糖化低密度脂蛋白与颈动脉粥样硬化的关系研究

目的　通过比较颈动脉粥样硬化患者与对照组之间的糖化低密度脂蛋白的血浆含量 ,寻找颈动脉粥样硬化与糖化低密度脂蛋白之间的关系。方法　颈动脉粥样硬化组 1 0 3例 (其中合并糖尿病组 47例 ,不合并糖尿病组 56例 ) ,对照组 43例。应用微柱亲和层析法分别测定两组糖化低密度脂蛋白的含量。结果　颈动脉粥样硬化组 (糖尿病组和非糖尿病组 )糖化低密度脂蛋白含量均较对照组明显增高 (P <0 .0 1 )。颈动脉粥样硬化造成动脉的狭窄程度与糖化低密度脂蛋白呈明显正相关 (r =0 .40 93 ,P <0 .0 1 )。非糖尿病合并颈动脉粥样硬化组的患者午餐后 2h血糖增高 ,同时胰岛素也明显增高 ,差异有显著性意义 (P <0 .0 5)。提示葡萄糖耐量异常和高胰岛素血症的存在。结论　糖化低密度脂蛋白在糖尿病和非糖尿病合并颈动脉粥样硬化发病方面均起重要的作用     

糖化和糖氧化修饰低密度脂蛋白与动脉粥样硬化

糖化糖氧化修饰低密度脂蛋白是低密度脂蛋白的载脂蛋白和脂质被糖化和糖氧化修饰后形成的产物。它们之间以及它们与氧化修饰低密度脂蛋白之间有着密切的联系。它们对动脉继样硬化特别是对糖尿病患者动脉继样硬化的发生和发展起着其重要的促进作用。     

糖化和糖氧化修饰低密度脂蛋白与动脉粥样硬化

糖化和糖氧化修饰低密度脂蛋白是低密度脂蛋白的载脂蛋白和脂质被糖化和糖氧化修饰后形成的产物。它们之间以及它们与氧化修饰低密度脂蛋白之间有着密切的联系。它们对动脉粥样硬化特别是对糖尿病患者动脉粥样硬化的发生和发展起着极其重要的促进作用。     

糖化血红蛋白水平与糖尿病合并颈动脉粥样硬化的关系

目的 探讨糖化血红蛋白(HbA1c)水平对糖尿病合并颈动脉粥样硬化(AS)的影响及其相关性.方法 选取200例糖尿病患者进行颈动脉超声检查,IMT≥0.9 mm或粥样斑块形成者设为IMT阳性组,其余为IMT阴性组,另取80例正常体检者设为正常对照组,测定三组受试者血清HbA1c水平,并分析HbA1c水平与颈动脉AS程度的相关性.结果 与对照组比较,IMT阴性组及IMT阳性组患者血清HbA1c水平明显高于对照组(P＜0.01);与IMT阴性组比较,ITM阳性组患者血清HbA1c水平较高(P＜0.05),且HbA1c水平与颈动脉AS程度呈正相关,相关系数r=0.791,P＜0.01.结论 HbA1c可能促进了AS的发生与发展,降低血液HbA1c水平对防治AS有重要意义.     

糖尿病肾病患者颈动脉粥样硬化的调查

目的调查糖尿病肾病患者颈动脉粥样硬化(AS)发生率.方法颈动脉超声检查观测患者AS情况,同时测定颈动脉壁内膜一中层厚度(IMT).结论糖尿病肾病患者颈动脉硬化发生率较正常人高,颈动脉B超作为一种非创伤性检查手段对糖尿病肾病动脉硬化情况很有帮助.     

