低密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值与脑梗死的关系研究

目的：探讨低密度脂蛋白胆固醇（LDL-C）与高密度脂蛋白胆固醇（HDL-C）的比值（LDL-C/HDL-C）与脑梗死发生的关系。方法将本院2013年2月～2014年3月接收的136例确诊为脑梗死的患者作为试验组,对照组为110例同期检查的健康体检者,测定并比较两组LDL-C、HDL-C、总胆固醇（TC）、三酰甘油（TG）的含量,计算LDL-C/HDL-C。结果试验组的LDL-C、TC及LDL-C/HDL-C显著高于对照组,HDL-C明显低于对照组,差异有统计学意义（P＜0.05）,而两组间的TG水平差异无统计学意义（P＞0.05）。脑梗死与LDL-C、TC及LDL-C/HDL-C呈正相关（r=0.148、0.106、0.162,P＜0.05）,与HDL-C呈负相关（r=-0.096,P＜0.05）,而与TG水平无显著性关系（P＞0.05）。结论 LDL-C/HDL-C明显增高与脑梗死发生具有重要的相关性,其可以作为一项生化指标对脑梗死的发生进行预测判断,相对于单一的LDL-C或HDL-C指标具有更高的敏感性和独立性,该比值具有较高的临床价值。     

更年期综合征超敏C-反应蛋白与血脂改变及其意义

目的：探讨超敏C-反应蛋白（hs-CRP）、血脂在女性更年期综合征中的临床应用价值。方法测定90例更年期综合征妇女（其中排除合并其他病症者52例为观察组I;合并心脑血管疾病者38例为观察组II）和43例健康妇女（对照组）的hs-CRP及血脂,并做比较分析。结果观察组I与对照组相比,总胆固醇（TC）、甘油三酯（TG）明显升高,差异有统计学意义（P〈0.05）, hs-CRP、低密度脂蛋白胆固醇（LDL-C）升高,高密度脂蛋白胆固醇（HDL-C）降低,但差异无统计学意义（P〉0.05）;观察组II与对照组相比, hs-CRP、TC、TG、LDL-C明显升高, HDL-C明显降低,差异有统计学意义（P〈0.05）;观察组II与观察组I相比, hs-CRP、TC、TG、LDL-C明显升高, HDL-C明显降低,差异有统计学意义（P〈0.05）。hs-CRP与TC、TG、LDL-C呈正相关（P〈0.05）,与HDL-C成负相关（P〈0.05）。结论单纯更年期综合征患者存在血脂异常及hs-CRP开始增高,更年期综合征合并心脑血管疾病者血脂及hs-CRP明显异常,炎症可能参与了更年期综合征的进展, hs-CRP、血脂是预测未来风险的良好指标。     

超敏C反应蛋白和TC/HDL-C联合检测诊断冠心病

目的探讨超敏C反应蛋白(hs-CRP)和胆固醇/高密度脂蛋白胆固醇比值(TC/HDL-C)联合检测对冠状动脉硬化性心脏病(CHD)的诊断价值。方法对189例CHD患者和50例健康对照者进血清hs-CRP,TC,HDL-C测定及分析。结果 CHD患者的hs-CRP,TC含量和TC/HDL-C比值均显著高于对照组,而HDL-C低于对照组,差异均有统计学意义(P<0.01)。UA组的hs-CRP,TC含量和TC/HDL-C比值均显著高于SA组,而HDL-C低于SA组,差异均有统计学意义(P<0.05);hs-CRP诊断阳性率为81.5%;TC/HDL-C为76.2%,二者联合检测阳性率为94.5%,高于前二者,差异有统计学意义(P<0.05)。结论联合应用hs-CRP和TC/HDL-C比值更能预测发生CHD的危险性,也有利于提高临床医生冠心病诊断的准确性。     

