上海交通大学学报(医学版)

• 论著(临床研究) • 上一篇    下一篇

Apo B和Apo AⅠ/Apo B比值在家族性高胆固醇血症与家族性混合型高脂血症鉴别诊断中的作用

颜丽1,付晓艳1,周珊珊2,刘维娟3,何津祥1,4,何津春1,5   

  1. 1.兰州大学第一临床医学院, 兰州 730000; 2.河北省儿童医院检验科, 石家庄 050000; 3.临汾市人民医院检验科, 临汾 041000; 4.兰州大学第一医院放疗科, 兰州 730000; 5.兰州大学第一医院医学检验中心, 兰州 730000
  • 出版日期:2016-05-28 发布日期:2016-05-26
  • 通讯作者: 何津春, 电子信箱: jinchunhe@163.com。
  • 作者简介:颜丽(1990—), 女, 硕士生; 电子信箱: yanlilzu@163.com。
  • 基金资助:

    国家“十五”重大科技专项(2002BA711A08-17);教育部科技基础平台建设(505015);甘肃省自然科学研究基金(1308RJZA218,1302FKDA034)

Value of Apo B and ratio of Apo AⅠ/Apo B in differential diagnosis between familial hypercholesterolemia and familial combined hyperlipidemia

YAN Li1, FU Xiao-yan1, ZHOU Shan-shan2, LIU Wei-juan3, HE Jin-xiang1,4, HE Jin-chun1,5   

  1. 1.First Clinical School of Lanzhou University, Lanzhou 730000, China; 2.Department of Laboratory Medicine, Childrens Hospital of Hebei Province, Shijiazhuang 050000, China; 3.Department of Laboratory Medicine, Peoples Hospital of Linfen, Linfen 041000, China; 4.Department of Radiotherapy, First Hospital of Lanzhou University, Lanzhou 730000, China; 5.Department of Laboratory Medicine, First Hospital of Lanzhou University, Lanzhou 730000, China
  • Online:2016-05-28 Published:2016-05-26
  • Supported by:

    National Science and Technology Major Project of the Ministry of Science and Technology of China during the“10th Five-Year Plan”,2002DA711A028-17;Science and Technology Foundation Construction of Ministry of Education,505015; Natural Science Foundation of Gansu Province,1308RJZA218,1302FKDA034

摘要:

目的 分析家族性高胆固醇血症(FH)家系与家族性混合型高脂血症(FCHL)家系成员之间血脂水平及肾功能指标的差异,探寻用于FH和FCHL鉴别诊断的指标。方法 收集符合诊断标准的FH家系6个(共47人),FCHL家系23个(共94人),正常对照组家系10个(共57人),在FH家系和FCHL家系内又分为血脂升高的受累组和血脂正常的未受累组,比较各组之间的血脂水平和肾功能指标(包括CO2CP、BUN、Cr、BUN/Cr、UA)。结果 FH家系受累组TC、HDL-C 、LDL-C及Apo B水平均明显高于未受累组和对照组,Apo AⅠ/Apo B比值明显低于未受累组和对照组,LP(a)、BUN和Cr水平也高于未受累组和对照组,TAG水平高于未受累组和对照组,差异均有统计学意义。FCHL家系受累组TC、TAG、LDL-C及Apo B水平均明显高于未受累组和对照组,HDL-C水平高于未受累组和对照组,Apo AⅠ/Apo B比值明显低于未受累组和对照组,LP(a)和BUN水平也高于对照组,差异均有统计学意义。2个家系受累组间相比,FH家系LDL-C和Apo B水平明显高于FCHL家系,TC水平和Apo AⅠ/Apo B比值也高于FCHL家系,而TAG水平明显低于FCHL家系。结论 除常用的TC、TAG和LDL-C之外,Apo B和Apo AⅠ/Apo B有望成为FH与FCHL鉴别诊断的指标。

关键词: 家族性高胆固醇血症, 家族性混合型高脂血症, 载脂蛋白B , 载脂蛋白AⅠ

Abstract:

Objective To analyze the differences in lipid levels and renal function indexes between family members with familial hypercholesterolemia (FH) and familial combined hyperlipidemia (FCHL) and investigate indexes that may be used for the differential diagnosis between FH and FCHL. Methods Six FH pedigrees (47 persons) and 23 FCHL pedigrees (94 persons) that met the diagnosis criteria and 10 normal control pedigrees (57 persons) were recruited. Persons in FH and FCHL pedigrees were assigned to the affected groups with elevated blood lipid levels and the non-affected groups with normal blood lipid levels. Blood lipid levels and renal function indexes (including CO2CP, BUN, Cr, BUN/Cr, and UA) were compared between groups.  Results The affected group in FH pedigrees had remarkably higher levels of TC, HDL-C, LDL-C, and Apo B, remarkably lower level of Apo AⅠ/Apo B, and higher levels of LP(a), BUN, Cr, and TAG as compared with the non-affected group and the control group. The differences were statistically significant. The affected group in FCHL pedigrees had remarkably higher levels of TC, TAG, LDL-C, and Apo B, remarkably lower level of Apo AⅠ/Apo B, and higher levels of HDL-C, LP(a), and BUN as compared with the non-affected group and the control group. The differences were statistically significant. The affected group in FH pedigrees had significantly higher levels of LDL-C and Apo B, higher levels of TC and Apo AⅠ/ Apo B, and significantly lower level of TAG as compared with the affected group in FCHL pedigrees. Conclusion In addition to commonly used indexes TC, TAG, and LDL-C, the Apo B level and the ratio of Apo AⅠ/Apo B are potential indexes for the differential diagnosis between FH and FCHL.

Key words: familial hypercholesterolemia, familial combined hyperlipidemia, apolipoprotein B; apolipoprotein AⅠ