２９比１．３２&;#177;１．１６，Ｐ〈０．００１，３５．６％比１３．７％     

脂蛋白脂酶基因多态性与冠心病关系的初探

目的探讨脂蛋白脂酶（ＬＰＬ）基因多态性与冠心病的关系。方法选择１０６例住院存活的心肌梗塞病人按１∶１进行病例对照研究，采用条件Ｌｏｇｉｓｔｉｃ回归分析。结果吸烟、ＬＰＬ基因型ＰＶＵⅡ（－－）和单倍体基因型Ｈ＋Ｐ－是冠心病独立的危险因素；高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）和载脂蛋白（Ａｐｏ）Ａ／Ｂ比值是冠心病的保护因素。去除其它因素的影响后，ＬＰＬＰＶＵⅡ（－－）／非（－－）和Ｈ＋Ｐ－／非Ｈ＋Ｐ－的ＯＲ值为１７．１８和３．６７；ＨＤＬ－Ｃ、ＡｐｏＡ／Ｂ比值的ＯＲ值在模型Ａ和Ｂ中分别为０．１４、０．１５和０．０４、０．０９。结论除传统的危险因素外，ＬＰＬ基因型ＰＶＵⅡ（－－）和单倍体Ｈ＋Ｐ－可能是易患冠心病的遗传标志；ＨＤＬ－Ｃ、ＡｐｏＡ／Ｂ比值可能是较其它血脂指标更好的冠心病独立预测因素     

川芎嗪对冠心病患者脂质过氧化作用及血液流变学的影响

对４２例冠心病患者应用川芎嗪治疗前后的血清脂蛋白代谢、过氧化脂质、抗氧化酶活性及血液流变学进行了对照观察。结果表明：①血清ＴＧ、ＴＣ、（ＬＤＬ＋ＶＬＤＬ）－Ｃ值及ＴＣ／ＨＤＬ－Ｃ比值均明显降低（Ｐ〈０．０１，Ｐ〈０．０５），而ＨＤＬ－Ｃ则显著升高（Ｐ〈０．０５）；②ＭＤＡ水平显著降低（Ｐ〈０．０１），ＳＯＤ及ＧＡＴ活性明显提高（Ｐ〈０．０５，Ｐ〈０．０１）；③血浆粘度、红细胞压积和纤维蛋白原均降低     

冠状动脉造影确诊冠心病与非冠心病患者的血脂比较

目的　通过比较和分析冠状动脉造影（ＣＡＧ）确诊为冠心病（ＣＨＤ） 和冠状动脉基本正常者的血脂代谢改变情况,了解血脂代谢紊乱与ＣＨＤ 之间的关系。方法　对３７１ 名住院病人进行ＣＡＧ 并根据狭窄程度分为三组：Ａ 组（ＣＡＧ 基本正常,冠状动脉狭窄＜ ３０％ ,ｎ ＝ １１１ 例） ,Ｂ 组（ＣＡＧ证实至少有一支冠状动脉内径狭窄≥５０％ ,ｎ ＝ ２０３例） ,Ｃ组（ 急性心肌梗死患者,ｎ＝ ５７ 例）,除外糖尿病、瓣膜病及先天性心脏病患者。结果　血清ＴＣ：Ａ组（５－２２±１．１２）ｍｍｏｌ／Ｌ（２００．８ ±４３．１） ｍｇ／ｄＬ,Ｂ 组（５－５８ ±１－２６） ｍｍｏｌ／Ｌ,（２１４－６ ±４８－５） ｍｇ／ｄＬ,Ｃ 组（５－０９ ±１－１２） ｍｍｏｌ／Ｌ（１９５－８ ±４３－１） ｍｇ／ｄＬ,（ Ｐ＝ ０－０３１ ７） ;ＬＤＬ－ Ｃ：Ａ 组（３－１３±１－１４）ｍｍｏｌ／Ｌ（１２０．４ ±４３．８） ｍｇ／ｄＬ,Ｂ 组（３－６９ ±１－０９） ｍｍｏｌ／Ｌ（１４１－９ ±４１－９） ｍｇ／ｄＬ,Ｃ组（３－２３±１－１５）ｍｍｏｌ／Ｌ（１２４－４ ±４４－２） ｍｇ／ｄＬ,（Ｐ＝ ０－０２７ ４） ;ＨＤＬ－ Ｃ：Ａ 组（１－１８ ±０－４１） ｍｍｏｌ／     