老年高血压病和糖尿病患者颈动脉粥样硬化的临床研究

目的　研究老年高血压病、糖尿病患者颈动脉粥样硬化的特征。方法　 82例住院患者分为高血压病组 (EH ,2 2例 )、糖尿病合并高血压病组 (DM EH ,4 6例 )、糖尿病组 (DM ,14例 ) ,比较 3组患者血脂改变及颈动脉超声检测结果。结果　DM组和DM EH组患者血浆TG水平均明显升高。DM组和DM EH组颈动脉阻力指数均显著升高 ,3组颈总动脉内膜 中膜厚度明显增厚。DM EH组患者斑块指数较单纯EH组明显增高。结论　老年高血压合并糖尿病者 ,并发颈动脉粥样硬化的危险性明显增加。     

老年人颈动脉粥样硬化与冠状动脉粥样硬化的关系

为探讨老年人颈动脉粥样硬化与冠状动脉粥样硬化的关系,对94例进行冠状动脉造影的老年患者进行颈动脉超声检查。颈动脉粥样硬化斑块积分采用Sutton法,结果发现,冠状动脉病变单支组和多支组内膜一中膜厚度,斑块积分显著高于正常组,冠状动脉病变多支组显著高于单支组（P均＜0．05）,斑块指数与年龄,吸烟,低密度脂蛋白胆固醇／高密度脂蛋白胆固醇比值,收缩压以及高血压病程及程度密切相关,结果提示,颈动脉粥样硬化与冠状动脉粥样硬化的病变是平行的。     

颈动脉粥样硬化病人血单个核细胞中低密度脂蛋白受体基因表达的研究

研究颈动脉粥样硬化病人外周血单个核细胞低密度脂蛋白受体（ＬＤＬＲ）基因表达与颈动脉粥样硬化程度的相关性。选择颈动脉粥样硬化病人３５例和对照组３１例,采用逆转录ＰＣＲ（ＲＴ－ＰＣＲ）定量测定ＬＤＬＲ的基因表达,以β－ａｃｔｉｎ作为内标物。颈动脉粥样硬化病人外周血单核细胞ＬＤＬＲ基因表达量低于对照组,ＬＤＬＲ基因表达量与血中低密度脂蛋白（ＬＤＬ）水平呈负相关。ＬＤＬＲ表达减少参与了颈动脉粥样硬化的发病过程     

颈动脉粥样硬化与冠状动脉粥样硬化之间的关系

目的 探讨颈动脉粥样硬化与冠状动脉粥样硬化之间的关系及无创性颈动脉超声检查在筛选冠心病高危人群中的价值.方法 将101例接受冠脉造影的患者,同时行颈动脉超声检查和血脂检测.根据冠脉造影结果分为冠心病组和对照组,分别检测双侧颈总动脉内-中膜厚度及斑块的形成情况,并与冠状动脉造影结果进行对比研究.结果 ①冠心病组甘油三酯明显高于对照组[(2.26±1.55)Vs(1.73±0.94) mmol/L,P＜0.05],而高密度脂蛋白明显降低[(1.65±0.54)vs(1.94±0.46) mmoL/L,P ＜0.05].②与对照组比较,冠心病组患者颈动脉内膜增厚率(71.1％)和斑块形成率(43.4％)增高,两组之间比较有统计学差异(P＜0.05).结论 甘油三酯增高及高密度脂蛋白降低为动脉粥样硬化的危险因素.冠状动脉粥样硬化病变程度和颈动脉粥样硬化病变程度密切相关.利用颈动脉超声检查可对冠心病的高危人群进行筛选,并且该无创技术与冠心病的危险因素相结合可提高对冠心病的预诊能力.     

2型糖尿病颈动脉粥样硬化患者血清二肽基肽酶4和氧化低密度脂蛋白水平改变

目的探讨T2DM合并颈动脉粥样硬化(CAS)患者血清二肽基肽酶4(DPP-4)和氧化低密度脂蛋白(ox-LDL)水平改变。方法回顾性分析2020年1~10月于宜昌市第二人民医院内分泌科住院的T2DM患者120例,根据颈动脉彩超检查颈动脉内膜中层厚度及直接观察有无动脉粥样斑块形成,分为单纯T2DM组(T2DM,n=60)及T2DM合并CAS组(CAS,n=60),同期选取性别、年龄匹配的本院体检健康者30名为正常对照(NC)组。分析各组血清DPP-4、ox-LDL指标差异。结果CAS、T2DM组血清DPP4、ox-LDL水平高于NC组(P<0.05或P<0.01)。CAS组血清DPP-4、ox-LDL水平高于T2DM组(P<0.05或P<0.01)。Spearman相关分析显示,T2DM患者血清DPP-4水平与ox-LDL、HbA₁c、HOMA-IR、CIMT呈正相关(P<0.05或P<0.01),与HDL-C呈负相关(P<0.05)。Logistic回归分析结果显示,DPP-4、ox-LDL是T2DM合并CAS的危险因素。结论T2DM合并CAS患者血清DPP-4、ox-LDL水平升高,是T2DM合并CAS的危险因素。     

