动脉粥样硬化患者高同型半胱氨酸血症与胆固醇逆向转运的关系  

Relationship between Hyperhomocysteinemia and Reverse Cholesterol Transport in Patients with Atherosclerosis

作　　者：赵佳[1] 左林 姜小建[1] 姚创利[1] 朱建伟[1] ZHAO Jia;ZUO Lin;JIANG Xiao-jian;YAO Chuang-li;ZHU Jian-Wei(Department of Clinical Laboratory,Xi’an Central Hospital,Xi’an 710003,China;Department of Radiology,Tangdu Hospital of Air Force Medical University,Xi’an 710038,China)

机构地区：[1]西安市中心医院检验科,西安710003 [2]空军军医大学唐都医院放射科,西安710038

出　　处：《现代检验医学杂志》2019年第6期47-49,53,共4页Journal of Modern Laboratory Medicine

基　　金：西安市科技计划项目[项目编号：201805102YX10SF36(6)]

摘　　要：目的探讨高同型半胱氨酸(high homocysteine, HHcy)对动脉粥样硬化(atherosclerosis, AS)患者血脂和卵磷脂胆固醇酰基转移酶(lecithin cholesterol acyl transferase, LCAT)的影响。方法选取2018年9月~2019年6月诊断有颈动脉粥样硬化的185例患者作为研究对象。根据患者是否存在HHcy,分为HHcy组和对照组。测定同型半胱氨酸(homocysteine, Hcy)、血脂水平和LCAT浓度,分析Hcy水平与血脂水平及LCAT浓度的相关性。结果 HHcy组高密度脂蛋白胆固醇(high density lipoprotein cholesterol, HDL-C)、载脂蛋白AⅠ(apolipoprotein AⅠ, ApoAⅠ)水平和LACT浓度显著低于对照组,差异均具有统计学意义(t=2.318,2.405,2.484,均P<0.05);HHcy组Hcy水平显著高于对照组,差异具有统计学意义(t=11.266,P<0.001)。Hcy水平与HDL-C,ApoAⅠ水平和LCAT浓度均呈负相关(r=-0.197,P=0.008;r=-0.212,P=0.006;r=-0.221,P=0.005)。结论 HHcy是AS的一个独立危险因素。HHcy可能通过降低ApoAⅠ,HDL和LCAT水平,影响它们在胆固醇逆向转运(reverse cholesterol transport, RCT)中的作用,从而促进AS的发生与发展。Objective To investigate the effect of high homocysteine(HHcy)on blood lipid and lecithin cholesterol acyl transferase(LCAT)in patients with atherosclerosis(AS).Methods 185 cases of patients with carotid artery AS plaque diagnosed by neck doppler ultrasound in the department of neurology of Xi’an Central Hospital from September 2018 to June 2019 were selected as the research objects.According to the presence or absence of HHcy,the patients were divided into HHcy group and control group.The levels of homocysteine(Hcy)and blood lipid and the concentration of LCAT were detected.The correlations between the level of Hcy and the level of blood lipid and the concentration of LCAT were analyzed.Results The levels of high density lipoprotein cholesterol(HDL-C)and apolipoprotein AⅠ(ApoAⅠ)and the concentration of LACT in the HHcy group were significantly lower than that in the control group,and the differences were statistically significant(t=2.318,2.405,2.484,all P<0.05).The level of Hcy was significantly higher than that in the control group,and the difference was statistically significant(t=11.266,P<0.001).The level of Hcy was negatively correlated with the levels of HDL-C,ApoAⅠand the concentration of LACT(r=-0.197,P=0.008;r=-0.212,P=0.006;r=-0.221,P=0.005).Conclusion HHcy is an independent risk factor for AS.HHcy may affect the function of ApoAⅠ,HDL and LCAT in reverse cholesterol transport(RCT)by reducing their levels,thereby promoting the occurrence and development of AS.

关 键 词：动脉粥样硬化 高同型半胱氨酸血症 胆固醇逆向转运 高密度脂蛋白 载脂蛋白AⅠ 卵磷脂胆固醇酰基转移酶 

分 类 号：R543.5[医药卫生—心血管疾病] R446.112[医药卫生—内科学]