动脉粥样硬化、急性冠脉综合征患者血清HDL2b水平变化及临床意义
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摘要
目的研究动脉粥样硬化、急性冠脉综合征患者血清高密度脂蛋白2b(HDL2b)水平变化及临床意义。方法选取2016年2月～2017年12月中国人民武装警察部队浙江省总队医院(以下简称"我院")收治的动脉粥样硬化患者81例记为A组,另取同期我院收治的急性冠脉综合征患者175例记为B组,再取同期于我院进行体检的健康人员100名记为对照组。分别比较三组血清HDL2b水平以及各项血脂指标水平,并分析其相关性;比较冠状动脉病变不同程度的急性冠脉综合征患者的血清HDL2b水平。结果 A、B组血清HDL2b水平均低于对照组,B组血清HDL2b水平低于A组,差异均有统计学意义(P <0.05)。A、B组HDL-C水平均低于对照组,B组HDL-C水平低于A组,差异均有统计学意义(P <0.05)。Pearson相关性分析结果提示,B组血清HDL2b与HDL-C呈正相关(P <0.05)。单支病变组、双支病变组、多支病变组患者血清HDL2b水平呈降低趋势,且单因素方差分析提示,各组间差异均有统计学意义(P <0.05)。结论动脉粥样硬化、急性冠脉综合征患者血清HDL2b水平均呈低表达,临床工作中可通过检测血清HDL2b水平,从而明确患者代谢紊乱和疾病的关系,可为临床治疗方案的制订提供指导作用。
Objective To study the changes and clinical significance of serum high density lipoprotein 2 b(HDL2 b) in patients with atherosclerosis and acute coronary syndromes. Methods A total of 81 cases with atherosclerosis admitted to Zhejiang Provincial General Hospital of Chinese People′s Armed Police Force("our hospital" for short) from February2016 to December 2017 were selected as group A, another 175 cases with acute coronary syndrome admitted to our hospital in the same period were selected as group B, and then 100 healthy individuals that performed physical examination in our hospital in the same period were taken as control group. Serum HDL2 b level and serum lipid level were compared among the three groups, and their correlation was analyzed. Serum HDL2 b levels were compared in patients with acute coronary syndrome of different degrees coronary artery disease. Results The serum level of HDL2 b in group A and B were lower than that in the control group, and the serum level of HDL2 b in group B was lower than that in group A, the differences were statistically significant(P < 0.05). High density lipoprotein cholesterol(HDL-C) level in group A and B were lower than that in the control group, and HDL-C level in group B was lower than that in group A,and the differences were statistically significant(P < 0.05). According to the Pearson correlation analysis results, there was a positive correlation between serum HDL2 b and HDL-C in group B(P < 0.05). There was a decreasing tendency of HDL2 b level in the single vessel lesion group, double vessels lesion group, multiple vessels lesion group orderly.Single factor analysis of variance could prompt that the differences among the three groups were statistically significant(P < 0.05). Conclusion Serum HDL2 b levels is low expressed in patients with atherosclerosis and acute coronary syndrome. In clinic, the relationship between metabolic disorder and disease can be determined by detecting serum HDL2 b level, and it can provide guidance for clinical treatment therapy.
