中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2015年
11期
936-942
,共7页
龚志忠%齐玥%赵帆%刘静%王薇%刘军%孙佳艺%解武祥%李岩
龔誌忠%齊玥%趙帆%劉靜%王薇%劉軍%孫佳藝%解武祥%李巖
공지충%제모%조범%류정%왕미%류군%손가예%해무상%리암
动脉粥样硬化%胆固醇,VLDL%胆固醇吸收标志物%胆固醇合成标志物
動脈粥樣硬化%膽固醇,VLDL%膽固醇吸收標誌物%膽固醇閤成標誌物
동맥죽양경화%담고순,VLDL%담고순흡수표지물%담고순합성표지물
Atherosclerosis%Cholesterol,VLDL%Cholesterol absorption marker%Cholesterol synthesis marker
目的 通过评价极低密度脂蛋白胆固醇(VLDL-C)水平与胆固醇吸收和合成标志物水平及其变化的关联性,探索降低VLDL-C的有效方法.方法 从2008年10月到2009年6月在河南省和山西省两家医院心内科,连续入选363例从未服用过他汀药物的冠心病中高危患者,基线时测定患者体内VLDL-C水平和胆固醇吸收、合成标志物水平,并进行统一的问卷调查和体格检查,期间给予患者阿托伐他汀20mg/d对血脂进行干预,共持续4周,试验结束时再次测定VLDL-C和胆固醇吸收、合成标志物的水平.分析时按胆固醇吸收、合成标志物水平或降低幅度三分位进行分组及交叉分组,采用协方差分析方法调整年龄和性别后比较在不同胆固醇吸收和合成状态下患者VLDL-C的水平及其变化情况.并采用偏相关分析方法和多元线性回归的方法分析VLDL-C的水平与胆固醇吸收、合成标志物的关联性.结果 (1)363例患者中最终共283例患者纳入统计分析,平均年龄为(55.43±9.01)岁,VLDL-C基线水平为1.06(0.65,1.86)mmol/L,胆固醇吸收标志物菜油固醇为6.01(3.78,9.45)mg/L,合成标志物7-烯胆烷醇为13.46(8.30,21.07)mg/L.(2)偏相关分析和多元回归结果均显示VLDL-C基线水平与胆固醇吸收标志物菜油固醇水平呈正相关(r=0.153,P＜0.05),但与胆固醇合成标志物7-烯胆烷醇的相关性无统计学意义(r=0.182,P=0.173).在不同的胆固醇吸收、合成状态下随着基线菜油固醇水平的升高,VLDL-C基线水平呈现明显的上升趋势(趋势性检验P=0.035).(3)经4周阿托伐他汀干预后,VLDL-C下降了38.0％,VLDL-C的降幅与菜油固醇的降幅呈明显正相关(r=0.331,P＜0.001),随着菜油固醇下降幅度的增加,VLDL-C的下降幅度亦呈现明显增加的趋势(趋势性检验P=0.032),而VLDL-C变化与7-烯胆烷醇变化的相关性则无统计学意义(趋势性检验P=0.798).结论 VLDL-C水平与胆固醇吸收标志物有明显的相关性,为进一步研究胆固醇吸收抑制剂是否可以更有效降低VLDL-C水平提供了初步的假设.
目的 通過評價極低密度脂蛋白膽固醇(VLDL-C)水平與膽固醇吸收和閤成標誌物水平及其變化的關聯性,探索降低VLDL-C的有效方法.方法 從2008年10月到2009年6月在河南省和山西省兩傢醫院心內科,連續入選363例從未服用過他汀藥物的冠心病中高危患者,基線時測定患者體內VLDL-C水平和膽固醇吸收、閤成標誌物水平,併進行統一的問捲調查和體格檢查,期間給予患者阿託伐他汀20mg/d對血脂進行榦預,共持續4週,試驗結束時再次測定VLDL-C和膽固醇吸收、閤成標誌物的水平.分析時按膽固醇吸收、閤成標誌物水平或降低幅度三分位進行分組及交扠分組,採用協方差分析方法調整年齡和性彆後比較在不同膽固醇吸收和閤成狀態下患者VLDL-C的水平及其變化情況.併採用偏相關分析方法和多元線性迴歸的方法分析VLDL-C的水平與膽固醇吸收、閤成標誌物的關聯性.結果 (1)363例患者中最終共283例患者納入統計分析,平均年齡為(55.43±9.01)歲,VLDL-C基線水平為1.06(0.65,1.86)mmol/L,膽固醇吸收標誌物菜油固醇為6.01(3.78,9.45)mg/L,閤成標誌物7-烯膽烷醇為13.46(8.30,21.07)mg/L.(2)偏相關分析和多元迴歸結果均顯示VLDL-C基線水平與膽固醇吸收標誌物菜油固醇水平呈正相關(r=0.153,P＜0.05),但與膽固醇閤成標誌物7-烯膽烷醇的相關性無統計學意義(r=0.182,P=0.173).在不同的膽固醇吸收、閤成狀態下隨著基線菜油固醇水平的升高,VLDL-C基線水平呈現明顯的上升趨勢(趨勢性檢驗P=0.035).(3)經4週阿託伐他汀榦預後,VLDL-C下降瞭38.0％,VLDL-C的降幅與菜油固醇的降幅呈明顯正相關(r=0.331,P＜0.001),隨著菜油固醇下降幅度的增加,VLDL-C的下降幅度亦呈現明顯增加的趨勢(趨勢性檢驗P=0.032),而VLDL-C變化與7-烯膽烷醇變化的相關性則無統計學意義(趨勢性檢驗P=0.798).結論 VLDL-C水平與膽固醇吸收標誌物有明顯的相關性,為進一步研究膽固醇吸收抑製劑是否可以更有效降低VLDL-C水平提供瞭初步的假設.
