目的 探讨川崎病（Kawasaki disease，KD）患儿血脂代谢与冠状动脉病变之间的关系。 方法 纳入2007年1月-2009年10月住院治疗的82例KD患儿，检测治疗前后血总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、极低密度脂蛋白（VLDL-C）、载脂蛋白A1（ApoA1）及载脂蛋白B100（ApoB100）水平。选取50例健康儿童作为对照。KD患儿在治疗前行超声心动图检查，根据超声心动图显示将KD组再分为冠状动脉病变组（CAL组，n=31）和非冠状动脉病变组（NCAL，n=51）。 结果 治疗前，KD患儿TC、ApoA1、HDLC降低，TG、LDL-C升高，与正常儿童相比有统计学意义（Plt;0.05）。KD患儿CAL组较NCAL组变化更明显，有统计学意义（Plt;0.05）。VLDL-C和ApoB100水平KD患儿与正常儿童比较、NCAL组与CAL组比较变化均不明显（Pgt;0.05）。治疗后与治疗前相比，NCAL组TC、TG、HDL-C、LDL-C、ApoA1恢复正常（Plt;0.05）），而CAL组仅TC、LDL-C、ApoA1恢复正常（Plt;0.05）。 结论 KD患儿存在血脂代谢紊乱，TC、TG、HDL-C、LDL-C、ApoA1与冠状动脉的损害有关，应早期进行干预。
Objective To analyze the prevalence and influencing factors of dyslipidemia among permanent residents in Longquanyi district of Chengdu for prevention and control of dyslipidemia. Methods Permanent residents in Longquanyi district were selected as research objects by convenient sampling method between November 2021 and February 2022. The dyslipidemia rate in the population was analyzed, and the influencing factors of dyslipidemia were analyzed by univariate and multivariate logistic regression. Results A total of 11 408 permanent residents were included. Among them, 3650 people had dyslipidemia, with a prevalence rate of 32.00% (3650/11408). The prevalence rates of high total cholesterol, high triglyceride, high low-density lipoprotein cholesterol, and low high-density lipoprotein cholesterol were 19.30% (2 202/11 408), 13.38% (1 526/11 408), 5.05% (576/11 408) and 0.73% (83/11 408), respectively. Multivariate logistic regression analysis showed that female, age≥30 years old, drinking, overweight / obesity, hypertension, diabetes and hyperuricemia were independent risk factors of dyslipidemia among permanent residents (P<0.05). Conclusions The prevalence of dyslipidemia in Longquanyi district is high, mainly with high total cholesterol and high triglyceride. Gender, age, drinking, body mass index, and the levels of blood pressure, blood glucose and blood uric acid are the factors affecting the incidence of dyslipidemia among permanent residents. Early intervention for high-risk groups with dyslipidemia should be adopted to effectively reduce the risk and burden of dyslipidemia.