比较不同剂量氟伐代和普伐他汀治疗原发性高胆固醇…

采用随机、双盲、平行对照方式，比较氟伐他汀４０－８０ｍｇ／ｄ，（Ａ组３３例）和普伐他汀２０－４０ｍｇ／ｄ（Ｂ组３５例）治疗原发性高胆固醇血症１２周后的疗效和安全性。结果：Ａ组服药１２周后，血清ＴＣ、ＬＤＬ－Ｃ、ＴＣ／ＨＤＬ－Ｃ水平与Ｏ周时比较分别降低１８．４％，２４．７％和１１．７％；Ｂ组分别降低２１．０％、３１．５％和２７．５％。Ａ组和Ｂ组服药１２周时降低ＴＣ的总有效率分别为７７．４％和８２％。     

老年男性冠心病患者血清硫酸脱氢表雄酮含量变化的临床意义

目的观察老年男性冠心病患者血清硫酸脱氢表雄酮（ＤＨＥＡ－Ｓ）含量变化，探讨其与睾酮（Ｔ）、胰岛素（ＩＮＳ）、血糖（Ｇｌｕ）、甘油三酯（ＴＧ）、总胆固醇（ＴＣ）、载脂蛋白Ｂ（ａｐｏＢ）及年龄的相关性。方法用放免法测定６９例老年男性冠心病患者血清ＤＨＥＡ－Ｓ含量，并与３５例年龄匹配的男性健康人对照。结果冠心病组ＤＨＥＡ－Ｓ含量（２．９６±１．８０μｍｏｌ／Ｌ）显著低于对照组（４．０６±１．７６μｍｏｌ／Ｌ，Ｐ＜０．０１），病情重组（２．４４±１．３６μｍｏｌ／Ｌ）又明显低于病情轻组（３．３２±２．１２μｍｏｌ／Ｌ，Ｐ＜０．０５）；冠心病组ＤＨＥＡ－Ｓ含量与年龄呈负相关（ｒ＝－０．３０５４，Ｐ＜０．０１），对照组两者也呈负相关（ｒ＝－０．３６１５，Ｐ＜０．０５）；冠心病患者ＤＨＥＡ－Ｓ降低与空腹血清ＩＮＳ、ＴＧ及ａｐｏＢ增高均呈负相关（分别为ｒ＝－０．３２９７、－０．２５１９及－０．２４１３，Ｐ＜０．０１或０．０５）。结论老年男性冠心病患者血清ＤＨＥＡ－Ｓ含量降低，并与冠心病某些危险因素如老年、高胰岛素血症、高甘油三酯血症、血清ａｐｏＢ高值相关，但其确切的发病机理有待深入研究。     

同型半胱氨酸与冠心病关系的探讨

目的　探讨同型半胱氨酸 (Hcy)水平与冠心病 (CHD)的关系。方法　 187例住院患者 ,分为CHD组 93例及对照组 94例 ,测定Hcy水平与吸烟史、糖尿病、高血压、年龄、性别、脑梗死史、心肌梗死史、血脂各指标之间的关系。已行冠状动脉造影者按前降支、回旋支、右冠状动脉中任 1支血管狭窄≥ 5 0 %者诊为单支病变组 ,2支以上为多支病变组。任 1支血管狭窄 <5 0 %者诊为冠状动脉造影阴性组。冠心病的多个易患因素进行logistic回归分析。结果　Hcy水平 :(1)CHD组显著高于对照组 ;(2 )有心肌梗死史者高于无心肌梗死史者 ;(3)与吸烟史、高血压、糖尿病、脑梗死史、年龄、性别、血脂各指标之间无明显相关关系 ;(4 )多支病变组显著高于冠状动脉造影阴性组 ,单支病变组略高于冠状动脉造影阴性组 ;(5 )logistic回归分析示Hcy水平、吸烟、高血压是冠心病发病的危险因素。结论　Hcy水平升高与CHD密切相关 ,有心肌梗死史者Hcy水平增高明显 ;冠状动脉病变支数越多 ,血浆Hcy水平越高。     

