脂餐后血浆乳糜微粒及其残粒相对含量与冠心病的关系.docVIP

???? 脂餐后血浆乳糜微粒及其残粒相对含量?与冠心病的关系 ???? ????【摘要】　目的　探讨脂肪餐负荷后，血浆乳糜微粒(CM)及其残粒的含量与冠心病病变程度的关系。方法　40例经冠状动脉造影证实的冠心病患者（CHD组）及32例健康人（对照组）禁食12～14小时后接受标准脂肪餐负荷试验，分别采集餐前及餐后6小时新鲜血浆进行密度梯度超速离心，分离d1.006 g/ml及d=1.006～1.019 g/ml脂蛋白组份，以3.5%十二烷基硫酸钠聚丙烯酰胺凝胶电泳（SDS）及激光密度扫描法测定上述两种脂蛋白组份中apo B48占总apo B的百分含量，以此间接反映乳糜微粒及其残粒的相对含量。结果　餐后6小时， CHD组血浆甘油三酯浓度及增量显著大于对照组。CHD组d1.006 g/ml apo B48的百分含量及增量均显著大于对照组（P值分别0.01～0.001），提示餐后6小时CM含量在CHD患者显著增多。餐后6小时，多支病变组d=1.006～1.019 g/ml apo B48的百分含量及增量均显著大于单支病变组（P值分别0.05～0.001），提示多支病变者餐后CM残粒的含量显著增加。结论　结果提示，餐后CM及其残粒含量增加与冠心病的发病及病变程度密切相关，可能是冠心病的危险因素之一，有必要进行大系列临床及流行病学研究证实。　　【关键词】　冠状动脉疾病　　乳糜微粒　　高脂血症 Chylomicrons and chylomicron remnants in coronary heart disease: A case-control study　　ZHANG Yuanli, YOU Kai, SUN Jie, et al. Peking Union Medical College Hospital, Beijing 100730　　【Abstract】　Objective　Epidemiologic studies have largely overlooked the atherogenic role of triglyceride-rich lipoproteins circulation in the postprandial state.We conducted a case-control study to test the effect of chylomicrons and chylomicron remnants on coronary heart disease.Methods　In 40 cases with coronary heart disease verified by coronary angiography and 32 healthy control subjects, density gradient ultracentrifugation was undergone using 3.5 ml fresh plasma before and 6 hours after a standard test meal to separate the d 1.006 g/ml fraction, which contained very low density lipoproteins (VLDL), chylomicrons and large chylomicron remnants, and d=1.006-1.019 g/ml fraction containing VLDL remnants (intermediate density lipoprotein, IDL) and smaller chylomicron remnants. The apo B48/apo B ratio in d1.006 g/ml fraction, a relative content of chylomicron and that in d=1.006-1.019, a relative content of smaller chylomicron remnants were measured using the methods of 3.5% polyacrylamide gel electrophoresis and densitometry.Results　The apo B48/apo B ratio in d1.006 g/ml fraction 6 hours after the meal was significantly higher in CHD cases than in controls, indicating the amount of chylomicrons in