ObjectivesTo systematically review the therapeutic efficacy of vitamin B1 for adjunctive treatment in type 2 diabetes mellitus.MethodsDatabases including PubMed, EMbase, The Cochrane Library, CNKI, VIP, WanFang Data and CBM were searched to collect randomized controlled trials (RCTs) on vitamin B1 for adjunctive treatment in type 2 diabetes mellitus from inception to July 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted by RevMan 5.3 and Stata 12.0 softwares. ResultsA total of 6 RCTs involving 346 patients were included. The results of meta-analysis showed that, compared with the control group, the vitamin B1 adjunctive group had a significant improvement in CRP (MD=–1.09, 95%CI –1.63 to –0.54, P<0.000 1). However, the fasting blood glucose (MD=–0.23, 95%CI –0.58 to 0.13,P=0.22), glycosylated hemoglobin (MD=0.13, 95%CI –0.25 to 0.52, P=0.49), 2 hours plasma glucose (MD=–0.18, 95%CI –1.03 to 0.67, P=0.68), systolic pressure (MD=2.94, 95%CI –1.31 to 7.18, P=0.18), diastolic pressure (MD=–1.60, 95%CI –4.24 to 1.05, P=0.24), triglycerides (MD=–0.12, 95%CI –0.32 to 0.09, P=0.27), total cholesterol (MD=0.21, 95%CI –0.05 to 0.46, P=0.12), high-density lipoprotein cholesterols (MD=0.03, 95%CI –0.07 to 0.12, P=0.56) and low-density lipoprotein cholesterols (MD=0.12, 95%CI –0.11 to 0.35, P=0.30) had no significant differences between both groups.ConclusionsVitamin B1 adjunctive treatment could not improve the levels of blood glucose, blood pressure and serum lipids. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
【摘要】 目的 探讨成都市成华区中老年人群血脂水平、分布特点及其与胰岛素抵抗指数（HOMA-IR）的关系。 方法 2007年5月在此区中老年（50~79岁）人群中随机抽取672人进行心血管危险因素研究调查，对其血脂水平及HOMA-IR进行统计分析。 结果 人群当中①女性各血脂项目的水平均比男性高，其中总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）的差异有统计学意义（Plt;0.05）；②三酰甘油（TG）升高的比例较高，其中男性为30.0%，女性为27.6%；大部分人群HDL-C、低密度脂蛋白胆固醇（LDL-C）水平处于合适范围，HDL-C降低的比例为6.0%，LDL-C升高的比例为7.3%；③随着TG水平的升高、HDL-C 水平的降低，HOMA-IR呈升高趋势；LDL-C水平的升高，HOMA-IR呈升高趋势，仅在女性人群中差异有统计学意义（Plt;0.05），在男性人群中差异无统计学意义；④TG与HOMA-IR呈正相关，相关系数为0.185（P=0.000）；HDL-C与HOMA-IR呈负相关，相关系数为-0.145（P=0.000）。LDL-C与HOMA-IR呈正相关，相关系数为0.099（P=0.010）。 结论 TG增高是成都市成华区中老年人群的显著特点，女性HDL-C比男性高；血脂紊乱与胰岛素抵抗相关。【Abstract】 Objective To investigate the relationship between blood lipids level and homeostasis model assessment-insulin resistance (HOMA-IR) in elder people in Chengdu. Methods In May 2007, 672 people aged from 50 to 79 years in Chengdu were recruited by random sampling methods for the survey of cardiovascular risk factors. The blood lipids level and HOMA-IR were statistically analyzed. Results ① The serum total cholesterol (TC) and high density lipoprotein chole sterol (HDL-C) were obviously higher in women than those in men (Plt;0.05). ② Triacylglycerol (TG) increased in 30.0% of men and 27.6% of women; HDL-C and low density lipoprotein cholesterin (LDL-C) in most of the involved people were appropriate. ③ HOMA-IR increased as the TG level increased and HDL-C decreased; HOMA-IR increased as the LDL-C level increased, which was significant in the females (Plt;0.05). ④ HDL-C was positively correlated with HOMA-IR (r=-0.145, P=0.000); LDL-C was positively correlated with HOMA-IR (r=0.099, P=0.010). Conclusion The increase of hypertriglyceridemia was the most frequent type of the dislipidemia in the elder people in Chengdu; HDL-C level is higher in women than in men. Dyslipidemia is correlated with insulin resistance.
Objective To study the relation between the pathogenesis of gallstone and blood lipid and protein.Methods Then indexes of blood lipid and protein in 204 cases of gallstone patients were measured and analysed by statistical software SPSS. Results There was a significant difference between the gallstone group and control in the value of proalbumin, total cholesterol, high density lipoprotein and carrier protein B (Ｐ＜0.01), the value of total protein, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol and carrier protein A1 were higher than those in the control (Ｐ＜0.05). Conclusion The indexes mentioned above may play an important role in the gallstone formation.