代谢综合征患者氧化型低密度脂蛋白与颈动脉硬化的相关性

目的探讨血清中氧化型低密度脂蛋白（oxidized low density lipoprotein,ox-LDL）水平与代谢综合征（metabolic syndrome,MS）患者危险因素和颈动脉内膜中层厚度（intima-media thickness,IMT）的关系及临床意义。方法入选86例MS患者和39例正常体检者,根据危险因素的数目分为低危MS组（n=42）和高危MS组（n=44）,用彩色超声多普勒测定IMT,ELISA方法检测受试者血清中ox-LDL,进行单因素方差分析和Logistic回归分析。结果血清ox-LDL水平、IMT在正常对照组、低危MS组和高危MS组中依次增高,各组间差异有显著性（P〈0.01）。以IMT〉0.9mm为颈动脉硬化（carotid atherosclerosis,CA）,Logistic回归分析结果示ox-LDL与CA独立相关,优势比为1.189（95%CI：1.078～1.312）。结论 ox-LDL是MS患者的CA的独立危险因素之一,血清ox-LDL可作为临床评价MS病情发展和CA的危险因子。     

Association between depression and subclinical carotid atherosclerosis in patients with Type 1 diabetes

Aims Recent studies have suggested an association between depression and subclinical atherosclerosis as measured by presence of carotid atherosclerotic plaque and increased intima‐media thickening in non‐clinical populations. Given the high prevalence of depression in patients with Type 1 diabetes and the diabetes‐related risk factors for atherosclerosis, we hypothesized that this relation might also be of special relevance in Type 1 diabetic patients. Methods Intima‐media thickness (IMT) and the presence of plaques in the carotid arteries were quantitatively assessed by high‐resolution ultrasound in 175 adults (89 men, 86 women) with an established diagnosis of Type 1 diabetes. Having been treated for depression or current Beck Depression Inventory scores > 10 were considered to indicate depression. Results In men, the risk of plaque was higher in depressed subjects relative to non‐depressed participants after adjustment for age, smoking status, systolic blood pressure, dyslipidaemia and body mass index [odds ratio (OR) 5.19; 95% confidence interval (CI) 1.29, 20.81]. Depressed women did not have an increased risk of plaque compared with non‐depressed women (OR 0.97; 95% 95% CI 0.22, 4.34). We did not observe an association between depression and IMT, in men or in women. Conclusions In line with previous research, our findings suggest a link between depression and subclinical atherosclerosis in Type 1 diabetic men, but not in women.     

Autoantibodies to oxidized low density lipoprotein: the relationship to low density lipoprotein fatty acid composition in diabetes

Autoantibodies to oxidized low density lipoprotein have been shown to be an independent predictor of the progression of carotid atherosclerosis. This study examines the relationship between low density lipoprotein fatty acid composition and autoantibodies to both malondialdehyde-modified and copper-oxidized low density lipoprotein in non-diabetic patients with (n = 17), and without (n = 18), definite evidence of previous myocardial infarction. The third group were non-insulin-dependent diabetic patients with no evidence of atherosclerosis (n = 15) and the fourth group were patients with non-insulin-dependent diabetes (n = 17) who had definite evidence of previous myocardial infarction. Fatty acids were measured by gas-liquid chromatography. Antibodies to malondialdehyde-modified low density lipoprotein and copper-oxidized low density lipoprotein were determined by an ELISA method. Autoantibodies to copper-oxidized low density lipoprotein were significantly higher in the non-diabetic patients with heart disease when compared to any other group (p < 0.05). Autoantibodies to malondialdehyde-modified low density lipoprotein were significantly higher in the non-diabetic subjects with heart disease and in both diabetic groups compared to non-diabetic subjects without coronary heart disease (p < 0.05). Lineolic acid (%) in low density lipoprotein did not differ between groups but arachidonic acid (%) was significantly lower in both diabetic and non-diabetic patients with coronary heart disease (p < 0.05). The diabetic patients with low antibodies had 39.6 ± 2.2 % polyunsaturated fatty acids in their low density lipoprotein while diabetic patients with high antibodies had 46.7 ± 1.2 % polyunsaturates in their low density lipoprotein (p < 0.01). This study confirms the association between antibodies to oxidized low density lipoprotein and coronary heart disease and shows raised low density lipoprotein antibody levels in diabetic patients with and without demonstrable atherosclerosis. In the diabetic patients, those with high antibody levels had high polyunsaturated fatty acid levels in their LDL suggesting a possible role for dietary intervention. © 1997 John Wiley & Sons, Ltd.     