목적 통과평개겁저밀도지단백담고순(VLDL-C)수평여담고순흡수화합성표지물수평급기변화적관련성,탐색강저VLDL-C적유효방법.방법 종2008년10월도2009년6월재하남성화산서성량가의원심내과,련속입선363례종미복용과타정약물적관심병중고위환자,기선시측정환자체내VLDL-C수평화담고순흡수、합성표지물수평,병진행통일적문권조사화체격검사,기간급여환자아탁벌타정20mg/d대혈지진행간예,공지속4주,시험결속시재차측정VLDL-C화담고순흡수、합성표지물적수평.분석시안담고순흡수、합성표지물수평혹강저폭도삼분위진행분조급교차분조,채용협방차분석방법조정년령화성별후비교재불동담고순흡수화합성상태하환자VLDL-C적수평급기변화정황.병채용편상관분석방법화다원선성회귀적방법분석VLDL-C적수평여담고순흡수、합성표지물적관련성.결과 (1)363례환자중최종공283례환자납입통계분석,평균년령위(55.43±9.01)세,VLDL-C기선수평위1.06(0.65,1.86)mmol/L,담고순흡수표지물채유고순위6.01(3.78,9.45)mg/L,합성표지물7-희담완순위13.46(8.30,21.07)mg/L.(2)편상관분석화다원회귀결과균현시VLDL-C기선수평여담고순흡수표지물채유고순수평정정상관(r=0.153,P＜0.05),단여담고순합성표지물7-희담완순적상관성무통계학의의(r=0.182,P=0.173).재불동적담고순흡수、합성상태하수착기선채유고순수평적승고,VLDL-C기선수평정현명현적상승추세(추세성검험P=0.035).(3)경4주아탁벌타정간예후,VLDL-C하강료38.0％,VLDL-C적강폭여채유고순적강폭정명현정상관(r=0.331,P＜0.001),수착채유고순하강폭도적증가,VLDL-C적하강폭도역정현명현증가적추세(추세성검험P=0.032),이VLDL-C변화여7-희담완순변화적상관성칙무통계학의의(추세성검험P=0.798).결론 VLDL-C수평여담고순흡수표지물유명현적상관성,위진일보연구담고순흡수억제제시부가이경유효강저VLDL-C수평제공료초보적가설.
Objective To evaluate the association between very low density lipoprotein cholesterol (VLDL-C) and cholesterol absorption and synthesis markers in patients with moderate and high risk of coronary heart disease.Methods A total 363 statin-na(i)ve patients with moderate and high risk of coronary heart disease were consecutively recruited from two hospitals in Shanxi and Henan provinces between October 2008 and June 2009.A standard questionnaire and physical examination were performed at baseline.Atorvastatin (20mg/day) was administered to patients for 4 weeks.Venous blood samples after an overnight fast were collected before and after treatment for measuring VLDL-C and cholesterol absorption and synthesis markers.In qualitative analyses,the baseline level of cholesterol absorption and synthesis markers and their reduction after atorvastatin treatment were categorized into 3 tertile groups.Results (1) Of 363 patients,283 patients with mean age of (55.43±9.01) years old with complete data were finally analyzed.The median level of baseline VLDL-C was 1.06(0.65,1.86)mmol/L.The median level of baseline cholesterol absorption marker (Campesterol) and cholesterol synthesis marker (Lathosterol) was 6.01(3.78,9.45)mg/L and 13.46(8.30,21.07)mg/L,respectively.(2) Partial correlation analysis and multiple regression showed the baseline level of VLDL-C was positively correlated with Campesterol (r=0.153,P＜0.05) but not with Lathosterol(r=0.182,P=0.173).Furthermore,baseline VLDL-C level significantly increased with fertile of the baseline level of Carnpesterol in the qualitative analyses (P for trend=0.035).(3) Mean reduction in VLDL-C levels was 38.0％ after 4 weeks atorvastatin treatment.VLDL-C reduction was positively correlated with Campesterol reduction (r=0.331,P＜0.001).VLDL-C reduction significantly increased with the tertile of Campesterol reduction (P for trend=0.032).But this trend was not observed between VLDL-C level and Lathosterol (P for trend=0.798).Conclusion The level of VLDL-C was closely related to cholesterol absorption marker,and further studies are needed to validate if inhibitor of cholesterol absorption (for example by Ezetimibe) could bring about more effective VLDL-C lowering effect in this patient cohort.