血清salusin-β和MCP-1表达与高血压患者发生冠心病的相关性分析

目的探讨血清心血管调节肽(salusin-β)和单核趋化蛋白-1(MCP-1)表达与高血压患者发生冠状动脉粥样硬化性心脏病(冠心病)的相关性。方法回顾性选择2016年1月至2018年6月于我院接诊的65例高血压合并冠心病患者(高血压合并冠心病组)和75例单纯高血压患者(单纯高血压组),选择同期体检健康者60例为对照组。比较3组受试者的基线资料、血清salusin-β、MCP-1表达。比较不同冠状动脉病变(SNYTAX)评分及不同病变类型的高血压合并冠心病血清salusin-β、MCP-1表达。结果与对照组比较,高血压合并冠心病组和单纯高血压组患者的体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、吸烟、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、salusin-β、MCP-1均增高,高密度脂蛋白胆固醇(HDL-C)降低(P<0.05),与单纯高血压组比,高血压合并冠心病组的TC、LDL-C、salusin-β、MCP-1均增高,HDL-C降低(P<0.05)。高血压合并冠心病组中,高、中危亚组血清salusin-β、MCP-1高于低危亚组,高危亚组血清salusin-β、MCP-1高于中危亚组(P<0.05);不稳定型心绞痛亚组、心肌梗死亚组血清salusin-β、MCP-1高于稳定型心绞痛亚组(P<0.05),心肌梗死亚组血清salusin-β、MCP-1高于不稳定型心绞痛亚组(P<0.05)。血清salusin-β、MCP-1呈正相关(P<0.05)。TC、LDL-C、HDL-C、salusin-β、MCP-1均是高血压发生冠心病的影响因素(P<0.05)。随访时间20~50个月,单纯高血压组死亡人数低于高血压合并冠心病组[1例(1.33%)vs.8例(10.76%),χ²=6.972,P=0.008)]。8例高血压合并冠心病死亡病例中,高危亚组5例,中危亚组3例,心肌梗死亚组6例,不稳定型心绞痛亚组2例,高危亚组及心肌梗死亚组死亡例数有增高趋势。结论血清salusin-β、MCP-1升高是高血压发生冠心病的危险因素,两者可用于评估冠心病的严重程度及预后。     

Hematocrit and risk of coronary heart disease: the Puerto Rico Heart Health Program

Hematocrit was determined in 2555 rural and 6151 urban men age 45 to 64 years participating in the Puerto Rico Heart Health Program, a prospective epidemiologic study of coronary artery disease (CAD). These participants were reexamined three additional times and mortality by cause and coronary heart disease (CHD) morbidity were carefully documented for 8 years of follow-up. Since hematocrit (Hct) is an indirect measure of blood viscosity, its value as an independent risk factor of CHD was evaluated. Within the Puerto Rican cohort, Hct is slightly lower in older age groups, and appears slightly lower in the rural than in the urban area. In the rural area 4.6% had Hct values below 40%; in the urban area 3.0% were below 40%. A higher Hct level was associated with cigarette smoking, higher relative weight, higher blood pressure, and higher serum cholesterol. An elevated Hct level was also associated with an increased risk of myocardial infarction (MI), coronary insufficiency or CHD death in the urban area. Incidence of MI, coronary insufficiency, or CHD death was more than double in the high hematocrit group (Hct > 49%) compared to the low group (Hct < 42%). Using a multivariate logistic function, the relationship remained statistically significant after adjustment for the above mentioned risk factors. These results provide further insight concerning the issue of the potential impact of elevated Hct as an independent risk factor contributing to the incidence of CHD mortality and morbidity.     

匹伐他汀钙治疗老年冠心病患者42例的疗效

目的：观察匹伐他汀钙治疗老年冠心病患者的疗效及安全性。方法：入选82例口服辛伐他汀10～20mg至少一年的老年冠心病患者,入院后随机分为辛伐他汀组（40例：继续服用辛伐他汀）和匹伐他汀组（42例,改为每晚睡前口服匹伐他汀钙1-2mg）,疗程为8周。分别于用药前、用药后2、4、8周检测两组肝功、血脂、磷酸肌酸激酶变化,并进行比较。结果：匹伐他汀钙组总胆固醇（Tc）和低密度脂蛋白-胆固醇（LDL—c）水平的下降与辛伐他汀片10～20mg／d相当[TC（4．31±0．67）mmol／L比（4．32±0．65）mmol／L,LDL—C（2．15±0．56）mmol／L比（2．05±0．78）mmol／L],P均〉0．05。不良反应较轻微,仅辛伐他汀组出现3例谷丙转氨酶、谷草转氨酶水平升高,在治疗4周时其值均明显高于匹伐他汀组（P〈0．05）。结论：匹伐他汀钙对老年冠心病患者疗效及安全性均较好,对肝功损害较轻。     