瑞舒伐他汀与阿托伐他汀治疗早发冠心病急性心肌梗死的临床疗效对比

目的：比较瑞舒伐他汀与阿托伐他汀治疗早发冠心病急性心肌梗死的临床疗效。方法选取2011年3月—2014年7月朔州市朔城区人民医院收治的早发冠心病急性心肌梗死患者256例,采用随机数字法将其分为观察组与对照组,各128例。两组患者均予以常规药物治疗,观察组患者在常规药物治疗基础上加用瑞舒伐他汀治疗,对照组患者在常规药物治疗基础上加用阿托伐他汀治疗。观察两组患者血脂情况〔血清总胆固醇（ TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）〕、左室射血分数（LVEF）、超敏C反应蛋白（ hs-CRP）及血管内皮舒张功能（ FMD）情况。结果治疗前两组患者TC、TG、LDL-C、HDL-C比较,差异无统计学意义（P﹥0.05）,治疗后观察组患者TC、LDL-C低于对照组,差异有统计学意义（P﹤0.05）;治疗前两组患者LVEF、hs-CRP、FMD比较,差异无统计学意义（ P﹥0.05）,治疗后观察组患者hs-CRP低于对照组,差异有统计学意义（ P﹤0.05）。结论瑞舒伐他汀与阿托伐他汀治疗早发冠心病急性心肌梗死的临床疗效相当,但瑞舒伐他汀改善患者TC、LDL-C、hs-CRP效果更佳。     

超敏C-反应蛋白和胆固醇/高密度脂蛋白胆固醇比值联合测定在心血管疾病中的应用

目的 探讨超敏C-反应蛋白(hs-CRP)和胆固醇(TG/HDL-C)在心血管疾病中的应用.方法 超敏C-反应蛋白的测定采用胶乳比浊法,总胆固醇/高密度脂蛋白胆固醇的测定,分别采用氧化酶法和一步法.结果 hs-CRP、TC/HDL-C在高血压组、冠心病组(CAD)和急性心肌梗死组(AMI)与健康对照组比较,均显著升高(P<0.01).而且急性心肌梗死组显著高于冠心病组(P<0.01),冠心病组又高于高血压组(P<0.05).结论 hs-CRP浓度和心血管疾病及其病变程度明显相关,且联合检测hs-CRP和TC/HDL-C可提高心血管疾病的预测及危险程度的评估.     

总胆固醇与高密度脂蛋白胆固醇比值预测冠心病危险性的临床评价

目的评价总胆固醇与高密度脂蛋白胆固醇比值预测冠心病危险性的价值.方法冠心病患者117例列入冠心病组,健康人100例列入对照组,测定两组的TC/HDL-C、TC、TG、HDL-C和LDL-C并比较其差异性和异常率.结果冠心病组与对照组的单项血脂指标对比有显著性差异,TC/HDL-C有高度显著性差异（P＜0.01）,冠心病组TC/HDL-C异常率明显高于对照组（x^2=18.68,OR值=3.375）,也较其它单项血脂指标高,TC、TG、LDL-C和HDL-C的OR值分别为1.646、1.678、2.441和2.186.结论总胆固醇与高密度脂蛋白胆固醇比值作为冠心病危险因素的预测价值和灵敏度高于单项血脂指标.     

60例老年高尿酸血症与冠心病的相关性分析

目的：观察老年冠心病患者的血清尿酸水平,以探析高尿酸血症与冠心病之间的关系。方法：选取本院收治的60例冠心病患者作为观察组,另选60例非冠心病住院患者作为对照组,进行回顾性分析,比较两组血清尿酸（UA）、总胆固醇（TC）、三酰甘油（TG）和高密度脂蛋白胆固醇（HDL-C）。结果：对比观察组与对照组的血清生化学指标检测结果,两组的血清尿酸水平差异具有统计学意义（P〈0.05）,比较TC、TG、HDL-C差异无统计学意义（P〉0.05）。结论：老年冠心病患者的血清中尿酸水平明显高于非老年冠心病患者,故高尿酸血症与冠心病的发生发展有相关性。     