ObjectiveTo investigate the prevalence status and characteristics of dyslipidemia and cardiovascular risk factors in urban communities of Chengdu city. MethodsBy cluster sampling, a population of 994 inhabitants were selected from 14 urban communities in Chengdu city between February and October 2010. We investigated patients between 35-70 years old who lived in the area over 2 years, by using questionnaires survey, physical examination, and laboratory tests. According to the age, the respondents were divided into three groups: young group ( ≤ 44 years old), middle-aged group (45-59 years old) and elderly group ( ≥ 60 years old). We further investigated the major cardiovascular risk factors for hyperlipidemic patients. ResultsThe prevalence of dyslipidemia in Chengdu urban area was 28.47% (283/994), and standardized prevalence rate was 24.65% (male, 24.68%; female, 30.91%). The prevalence rate between male and female had significant diTherence (χ2=4.513, P=0.034). Female elderly group and middle-aged group had a significantly higher prevalence than the young group (P<0.05), while the male prevalence had no statistical diTherences among all age groups (P>0.05). Hypertension was most common in patients with dyslipidemia (male, 50.04%; female, 52.41%) followed by diabetes and coronary heart disease. There was no difference between male and female in the prevalence of dyslipidemia accompanied hypertension, history of stoke and coronary heart disease, abdominal obesity,or obesity (P>0.05). Higher prevalence with smoking and drinking was in male patients (P<0.05). ConclusionThe prevalence of dyslipidemia is relatively high in urban communities of Chengdu city. According to the region of hyperlipemia epidemiological characteristics and risk factors, by using comprehensive intervention measures, we can reduce the prevalence of dyslipidemia.
Objective To investigate the effect of chronic altitude hypoxia exposure on serum lipoprotein levels in healthy subjects and patients with pulmonary hypertension, and whether there is a difference in serum lipoprotein levels between patients with pulmonary hypertension at middle and high altitude. Methods The case data of 245 Han patients with COPD complicated with pulmonary hypertension admitted to the Affiliated Hospital of Qinghai University from January 2018 to September 2022 were retrospectively analyzed. According to the altitude of their long-term residence before onset, the patients were divided into two groups, 119 cases in the middle altitude group (1500 m~2500 m). 126 cases were in the high altitude group of 2500 m~4500 m. In addition, the physical examination data of 50 healthy people in the intermediate and high altitude groups were collected as the control group (the age and gender of the healthy people in the same altitude group were similar to those in the COPD-PH group), a total of 4 groups were collected. The general data, pulmonary artery systolic blood pressure (PASP), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) of the four groups were compared, and the correlation between pulmonary artery systolic blood pressure (PASP) and related variables was analyzed. ResultsThere were no significant differences in age, gender, smoking and drinking between the healthy control group and COPD-PH group (all P>0.05). There were significant differences in body mass index, PASP, TC, TG, HDL-C, LDL-C, TG/HDL-C, HDL-C/LDL-C between the healthy control group and the COPD-PH group (all P<0.05). In the healthy control group, only BMI was significantly different between the high altitude group and the middle altitude group (P<0.05). In the COPD-PH group, PASP, BMI, TC, HDL-C and TG/HDL-C in the high altitude group were significantly different from those in the moderate altitude group (all P<0.05). There were no significant differences in age, gender, smoking, drinking, TG, LDL-C and HDL-C/LDL-C between the two groups (all P>0.05), when gender, age, altitude, body mass index, PASP, smoking and drinking were included in the multi-factor linear regression equation of lipoprotein (TC, TG, HDL-C and LDL-C), it was found that different elevations (middle and higher elevations) only had statistically different effects on HDL-C (b=-0.046, t=-2.209, P=0.028). Correlation analysis showed that PASP was not correlated with age, altitude, body mass index and blood lipids (TC, TG, HDL-C, LDL-C) in the healthy control group (all P>0.05). However, in the COPD-PH group, PASP was negatively correlated with blood lipid indicators (TC, HDL-C and LDL-C). PASP was positively correlated with altitude (a risk factor for hypoxia). ConclusionsHypoxia environment factors characterized by altitude are closely related to the severity of pulmonary artery pressure in patients with COPD-PH, and higher pulmonary artery systolic pressure is closely related to lower levels of TC, HDL-C and LDL-C.
