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目的:探讨高脂脾虚及单纯高脂血症患者血浆高密度脂蛋白亚类分布特征及与血脂水平的关系。方法:采用双向电泳-免疫印迹检测法分析40例高脂脾虚、50例单纯高脂血症患者以及68例正常对照者血浆HDL亚类的组成及含量。结果:与正常组比较,单纯高脂血症组及高脂脾虚组BMI、TC、TG、LDL-C水平显著增加(P<0.01)、HDL-C水平显著减少(P<0.01);高脂脾虚组Glu水平较正常组显著增加(P<0.05)、apoA-I水平显著减少(P<0.05)。高脂脾虚组BMI、LDL-C水平较单纯高脂血症组显著增加(P<0.05或P<0.01),HDL-C水平较单纯高脂血症组显著减少(P<0.01)。HDL亚类分析结果显示,与正常组比较,单纯高脂血症组及高脂脾虚组小颗粒preβ2-HDL含量显著增加(P<0.01)、而大颗粒HDL2b含量显著减少(P<0.01);高脂脾虚组小颗粒HDL3a较正常组显著增加(P<0.05)。高脂脾虚组大颗粒HDL2b含量较单纯高脂血症组显著减少(P<0.05)。相关分析发现,高脂脾虚组血浆TC与preβ1-HDL、preβ2-HDL含量显著正相关(P<0.01),与HDL2b含量显著负相关(P<0.05);TG与preβ1-HDL、preβ2-HDL、HDL3c含量显著正相关(P<0.05),与HDL2a、HDL2b含量显著负相关(P<0.05或P<0.01)。血浆HDL-C与HDL2a、HDL2b含量显著正相关(P<0.05)、与preβ1-HDL、preβ2-HDL含量显著负相关(P<0.05)。结论:单纯高脂血症及高脂脾虚患者血浆HDL颗粒直径均呈变小趋势,后者变化程度更加明显,这可能是“脾失健运”的微观体现。
Objective: To investigate the distribution of plasma high-density lipoprotein (PCD) subtypes in patients with hyperlipidemia and hyperlipidemia and the relationship with plasma lipid levels. Methods: The composition and content of plasma HDL subclasses in 40 patients with hyperlipidemia and spleen deficiency, 50 patients with simple hyperlipidemia and 68 normal controls were analyzed by two-dimensional electrophoresis and immunoblotting. Results: Compared with normal group, the levels of BMI, TC, TG and LDL-C in hyperlipidemia group and hyperlipidemia group were significantly increased (P <0.01) and HDL-C levels were significantly decreased Glu level in spleen deficiency group was significantly higher than that in normal group (P <0.05), apoA-I level was significantly decreased (P <0.05). The levels of BMI and LDL-C in hyperlipidemia and spleen deficiency group were significantly higher than those in hyperlipidemia group (P <0.05 or P <0.01), and the levels of HDL-C in hyperlipidemia and spleen deficiency group were significantly decreased (P <0.01). HDL subclass analysis showed that compared with the normal group, the content of preβ2-HDL in the hyperlipidemia group and the hyperlipidemic spleen deficiency group increased significantly (P <0.01), while the content of HDL2b in the macrophage HDL2b group decreased significantly (P <0.01). The HDL3a of HDL3a in high fat spleen deficiency group was significantly higher than that in normal group (P <0.05). The content of HDL2b in large fat-spleen deficiency group was significantly lower than that in simple hyperlipidemia group (P <0.05). Correlation analysis showed that there was a significant positive correlation between plasma TC and prebeta1-HDL, prebeta2-HDL and HDL2b in hyperlipemia spleen deficiency group (P <0.05) HDL3c content was significantly and positively correlated (P <0.05), and HDL2a, HDL2b content was significantly negative correlation (P <0.05 or P <0.01). Plasma HDL-C was significantly and positively correlated with HDL2a and HDL2b levels (P <0.05), but negatively correlated with the levels of preβ1-HDL and preβ2-HDL (P <0.05). Conclusion: The plasma HDL particle diameter of patients with hyperlipidemia and hyperlipidemic spleen deficiency tended to decrease, and the latter changed more obviously. This may be the microscopic manifestation of “spleen loss of health”.