Effects of traditional coronary risk factors on rates of incident coronary events in a low-risk population. The Adventist Health Study.

BACKGROUND. California Seventh-Day Adventists have lower mortality rates from coronary heart disease (CHD) than other Californians. Associations between traditional risk factor and CHD events have not been reported previously for Adventists. METHODS AND RESULTS. A cohort study allowed 6 years of follow-up of 27,658 male and female California Seventh-Day Adventists. Data collected included age, sex, physician-diagnosed hypertension and diabetes mellitus, body height, weight, previous and current cigarette smoking habits, and current exercise habits. Incident cases of definite myocardial infarction (MI) and definite fatal CHD were diagnosed according to recognized criteria. Both stratified and proportional hazards analyses demonstrated that in this low-risk population, the above traditional coronary risk factors exhibit their usual associations with risk of CHD events. It was noted that exercise had a strong negative association with fatal CHD events (relative risks [RR], 1.0, 0.66, and 0.50 with increasing exercise) but no association with risk of MI (either nonfatal or all cases). Conversely, obesity was much more clearly associated with MI (RR, 1.0, 1.18, and 1.83 with increasing tertiles of obesity) than with fatal events. The importance of the risk factors was similar in both sexes, except that the effect of cigarette smoking seemed more pronounced in women. CONCLUSIONS. The epidemiology of coronary heart disease in this low-risk California population appears to be at least qualitatively similar to that seen in other groups. There was evidence that the effects of exercise and obesity may differ depending on whether fatal CHD and MI (either all MI or nonfatal alone) is the end point.     

青年男性急性心肌梗死的危险因素及介入治疗后1年随访分析

目的分析青年男性急性心肌梗死患者的临床危险因素,及接受冠状动脉介入治疗患者的1年期预后。方法纳入2008年1月至2012年1月在我院诊断为急性心肌梗死的男性患者727例,其中年龄≤40岁的急性心肌梗死患者322例,年龄≥60岁的急性心肌梗死患者405例,对比两组临床资料;对两组中行冠状动脉介入治疗的537例患者进行1年随访研究。结果青年组患者的吸烟、饮酒、肥胖、早发冠心病家族史比例及血三酰甘油、血浆纤维蛋白原水平高于老年组,apoA1水平低于老年组,差异有统计学意义(均为P<0.05),两组间糖尿病史比例、总胆固醇、HDL-C、LDL-C、apoB及尿酸水平差异无统计学意义(均为P>0.05)。Logistic回归分析显示,吸烟(P=0.008)、肥胖(P=0.013)、早发冠心病家族史(P=0.022)、高三酰甘油(P=0.021)是青年男性患AMI的独立危险因素。青年组PCI术后1年全因死亡率、复合MACE发生率、靶血管重建率、心力衰竭再住院发生率较老年组低(均为P<0.05)。结论 40岁以下青年男性急性心肌梗死的危险因素是吸烟、早发冠心病家族史、肥胖、高三酰甘油;青年男性急性心肌梗死患者行介入治疗1年随访预后良好。     

Prevalence of risk factors and indicators of mortality among males 40-59 years of age with various forms of ischemic heart disease (data of a 5-year prospective study)

A collaborative study was undertaken to assess the efficacy of multifactor prevention of myocardial infarction and cerebral stroke. A representative group of 5951 males aged 40-50 years was examined in Kaunas. Coronary heart disease (CHD) was detected in 11.1%, including 2.7% who had a history of myocardial infarction, 2.5% had exertional angina, its painless type was found in 5.9%. In males with CHD, arterial hypertension, hypercholesterolemia, obesity were more common and smoking was more infrequent than in those without the disease. The results of the 5-year follow-up showed that CHD males had higher total and cardiovascular mortality and myocardial infarction morbidity rates than males without CHD. Males with prior MI and pain-free CHD significantly differed from those from the control group in total and cardiovascular mortality rates. No statistically significant difference was found in MI mortality and morbidity rates between male patients with exertional angina and controls.     