ObjectiveTo investigate the role of apelin, glycosylated hemoglobin (HbA1c), cholesterol (TC), triglyceride (TG), High density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC) in the development and progress of diabetic retinopathy (DR). MethodsThe serum concentration of apelin, HbA1c, TC, TG, HDLC and LDLC were measured in 30 normal control subjects and 90 patients with type 2 diabetic mellitus, including 30 cases without DR (NDR), 30 with non-proliferative DR (NPDR), 30 with proliferative DR (PDR). These data were analyzed by SPSS for windows 13.0. ResultsThe serum concentration of apelin, HbA1c, TC, HDLC, LDLC were significantly higher in NDR, NPDR, PDR group than those in control group (F=403.06, 5.45, 4.27, 201.56, 4.90;P < 0.05). The serum concentration of TG has no significantly difference (F=2.19, P > 0.05). The serum concentration of apelin, HbA1c, TC, LDLC were significantly higher in NDR, NPDR, PDR group than those in control group (t=0.30, 0.58, 0.79;P < 0.05), the serum concentration of HDLC were significantly lower than those in control group(t=0.79, P < 0.01). There were significantly positive correlation between the progression of DR and the serum concentration of apelin, HbA1c, TC, LDLC(r=0.962, 0.562, 0.935;P < 0.05). There were significantly negative correlation between the progression of DR and the serum concentration of HDLC(r=-0.753, P < 0.01). There were correlation between apelin and HbA1c, LDLC and HDLC(r=0.956, 0.741, -0.691;P < 0.01). ConclusionOur data demonstrated that serum apelin levels increased significantly in patients with diabetic retinopathy, and are closely related to blood sugar, blood lipid metabolic abnormalities.
Objective To analyze the clinical features， common etiologies， prevention measurements of recurrent acute pancreatitis （AP）. Methods The clinical characteristics and imaging examination data of 43 patients with recurrent AP were analyzed retrospectively， which was compared with the results of 258 patients with primary AP. The recurrence etiologies were analyzed. Results There were no significant differences on the fever， jaundice， abdominal pain relief time， pancreatic local complications， and ratio of severe AP between two groups （P＞0.05）. Comparion of etiologies between recurrent AP and primary AP， cholecystitis and diet factor （alcoholic） had priority in patients with primary AP （P=0.038， P=0.006， respectively）， but the hyperlipidemic， duodenal nipple disease， and small stone in the common bile duct were the major etiologies in patients with recurrent AP （P=0.007， P=0.008， respectively）. No relapse was found within the follow up for 3 months to 2 years （the average time was 14.2 months）. Conclusion Find out the exact etiology and performe correct therapy are the key to the treatment and prevention of recurrent AP.
Patients undergoing coronary artery bypass grafting (CABG) belong to the very high-risk group of atherosclerotic cardiovascular disease. Although CABG gets advantages in relieving symptoms and improving long-term outcomes, a significant risk of cardiovascular adverse events after surgery still exists and standardized secondary prevention is needed. Lipid management plays a critical role as a secondary preventive strategy in CABG. However, lipid management of CABG patients in real clinical setting is inadequate, including lack of standardized lipid-lowering strategy, low goal attainment rate, as well as poor long-term medication adherence. In recent years, a series of clinical trials have provided a lot of groundbreaking new evidence for lipid management in patients with cardiovascular diseases which offers new strategies together with objectives of lipid-lowering and comprehensive management for patients undergoing CABG. This article reviews the strategy and research progress of lipid management after CABG, aiming to provide objective reference for clinical treatment.