免疫分离法检测脂蛋白残粒胆固醇的临床意义

Clinical significance of remnant lipoprotein cholesterol determination by immunoseparation assay

目的探讨脂蛋白残粒胆固醇(RLP-C)在动脉粥样硬化性疾病及与动脉粥样硬化有关的代谢性疾病中的应用价值以及RLP-C与其他血脂指标的关系。方法采用免疫分离法测定冠心病(CHD)、脑梗死(CI)、2型糖尿病(DM)、慢性肾功能衰竭(CRF)患者及正常对照者的RLP-C水平,并同时测定三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A-I(apo A-I)、载脂蛋白B(apoB),极低密度脂蛋白胆固醇(VLDL-C)按VLDL-C=TC-HDL-C-LDL-C计算,并分析RLP-C与其他血脂指标的相关性。结果CHD组、CI组、DM组和CRF组患者的RLP-C水平明显高于正常对照组(P<0.01),并且RLP-C水平与TG、VLDL-C呈显著相关(P<0.01、P<0.05)。结论RLP-C可作为一个新的标志物用于对动脉粥样硬化与动脉粥样硬化有关的代谢性疾病的危险性评估。

Objective To investigate the application value of remnant lipoprotein cholesterol （RLP-C） for the atherosclerosis and the metabolic diseases related to atherosclerosis, and the relationship between RLP-C and other lipid parameters. Methods The serum levels of RLP-C in coronary heart disease （ CHD ） patients, cerebral infarction （ CI ） patients, type 2 diabetes mellitus（DM） patients, chronic renal failure （CRF） patients and normal controls were determined by immunoseparation assay. The levels of triglyeeride （TG） , total cholesterol （TC） ,high density lipoprotein-cholesterol （HDL-C） and low density lipoprotein-cholesterol （LDL-C） were determined by enzymatic methods. The levels of apolipoprotein A-I （apo A-I） and apolipoprotein B （apo B） were determined by immunoturbidimetry methods, and the very low density lipoprotein-cholesterol （VLDL-C） was calculated according to the formula ： VLDL-C = TC - HDL-C -LDL-C, and the correlation between RLP-C and other lipid parameters was also analysed. Results The levels of RLP-C in patients with CHD, CI, DM and CRF were significantly higher than that in normal controls（P 〈0.01 ）. The level of RLP-C was significantly correlated with TG and VLDL-C （ P 〈 0.01 ,P 〈 0. 05 ）. Conclusions RLP-C could be considered as a new marker to assess the risk of atherosclerosis and the metabolic diseases related to atherosclerosis.