急性冠状动脉综合征与高敏C反应蛋白相关性研究

目的 观察不同类型急性冠状动脉综合征（ACS）患者血清TG、HDL-C、LDL-C水平变化及其与高敏C反应蛋白（hs-CRP）的关系,探讨临床识别和预测ACS的指标.方法 将132例冠状动脉粥样硬化性心脏病（冠心病）患者分为ACS组和稳定型冠心病组（SCHD组）,同时选择66例健康体检者作对照组,分别测定、比较3组的血清TG、HDL-C、LDL-C、hs-CRP水平.结果 ACS组和SCHD组患者血清hs-CRP水平[分别（9.26±10.98）mmol/L和（4.65±7.56）mmol/L]显著高于对照组[（1.21±1.32）mmol/L],差异有统计学意义（P＜0.05）.ACS组血清hs-CRP水平显著高于和SCHD组,差异有统计学意义（P＜0.01）.血清hs-CRP水平与TG含量呈显著正相关（r=0.62,P＜0.01）,与LDL-C含量亦呈明显正相关（r=0.41,P＜0.01）,与HDL-C含量呈显著负相关（r=-0.54,P＜0.01）.结论 ACS患者血清hs-CRP水平显著增高 hs-CRP水平与ACS的严重程度呈正相关,是动脉粥样硬化斑块不稳定的标志.     

阿托伐他汀治疗冠心病合并高脂血症患者的效果观察

目的：探讨阿托伐他汀治疗冠心病合并高脂血症患者的临床效果。方法选取2009年12月～2013年12月期间的104例冠心病合并高脂血症的患者随机分为试验组52例和对照组52例,对照组患者采用抗凝药、β受体阻滞药等常规治疗药物和血脂康等非他汀降脂药物进行治疗,试验组患者在对照组基础上给予阿托伐他汀治疗,两组患者治疗2个月后观察血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）和C反应蛋白（CRP）的变化情况。结果试验组患者经过治疗后TC、LDL-C、TG、CRP均较治疗前明显下降,差异具有统计学意义（P＜0.05）,且该指标均明显低于对照组患者,差异具有统计学意义（P＜0.05）,而试验组患者的HDL-C有所上升,但是差异无统计学意义（P＞0.05）,并且两组患者的不良反应发生率无明显差异。结论临床上使用阿托伐他汀治疗冠心病合并高脂血症的患者具有良好的的降低血脂的作用,且无明显不良反应,值得临床推广使用。     

冠心病患者血脂及血清CRP水平变化特点

目的：探讨冠心病患者血脂及血清C反应蛋白（ CRP）水平变化特点。方法选取冠心病患者100例分为3组：稳定型心绞痛（ SAP）组46例、不稳定型心绞痛（ UAP）组31例和急性心肌梗死（ AMI）组23例,对患者进行常规内科治疗,并加用阿托伐他汀药物治疗,检测患者治疗前后血脂指标、三酰甘油（ TG）、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）及血清CRP的水平,并选取健康志愿者60例作为对照组,进行比较分析。结果治疗前SAP组、UAP组、AMI组患者血清CRP、TC、TG及LDL－C均高于对照组,而HDL－C均低于对照组,差异均有统计学意义（P＜0．05）;SAP组、UAP组血清CRP、TC、TG及LDL－C均低于AMI组,HDL－C均高于AMI组,差异均有统计学意义（P＜0．05）;SAP组血清CRP低于UAP组,差异有统计学意义（P＜0．05）。治疗后患者血清CRP、TC、TG及LDL－C水平均显著低于治疗前,HDL－C均高于治疗前,差异均有统计学意义（ P＜0．05）。结论血脂及血清CRP能够反映冠心病患者的疾病状况,对患者疾病预测及治疗具有重要的临床意义。     

高血脂的治疗

随着生活水平的不断提高,人们的饮食结构也逐渐改变,高脂血症正威胁着人类的健康。调查显示,我国约有9000万人患有高血脂。高血脂已成为中、老年人的常见病,而由此引发的各种心脑血管病已成为威胁中、老年人生命的主要的祸首。因为胆固醇沉积在动脉壁上,形成动脉粥样硬化斑块(a     

