脂餐后血浆乳糜微粒及其残粒相对含量与冠心病的关系  

Chylomicrons and chylomicron remnants in coronary heart disease: A case control study

作　　者：张原力[1,2,3] 游凯[1,2,3] 孙杰[1,2,3] 薛红[1,2,3] 范中杰 陈保生 方圻[1,2,3] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院心内科 [2]中国医学科学院基础所生化国家重点实验室 [3]北京安贞医院心脏儿科

出　　处：《中华心血管病杂志》1999年第2期98-101,共4页Chinese Journal of Cardiology

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ｄ＜１．００６ｇ／ｍｌ及ｄ＝１．００６～１．０１９ｇ／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ＰＡＧＥ）及激光密度扫描法测定上述两种脂蛋白组份中ａｐｏＢ４８占总ａｐｏＢ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ｄ＜１．００６ｇ／ｍｌａｐｏＢ４８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＝１．００６～１．０１９ｇ／ｍｌａｐｏＢ４８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?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 B 48 /apo B ratio in d<1.006 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 B 48 /apo B ratio in d<1.006 g/ml fraction 6 hours after the meal was significantly higher in CHD cases than in controls, indicating the amount of chylomicrons in postprandial plasma was larger in CHD cases. The apo B 48 /apo B ratio in d=1.006 1.019 g/ml fraction 6 hours after the meal was significantly higher in cases with multivessel lesions than in cases with single vessel lesion, indicating the amount of chylomicron remnants was related with the degree of coronary artery disease. Conclusions The above results suggest that the relative concentration of chylomicrons and chylomicron remnants is a risk fator for coronary heart disease alongside other conventional factors.

关 键 词：冠心病 乳糜微粒 脂肪餐后 残粒 相对含量 

分 类 号：R541.4[医药卫生—心血管疾病]