Objective To study the changes and clinical significance of serum high density lipoprotein 2 b(HDL2 b) in patients with atherosclerosis and acute coronary syndromes. Methods A total of 81 cases with atherosclerosis admitted to Zhejiang Provincial General Hospital of Chinese People′s Armed Police Force("our hospital" for short) from February2016 to December 2017 were selected as group A, another 175 cases with acute coronary syndrome admitted to our hospital in the same period were selected as group B, and then 100 healthy individuals that performed physical examination in our hospital in the same period were taken as control group. Serum HDL2 b level and serum lipid level were compared among the three groups, and their correlation was analyzed. Serum HDL2 b levels were compared in patients with acute coronary syndrome of different degrees coronary artery disease. Results The serum level of HDL2 b in group A and B were lower than that in the control group, and the serum level of HDL2 b in group B was lower than that in group A, the differences were statistically significant(P < 0.05). High density lipoprotein cholesterol(HDL-C) level in group A and B were lower than that in the control group, and HDL-C level in group B was lower than that in group A,and the differences were statistically significant(P < 0.05). According to the Pearson correlation analysis results, there was a positive correlation between serum HDL2 b and HDL-C in group B(P < 0.05). There was a decreasing tendency of HDL2 b level in the single vessel lesion group, double vessels lesion group, multiple vessels lesion group orderly.Single factor analysis of variance could prompt that the differences among the three groups were statistically significant(P < 0.05). Conclusion Serum HDL2 b levels is low expressed in patients with atherosclerosis and acute coronary syndrome. In clinic, the relationship between metabolic disorder and disease can be determined by detecting serum HDL2 b level, and it can provide guidance for clinical treatment therapy.
引文
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[2]范雪松,王恩世,贺建勋,等.小而密低密度脂蛋白胆固醇及其与低密度脂蛋白胆固醇之比与颈动脉粥样硬化斑块的关系[J].中华检验医学杂志,2018,41(3):219-226.
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[4]张涛,王旭兰,李秀红,等.丹参多酚酸盐对老年冠心病患者高密度脂蛋白功能的影响[J].中国老年学杂志,2018,38(4):795-798.
[5]褚杰,杜平,何晨,等.载脂蛋白B/A-1比值联合颈动脉斑块性质检查在冠心病患者危险性预测中的价值[J].实用临床医药杂志,2017,21(11):35-37.
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[9]刘茵茵,胡敏.载脂蛋白M的调控与脂代谢相关疾病[J].中华临床实验室管理电子杂志,2014,2(2):23-27.
[10]李运田,杜大勇,杨升华,等.HDL影响冠心病患者血小板ox-LDL诱导活化的体外分析[J].重庆医学,2015,44(13):1756-1758.
[11]侯曜曜,尔璐,张永亮,等.早发冠心病患者高密度脂蛋白抗HUVEC凋亡的作用机制[J].中国动脉硬化杂志,2017,25(7):671-678.
[12]陆兆华,叶少武,卢谦,等.老年冠心病高密度脂蛋白候选基因分布[J].临床心身疾病杂志,2016,22(z1):160-160.
[13]谭迎,田迪,刘挺榕,等.高密度脂蛋白亚组分促胆固醇逆转运及抗氧化功能研究[J].中国循环杂志,2013,28(1):25-28.
[14]肖华,陈英,姚振国,等.女性冠心病患者高密度脂蛋白亚组分的检测及临床意义[J].热带医学杂志,2013,13(1):57-58.
[15]杨彩娥,张春燕,田亚平,等.血清HDL2b水平与动脉粥样硬化和急性冠脉综合征的关系[J].标记免疫分析与临床,2018,25(2):158-161.
[16]谭迎,田迪,赖文岩,等.急性冠脉综合征患者高密度脂蛋白亚组分的抗炎、抗氧化功能研究[J].解放军医学杂志,2013,38(2):129-132.
[17]符少萍,陈焕清,杨雪梅,等.正常高密度脂蛋白胆固醇水平的再发主要心血管事件的冠心病患者高密度脂蛋白亚类分析[J].中国慢性病预防与控制,2017,25(5):381-383.
[18]Ishigami M,Ogasawara F,Nagao K,et al.Temporary sequestration of cholesterol and phosphatidylcholine within extracellular domains of ABCA1 during nascent HDLgeneration[J].Sci Rep,2018,8(1):6170.
[19]胡春阳,刘景委,李波,等.高密度脂蛋白颗粒与稳定型冠心病的相关性及严重程度分析[J].河北医学,2016,22(10):1645-1647.
[20]Seckler HDS,Fornelli L,Mutharasan RK,et al.A Targeted,Differential Top-Down Proteomic Methodology for Comparison of ApoA-I Proteoforms in Individuals with High and Low HDL Efflux Capacity[J].J Proteome Res,2018,17(6):2156-2164.