成人低密度脂蛋白亚型与颈动脉内膜中膜厚度的关系

目的评价Lipoprint法检测的低密度脂蛋白(LDL)亚型对颈动脉内膜中膜厚度(CA-IMT)的预测价值。方法回顾性分析扬州大学附属医院心内科住院患者175例,平均年龄67岁,其中男性106例(60.6%),女性69例(39.4%)。所有患者应用Lipoprint脂蛋白分类检测系统对LDL细分类胆固醇及血脂四项定量分析,应用彩色多普勒超声检测仪测量颈总动脉内膜中膜厚度,分别比较传统危险因素下各分组间血脂水平及CA-IMT的差异。通过线性相关分析CA-IMT与传统危险因素及LDL各亚型的相关性,应用Logistic回归方法评估LDL亚型对CAIMT的预测价值。结果与男性比较,女性患者LDL4水平偏低(P0.05),CA-IMT低于男性(P0.01)。合并高血压及糖尿病等传统危险因素的患者小而密低密度脂蛋白(sd LDL)及其亚型、CA-IMT均高于正常对照组,但差异无统计学意义(P0.05)。相关分析显示CA-IMT与性别呈负相关(P0.05),与总胆固醇(TC)、LDL、非高密度脂蛋白(non-HDL)呈正相关(P0.05);与sd LDL及LDL亚型LDL3、LDL4呈显著正相关(P0.01)。CA-IMT还与传统危险因素吸烟呈正相关(P0.05)。Logistic回归分析显示LDL、sd LDL以及sd LDL亚型LDL3、LDL4为CA-IMT增厚的独立预测因素。结论 sd LDL及其亚型与CA-IMT相关,对动脉粥样硬化有预测价值。     

颈动脉粥样硬化与血管性痴呆的相关性分析

目的探讨颈动脉粥样硬化对血管性痴呆发生、发展的影响。方法对61例血管性痴呆（VaD）患者（VaD组）及70例健康体检者（对照组）行高频超声检查,测定其颈总动脉、颈内动脉内-中膜厚度（IMT）及内径,颈动脉粥样硬化斑块的发生情况及斑块性质,采用全自动生化分析仪测定血TC、TG、HDL—C及LDL-C水平。结果VaD组颈总动脉IMT及颈内动脉IMT均明显大于对照组,颈总动脉及颈内动脉内径均明显小于对照组（P均〈0．05）;VaD组斑块发生率明显高于对照组（P〈0．05）;TC、TG、LDL-C水平均明显高于对照组、HDL-C明显低于对照组（P均〈0．05）。结论颈动脉粥样硬化形成与VaD的发生密切相关。     

Glycemic and blood pressure control in older patients with hypertension and diabetes: association with carotid atherosclerosis

Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure (Bp) control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness (CIMT) in patients with type 1 and type 2 diabetes. However, few studies have compared the relative importance of glycemic vs. Bp control in patients with diabetes and hypertension. We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes. Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects (508 males and 162 females) aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke. Subjects were categorized by their systolic blood pressure: tight control, < 130 mmHg; usual control, 130–139 mmHg; or uncontrolled, ≥ 140 mmHg, and by their hemoglobin A1c (HbA1c) level: tight control, < 6.5%; usual control, 6.5%–7.5%; or uncontrolled, ≥ 7.5%, respectively. Results The mean CIMT was 8.20 ± 0.11 mm, and carotid plaque was found in 52.5% (352/670) subjects. Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT (≥ 1.1 mm). The mean CIMT was significantly different between Bp control categories (7.60 ± 0.09 mm, 7.90 ± 0.08 mm, and 8.60 ± 0.12 mm, respectively, P = 0.03) but not between glycemic control categories (8.20 ± 0.10 mm, 8.1 ± 0.08 mm, and 8.40 ± 0.14 mm, respectively, P = 0.13) using ANCOVA analysis. Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque (OR = 1.08 and OR = 1.42, respectively), or elevated CIMT [Odd ratio (OR) = 1.17, 95% confidence interval (CI) 1.04–2.24, and OR = 1.54, 95% CI 1.36–2.96, respectively compared to tight Bp control; but did not show glycemic control as independent predictor of either having carotid plaque or elevated CIMT. Conclusions In older patients with hypertension and diabetes, blood pressure control, but not glycemic control is associated with subclinical carotid atherosclerosis.     

Ⅱ型糖尿病患者颈动脉粥样硬化与血尿酸、纤维蛋白原的关系

目的:探讨Ⅱ型糖尿病(T2DM)患者血清尿酸（UA）、纤维蛋白原(Fg)水平是否与颈动脉粥样硬化(AS)有关。方法: T2DM患者218例,根据有无颈AS分为2组, 对患者年龄、病程、高血压病、UA、肌酐(Cr)、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）、糖基化血红蛋白和Fg等AS危险因素进行单因素和多因素分析。结果: logistic回归分析显示年龄、病程、UA、Cr、UA /Cr、LDL-C,Fg与T2DM颈AS有相关性。UA危险因素的多元逐步回归分析显示病程、颈AS、Cr、TG、TC与UA相关;Fg危险因素的多元逐步回归分析显示,颈AS与Fg相关。结论: T2DM颈AS患者血清中UA、Fg明显升高,是AS的危险因素。     

颈动脉周围脂肪密度与颈动脉狭窄以及预后的关系

目的]探讨颈动脉周围脂肪密度与颈动脉狭窄以及预后的关系。 [方法]回顾性连续纳入209例2017年1月—2021年1月在台州市中心医院(台州学院附属医院)收治的颈内动脉颅外段狭窄的患者。通过颈动脉计算机断层成像血管造影评估最狭窄颈动脉轴层以及对侧同一轴层的血管周围脂肪密度;收集患者临床资料;根据指南对狭窄程度进行分度;回顾病史明确是否为症状性颈动脉狭窄;对患者进行1年的随访。 [结果]患者颈动脉狭窄侧的周围脂肪密度比狭窄对侧高4.2%(P＜0.001),且颈动脉周围脂肪密度随狭窄严重程度加重而增加。在狭窄侧,有症状组患者颈动脉周围脂肪密度比无症状组高6.25%(P＝0.015)。在无症状患者中,1年内发生狭窄侧相关脑血管结局事件组颈动脉周围脂肪密度比未发生患者组高12.4%(P＝0.017),Logistic回归分析校正两组差异因素结果仍具有统计学差异(OR＝1.060,95%CI:1.006～1.117,P＝0.028)。 [结论]颈动脉周围脂肪密度与颈动脉狭窄程度呈正相关;症状性颈动脉狭窄以及再发狭窄侧相关缺血性脑血管结局事件患者的颈动脉周围脂肪密度高。     

T2DM颈动脉粥样硬化与血尿酸关系

目的 :探讨 型糖尿病 （T2 DM）患者血清尿酸水平变化与颈动脉粥样硬化的关系。方法 :检测 10 2例 型糖尿病患者病程、空腹血糖、餐后血糖、体质量指数 （BMI）、血压、血清胆固醇、甘油三脂、尿酸、肾功 5项、心脏收缩和舒张功能。按是否有动脉粥样硬化分为 2组。结果 :在 T2 DM并发动脉粥样硬化组血清尿酸水平显著升高 （P<0 .0 1） ,心脏舒张功能显著降低 （P<0 .0 1） ,尿 β2 、α2 微球蛋白 ,AL b排泄增加 （均 P<0 .0 1）。结论 :T2 DM患者颈动脉粥样硬化时血清尿酸水平升高 ,同时伴心脏舒张功能损伤 ,这种尿酸变化可能与肾小管的损伤有关。