风湿性心脏病和扩张型心肌病患者血脂与载脂蛋白测定结果分析

Comparison of serum lipid levels with apolipoproteins in rheumatic heart disease and dilated cardiomyopathy

目的 通过测定风湿性心脏病 (RHD)和扩张型心肌病 (DCM)患者血脂与载脂蛋白水平 ,探讨RHD和DCM患者血脂与载脂蛋白异常的意义。方法 86例RHD患者、5 0例DCM患者和 10 6例健康体检者 ,采用酶法测定血脂。免疫比浊法测定载脂蛋白。结果 RHD和DCM患者血脂代谢异常主要表现为血脂和载脂蛋白的普遍降低 ,尤其是总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL C)、载脂蛋白B(ApoB)在DCM组降低明显 ,异常率分别达4 0 .0 %、4 0 .0 %、70 .0 % ;与对照组相比 ,RHD和DCM患者TC、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL C)、载脂蛋白A I(ApoAI)均降低 (P <0 .0 5 ) ,而DCM组同时伴LDL C和ApoB明显降低 (P <0 .0 5 ) ;与RHD组比较 ,DCM组LDL C和ApoB明显降低 (P <0 .0 5 ,0 .0 0 1)。结论 RHD和DCM患者的血脂和载脂蛋白普遍降低 ,DCM患者降低更明显 。

Objective To compare the levels of serum lipids with apolipoproteins in rheumatic heart disease(RHD) and dilated cardiomyopathy(DCM).Methods Eighty-six cases with rheumatic heart disease, 50 cases with dilated cardiomyopathy and 106 cases with normal lipids are enrolled in this study. Serum lipids are estimated enzymatically. Radio immunassay is used for the detection of apolipoproteins. Results The levels of serum lipids and apolipoproteins are commonly lower, the levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and apolipoprotein A-I (Apo AI) are significantly lower(P< 0.05), especially in DCM group, the abnormal lipid prevalence of TC, LDL-C and apolipoprotein B (Apo B) are 40.0%, 40.0%, 70.0% respectively. Compared with the control group, the levels of TC, TG, HDL-C and Apo AI in RHD group and DCM group are significantly lower(all P< 0.05). The levels of LDL-c and Apo B are significantly lower in the DCM group at the same time(P< 0.01, P< 0.05 respetively). Compared with RHD group, the levels of LDL-C and Apo B are significantly lower in DCM group(P< 0.05, P< 0.001 respetively). Conclusions The levels of serum lipids and apolipoproteins are lower in RHD and DCM groups compared with control group, especially in DCM group. The low levels of serum lipids with apolipoproteins may have influence in prognosis of these diseases. So the patients should not be blindly lowered their lipids in RHD and DCM groups.