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目的 探讨老年冠心病 (CHD)患者餐后血脂代谢特点以及对血小板活性的影响。方法 对 48例老年冠心病 (CHD)患者 (冠心病组 )和 3 0例老年健康自愿者 (对照组 )均禁食 12h后 ,分别接受脂肪餐负荷试验 ,于空腹及餐后 4h测定血清甘油三酯(TG)、总胆固醇 (CH)、高密度脂蛋白 (HDL -C)、低密度脂蛋白 (LDL -C)水平 ,并同时于空腹状态及餐后 4h采用生物活性法测定血小板衍生生长因子 (PDGF)、用酶联免疫标测法 (ELISA)检测血管性假血友病因子 (vWF)浓度。结果 冠心病组餐前及餐后 4hTG(P<0 0 1)、CH(P <0 0 5 )、LDL -C(P <0 0 1)、PDGF(P <0 0 1)、vWF(P <0 0 1)值均显著高于对照组 ,HDL -C(P <0 0 1)显著低于对照组。餐后 4h与餐前比较 ,TG、CH、LDL -C值明显上升 ,而HDL -C下降幅度无明显差异。冠心病组PDGF、vWF值在餐后 4h上升幅度存在显著性差异 (P <0 0 5 )。结论 老年冠心病人存在血脂代谢异常。餐后血脂更能反映老年人的代谢水平。餐后血脂代谢异常对血小板活化起促进作用 ,血小板反复活化可能参与了冠状动脉硬化早期病变
Objective To investigate the characteristics of postprandial blood lipid metabolism in elderly patients with coronary heart disease (CHD) and its effect on platelet activity. Methods Forty-eight CHD patients (coronary heart disease group) and 30 elderly healthy volunteers (control group) were fasted for 12 hours and then were respectively subjected to the fat meal loading test. Serum glycerol Triglyceride (TG), total cholesterol (CH), high-density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) were measured. Meanwhile, platelet-derived growth was measured by bioactivity method in fasting state and 4h Factor (PDGF), the vWF concentration was detected by enzyme-linked immunosorbent assay (ELISA). Results The coronary heart disease group had significant differences in pretreatment and postprandial 4h TG (P <0.01), CH (P <0 05), LDL C (P 0 01), PDGF <0 0 1) values were significantly higher than the control group, HDL-C (P <0 0 1) was significantly lower than the control group. 4h postprandial compared with before meals, TG, CH, LDL-C value increased significantly, while HDL-C decreased no significant difference. Coronary heart disease group PDGF, vWF value 4h postprandial rise there is a significant difference (P <0 05). Conclusion There is abnormal lipid metabolism in elderly coronary heart disease patients. Postprandial blood lipids better reflect the metabolic level of the elderly. Postprandial dyslipidemia can promote the activation of platelet, platelet activation may be involved in the early stage of coronary atherosclerosis