Ethnic immunity to coronary heart disease?

Dietary fat intake is often regarded as a major determinant of coronary heart disease (CHD) rate and it has been deemed unnecessary to invoke racial or other factors to explain the differences in CHD rates among different ethnic groups. Despite a high prevalence of CHD risk factors such as hypertension, obesity, and smoking, CHD remains a rarity in westernized black Africans. Cord blood total cholesterol (TC), low density lipoprotein cholesterol (LDLC) and apolipoprotein B (apo B) levels were measured and found to be respectively 12.1%, 18.3% and 22.4% lower in black neonates when compared to white neonates. These differences were again studied in a group of young black African males and a comparable group of age-matched whites who had been exposed to the same environment and western diet for at least 2 years. Although the body mass indices and serum albumin concentrations in the adult males were not significantly different, serum levels of TC, LDLC and apo B were 10.7%, 18.7% and 39.7% lower in the blacks, respectively. Furthermore, high density lipoprotein cholesterol (HDLC) and Apolipoprotein AI were 20.2% and 9.5% higher, homocysteine 45.6% lower and coagulation factor VII 26.6% lower in the adult black Africans. It is concluded that blacks are biochemically less responsive to an atherogenic diet than whites and these differences are already present at birth.     

体质指数与冠心病血脂关系的对照研究

目的：探讨冠心病患者的体质指数（BMI）与血脂异常的关系。方法：采用病例对照研究方法，以83对（1：1）冠心病患者和健康人为对象，测量身高、体重，并计算BMI；测定血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL—C）含量。结果：冠心病组BMI平均值明显大于对照组（t=2．36，P〈0.05），冠心病组超重和肥胖的检出率明显高于对照组（74.39％：34．94％，x^2=24．85，P〈0．01）；超重和肥胖与冠心病密切相关（OR=2．63）。冠心病组血脂异常的检出率也明显高于对照组（x^2=24．85，P〈0．01）；冠心病与正常对照组合并计算BMI与TC、TG、LDL-C呈正相关（r=0．688、0．406、0．243，P〈0．01、0.01、0．05）。结论：BMI与冠心病高血脂症密切相关。     

年轻人冠心病危险因素分布及聚集状况

目的　观察年轻人中冠心病危险因素的分布及聚集状况 ,为早期年轻人防治冠心病提供依据。方法　选择年轻冠心病患者 (经冠状动脉造影证实 ,年龄≤ 40岁 ) 1 78例作为疾病组 ,并以年龄匹配的冠状动脉造影正常的年轻人 70例作为对照组 ,分析了传统危险因素 (高血压、高血糖、高血脂、肥胖、吸烟史、家族史 )和新危险因素同型半胱氨酸 (HCY)、脂蛋白 (a)、小而密低密度脂蛋白、C反应蛋白 (CRP)在两组间的变化特点及聚集情况。结果　 (1 )在传统的危险因素中 ,疾病组的甘油三酯(TG)和胆固醇 (TC)水平、吸烟和家族史的比率明显高于对照组 (P <0 0 5) ;在新的危险因素中 ,疾病组的血浆HCY(2 1 66± 1 8 2 2 ) μmol L和CRP(5 78± 6 90 )mg L比对照组的血浆HCY(1 4 94± 8 97)μmol L和CRP(2 87± 2 0 0 )mg L明显增高 (P <0 0 1 ) ,其他危险因素在两组间比较差异无显著性。(2 )疾病组与对照组比较 ,有危险因素者明显增多 (P <0 0 5) ,2种以上新危险因素聚集增加 ,3种新危险因素聚集比较差异有显著性 (P <0 0 5) ,传统危险因素聚集性比较差异无显著性。 (3)logistic回归显示吸烟 (OR值为 2 4,95 %CI:1 31 5～ 4 2 75)、TG(OR值为 1 8,95 %CI:1 2 1 5～ 2 541 )、HCY(OR值为 1 9,95 %CI:1 0 60