老年冠心病患者餐后高甘油三酯血症与颈动脉及股动脉粥样硬化的关系  

Association between Postprandial Hypertriglyceridemia and Carotid,Femoral Arteries Atherosclerosis in Elderly Patients with Coronary Heart Disease

作　　者：苏琳[1] 孙立新[1] 张庆文[1] 赵志刚[2] 张万蕾[3] 

机构地区：[1]北京大学人民医院老年科,北京市100044 [2]石家庄市第一医院干部病房,河北省石家庄市050011 [3]北京大学人民医院超声室,北京市100044

出　　处：《中国动脉硬化杂志》2003年第1期53-56,共4页Chinese Journal of Arteriosclerosis

摘　　要：探讨餐后血脂代谢异常与动脉粥样硬化的关系。 47例冠心病患者及 3 0例对照组禁食 12～ 14h后 ,均接受低脂实验餐负荷试验。分别于空腹及餐后 4h采血测定血清甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A及载脂蛋白B的浓度。利用二维彩色多普勒超声 ,检测两组颈动脉内膜中层厚度及颈动脉、股动脉斑块的发生状况。与对照组相比 ,冠心病组空腹血清总胆固醇、载脂蛋白B浓度显著增高 ,冠心病组餐后 4h血清甘油三酯、低密度脂蛋白胆固醇浓度显著增高 (P <0 .0 5 ) ,餐后血清高密度脂蛋白胆固醇浓度显著降低 (P <0 .0 5 )。冠心病组颈总动脉内膜中层厚度、颈内动脉内膜中层厚度、颈动脉及股动脉斑块指数均较对照组增高 (P <0 .0 1)。餐后血清甘油三酯与空腹血清甘油三酯浓度呈正相关。颈动脉斑块指数与空腹总胆固醇呈正相关。Aim To investigate the role of postprandial triglyceride levels in atherosclerosis, we examined the correlation between postprandial triglyceride levels and the carotid and femoral arteries atherosclerosis in elderly patients with coronary heart disease (CHD). Methods Carotid intima-media thickness (IMT) and plaque in the carotid and femoral arteries were measured by ultrasonography in 47 elderly patients with CHD and 30 controls. Plasma triglyceride(TG),total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, Apo A, Apo B levels were measured after overnight fasting and 4 h after a meal. Results The fasting cholesterol and Apo B were significantly higher in CHD group than those of the control group (P<0.05). The postprandial triglyceride and low density lipoprotein cholesterol were significantly higher and the postprandial high density lipoprotein cholesterol was significantly lower in CHD group than those of the control group (P<0.05). The IMT of common carotid arteries and the plaque index of carotid and femoral arteries in CHD group were significantly higher than those of the control group (P<0.01). Common carotid IMT was significantly increased in CHD group compared with the control group. Postprandial triglyceride levels were correlated with fasting triglyceride levels. Fasting total cholesterol was correlated with the plaque index of carotid. Conclusion Postprandial hypertriglyceride despite normal fasting triglycerid levels may be an risk factor for atherosclerosis in elderly patient.

关 键 词：老年 冠心病 高甘油三酯血症 颈动脉 股动脉粥样硬化 

分 类 号：R541[医药卫生—心血管疾病]