甘草查尔酮B减轻高胆固醇饮食诱导的动脉粥样硬化

目的：探讨甘草查尔酮B是否能改善动脉粥样硬化。方法：采用高胆固醇饲料（HCD）喂食斑马鱼,建立斑马鱼动脉粥样硬化模型,并使用0.1 mg·L^-1和1 mg·L^-1甘草查尔酮B进行治疗。使用Tg （fli1a：EGFP）斑马鱼幼鱼构建模型,并向饲料中添加10 ng·g^-1橙色荧光标记的胆固醇,荧光显微镜检测斑马鱼血管中胆固醇蓄积。试剂盒检测LDL-C含量。分别使用Tg （lyz：DsRED2）和Tg （mpx：EGFP）和斑马鱼幼鱼构建模型,荧光显微镜检测斑马鱼血管中巨噬细胞浸润和中性粒细胞蓄积。HE染色和EVG染色检测斑马鱼血管中斑块形成的情况。结果：甘草查尔酮B显著减轻动脉粥样硬化斑马鱼血管中的胆固醇蓄积、中性粒细胞聚集和巨噬细胞浸润,降低LDL-C的含量,改善脂质代谢紊乱,最终减轻血管中的斑块形成。结论：甘草查尔酮B可有效减轻HCD诱导的动脉粥样硬化。     

The inhibitory effect of black soybean on hepatic cholesterol accumulation in high cholesterol and high fat diet-induced non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is defined as excess of fat in the liver. We investigated the effects of black soybean on the cholesterol metabolism and insulin resistance of mice fed high cholesterol/fat diets. Mice were randomly allocated into four groups that were fed different diets: the normal cholesterol/fat diet; high cholesterol/fat diets (HCD); and HCD with 1%, and 4% black soybean powder (1B-HCD, and 4B-HCD). Liver total cholesterol and triglyceride concentrations were significantly lower in the black soybean-supplemented groups than that in the HCD group. PCR revealed significantly lower hepatic SREBP2 and HMG-CoA reductase mRNA levels of black soybean-supplemented mice. Real-time PCR revealed significantly higher hepatic ABCA1 mRNA level of black soybean-supplemented mice, which may increase cholesterol efflux. Liver bile acids concentration was significantly high in the 4B-HCD group. Black soybean stimulated secretion of adiponectin, activation of pAMPK, and eliminated free fatty acids in the liver. Black soybean supplementation decreased MDA and nitrate level. The activities of SOD, catalase, and GPx were restored by black soybean supplementation. Our data strongly indicate that black soybean influences the balance between oxidative and antioxidative stress. We suggest that black soybean improves cholesterol metabolism, insulin resistance, and alleviates oxidative damage in NAFLD.     

高胆固醇与心血管危险因素相关性研究

目的探讨高胆固醇血症患者与血压、ALT、AST、血糖、血尿酸、尿素氮、肌酐水平,体重及体重指数、脂肪肝发生率的关系。方法收集海南医学院附属医院高胆固醇血症患者430例以及胆固醇正常者100例,抽血检测其血脂代谢水平（TG、TC、LDL、HDL）以及ALT、AST、血糖、血尿酸、尿素氮、肌酐水平和B超检出脂肪肝的水平,同时测量体重及体重指数,并测量血压。结果与胆固醇正常的体检者相比,高胆固醇血症患者的AST、血尿酸、肌酐水平及脂肪肝患病率、体重及体重指数、血压明显高于正常者,在统计学上有显著性差异。结论高胆固醇与体重指数、血压、脂肪肝、ALT、血尿酸、血尿素氮呈正相关。     

Effect of high dietary cholesterol on gentamicin-induced nephrotoxicity in rabbits