[2]范雪松,王恩世,贺建勋,等.小而密低密度脂蛋白胆固醇及其与低密度脂蛋白胆固醇之比与颈动脉粥样硬化斑块的关系[J].中华检验医学杂志,2018,41(3):219-226.
[3]王冲,王贵松.2型糖尿病患者HDL水平、结构、功能变化及其与动脉粥样硬化性心血管疾病的关系[J].中国医学前沿杂志:电子版,2018,10(2):26-32.
[4]张涛,王旭兰,李秀红,等.丹参多酚酸盐对老年冠心病患者高密度脂蛋白功能的影响[J].中国老年学杂志,2018,38(4):795-798.
[5]褚杰,杜平,何晨,等.载脂蛋白B/A-1比值联合颈动脉斑块性质检查在冠心病患者危险性预测中的价值[J].实用临床医药杂志,2017,21(11):35-37.
[6]尼菲拉·甫拉提,袁玉娟,穆叶赛·尼加提.急性冠脉综合征患者红细胞微粒水平与冠脉病变严重程度的关系[J].医学研究杂志,2018,47(3):20-23.
[7]Batuca JR,Amaral MC,Favas C,et al.Antibodies against HDL Components in Ischaemic Stroke and Coronary Artery Disease[J].Thromb Haemost,2018,118(6):1088-1100.
[8]孔路科,连云芝.高密度脂蛋白亚类在临床相关疾病中的分布特征[J].国际检验医学杂志,2014,33(7):878-880.
[9]刘茵茵,胡敏.载脂蛋白M的调控与脂代谢相关疾病[J].中华临床实验室管理电子杂志,2014,2(2):23-27.
[10]李运田,杜大勇,杨升华,等.HDL影响冠心病患者血小板ox-LDL诱导活化的体外分析[J].重庆医学,2015,44(13):1756-1758.
[11]侯曜曜,尔璐,张永亮,等.早发冠心病患者高密度脂蛋白抗HUVEC凋亡的作用机制[J].中国动脉硬化杂志,2017,25(7):671-678.
[12]陆兆华,叶少武,卢谦,等.老年冠心病高密度脂蛋白候选基因分布[J].临床心身疾病杂志,2016,22(z1):160-160.
[13]谭迎,田迪,刘挺榕,等.高密度脂蛋白亚组分促胆固醇逆转运及抗氧化功能研究[J].中国循环杂志,2013,28(1):25-28.
[14]肖华,陈英,姚振国,等.女性冠心病患者高密度脂蛋白亚组分的检测及临床意义[J].热带医学杂志,2013,13(1):57-58.
[15]杨彩娥,张春燕,田亚平,等.血清HDL2b水平与动脉粥样硬化和急性冠脉综合征的关系[J].标记免疫分析与临床,2018,25(2):158-161.
[16]谭迎,田迪,赖文岩,等.急性冠脉综合征患者高密度脂蛋白亚组分的抗炎、抗氧化功能研究[J].解放军医学杂志,2013,38(2):129-132.
[17]符少萍,陈焕清,杨雪梅,等.正常高密度脂蛋白胆固醇水平的再发主要心血管事件的冠心病患者高密度脂蛋白亚类分析[J].中国慢性病预防与控制,2017,25(5):381-383.
[18]Ishigami M,Ogasawara F,Nagao K,et al.Temporary sequestration of cholesterol and phosphatidylcholine within extracellular domains of ABCA1 during nascent HDLgeneration[J].Sci Rep,2018,8(1):6170.
[19]胡春阳,刘景委,李波,等.高密度脂蛋白颗粒与稳定型冠心病的相关性及严重程度分析[J].河北医学,2016,22(10):1645-1647.
[20]Seckler HDS,Fornelli L,Mutharasan RK,et al.A Targeted,Differential Top-Down Proteomic Methodology for Comparison of ApoA-I Proteoforms in Individuals with High and Low HDL Efflux Capacity[J].J Proteome Res,2018,17(6):2156-2164.