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目的血管粥样硬化好发于动脉,通常不发生于静脉,其机制尚未完全阐明。除外血管结构、血氧浓度、血流动力学的差异,血液某种生化成分,如血脂的质和量的变化有可能参与动脉粥样硬化的形成机制。本研究观察股动脉和正中静脉血脂和脂蛋白谱的变化,初步了解血脂因素是否参与血管粥样硬化。方法患者10例,男7例,女3例,年龄(60．0±10．7)岁,其中冠心病8例,心肌病1例(少1例)。取非抗凝的股动脉和正中静脉血标本。常规方法检测血脂和载脂蛋白,包括TG、TC、LDL-C、HDL-C、Apo(A、B、E)及LP(a)。改良梯度凝胶电泳(GGE)法检测血清脂蛋白,包括VLDL、IDL、Lp(a)、LDL、HDL亚类,以及白蛋白携带的游离脂肪酸。配对资料的t检验进行统计分析。结果常规方法未检出股动脉和正中静脉血脂和载脂蛋白水平存在显著差异。改良GGE法检测发现,正中静脉血清VLDL含量显著．低于股动脉中的含量(t=4．507,P<0．001),差值为血脂总体的(0．75±0．52)％,其他脂蛋白及其亚类含量的差异无统计学意义。结论患者股动脉和正中静脉血脂和脂蛋白含量的变化很小,改良GGE法因其高效、敏感度高,能够检出其中的差异。正中静脉血VLDL含量降低的原因,可能与外周血管网内脂蛋白脂酶对其中富含的TG的酯解作用有关。静脉血VLDL含量降低是否与其少发粥样硬化有关,尚需进一步研究。
Aims Vascular atherosclerosis develops in the arteries, usually not in the veins, and the mechanism has not been fully elucidated. Except for vascular structure, blood oxygen concentration, hemodynamic differences, blood biochemical composition, such as lipid quality and quantity changes may be involved in the formation of atherosclerosis mechanism. This study observed the femoral artery and median vein lipid and lipoprotein spectrum changes, a preliminary understanding of whether lipids are involved in atherosclerosis. Methods 10 patients, 7 males and 3 females, aged (60.0 ± 10.7) years, of which 8 cases of coronary heart disease, cardiomyopathy in 1 case (less 1 case). Non-anticoagulated femoral and median venous blood samples were taken. Lipid and apolipoproteins, including TG, TC, LDL-C, HDL-C, Apo (A, B, E) and LP (a) were determined by routine methods. Serum lipoproteins including VLDL, IDL, Lp (a), LDL, HDL subclasses and free fatty acids carried by albumin were detected by modified gradient gel electrophoresis (GGE). Paired t test data for statistical analysis. Results There were no significant differences in the levels of lipids and apolipoproteins between the femoral artery and median vein in the conventional method. Modified GGE test found that median venous serum VLDL content significantly. Lower than that in the femoral artery (t = 4.507, P <0.001), the difference was (0.75 ± 0.52)% of the total lipids, and there was no statistical difference in other lipoproteins and their subclasses Significance of learning. Conclusions The changes of blood lipids and lipoproteins in the femoral artery and median vein are small. The modified GGE method can detect the difference because of its high efficiency and sensitivity. The reason for the decrease of VLDL in the middle venous blood may be related to the effect of lipoprotein lipase in the peripheral vascular network on the esterification of TG which is rich in it. Whether the decrease of VLDL in venous blood is related to its less atherosclerosis needs further study.