Administration of gentamicin to rabbits intramuscularly at a dose of 80 mg/kg per day for 5 days induced nephrotoxicity exhibited by significantly (P < 0.001) elevated serum urea and creatinine levels and a significant (P < 0.001) decrease in renal cortical alkaline phosphatase (ALP) activity, in addition to tubular necrosis revealed by the histopathological examination of the kidney cortices. The deranged parameters returned to normal within 1 week of drug withdrawal, except the cortical ALP activity, which was still significantly lower compared to control. In contrast, feeding of 2% cholesterol-supplemented diet (CSD) to the rabbits for 15 days did not produce any nephrotoxic effects. However, the concurrent feeding of CSD for 15 days and gentamicin treatment at a dose of 80 mg/kg per day for 5 days, starting from day 10 of feeding, resulted in extensive nephrotoxic effects which were more severe than those observed with the gentamicin alone, with delayed recovery of the injured kidney following drug withdrawal. Gentamicin treatment produced significant elevation in serum total cholesterol, which was greater in animals fed with CSD. The serum triglyceride levels in the groups injected with gentamicin were also significantly greater than their respective controls. However, the serum phosphlipids were significantly reduced with gentamicin treatment and this reduction was greater in animals fed with cholesterol and treated with the drug. The liver cholesterol contents in animals fed with the CSD were significantly higher than those fed with the plain diet. However, the kidney cortices of the animals injected with the gentamicin showed significantly increased total phospholipid contents compared to their respective controls. On the other hand, the liver function was not altered in any of the experimental groups. In summary, the present results suggest that cholesterol feeding exacerbated the gentamicin-induced nephrotoxicity. Moreover, it delayed the period required by the injured kidney to recover back to normal. However, neither gentamicin treatment nor cholesterol feeding, or both together, had any injurious effects on the liver.     

Pharmacological management of high triglycerides and low high-density lipoprotein cholesterol.

Elevated serum triglycerides and low high-density lipoprotein (HDL) cholesterol are part of a metabolic syndrome that is increasingly being recognized as an important risk factor for cardiovascular disease. Several classes of pharmacological agents including fibrates, niacin and statins, can modify the triglyceride-HDL axis. Fibrates in particular have recently been shown in clinical trials not only to increase HDL, but also to reduce cardiovascular mortality in secondary prevention. More research is needed to further define the role of fibrates when used alone and in combination with statins in high-risk individuals.     

Novel microminipig model of atherosclerosis by high fat and high cholesterol diet, established in Japan

Novel atherosclerotic lesions were induced in the Microminipig (MMP, registered with the Japanese Ministry of Agriculture, Forestry and Fisheries as a novel variety of swine), the smallest pig available for experimental use, by feeding a high fat (12%) and high cholesterol (5%) diet (HFCD) with sodium cholate (SC, 0.7%) (HFCD/SC) for three months. Three MMPs were used: a male fed with normal diet (M-ND), and a male and an ovariectomized female fed with HFCD/SC (M-HFCD/SC and Fx-HFCD/SC). HFCD/SC induced hypercholesterolemia accompanied by an increase in serum total cholesterol (T-Cho), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and cholesterol ester (CE) from the first week. Serum levels of T-Cho, LDL-C and CE reached a maximum in two to three weeks, and HDL-C gradually increased during the experimental period (duration). Serum lipoprotein analysis showed a dominant LDL-C fraction, as seen in humans, in all three MMPs. Body weight gain in the MMPs fed with HFCD/SC was greater than in the animal fed with M-ND. At the end of the experiment, computed tomography scans of conscious animals showed increases in subcutaneous and abdominal fat in those fed with HFCD/SC, suggesting the induction of obesity. Atherosclerotic lesions in systemic arteries (including external and internal iliac arteries, abdominal aorta, coronary artery, cerebral arterial circle), fatty changes, and foamy cell infiltration in the liver and spleen were histopathologically observed in the MMPs fed with HFCD/SC. Atherosclerosis and the pathological findings induced by HFCD/SC in MMPs were similar to the pathological changes associated with human atherosclerosis, suggesting that the MMP has the potential to be a suitable animal model for human atherosclerosis.