医药学论文：脂蛋白a与疾病的关系研究

【摘要】 目的 探讨血清脂蛋白(a)［Lp(a)］与疾病的关系。方法 以64例健康成年人的血清Lp(a)为正常对照，收集肛周脓肿23例，高血压病58例，冠心病25例，急性心肌梗死6例，脑出血10例，脑梗塞恢复期13例，糖尿病38例(血脂正常32例，血脂异常6例)，慢性肾炎7例，慢性肾功能衰竭27例，重症肝炎及肝硬化15例，恶性肿瘤58例，测定Lp(a),并分别与正常对照组进行比较。急性肾功能衰竭1例连续检测血清Lp(a)及Cr浓度。结果 肛周脓肿、高血压、冠心病、急性心肌梗死、脑出血、脑梗塞恢复期、糖尿病(血脂异常)、慢性肾功能衰竭、重症肝炎及肝硬化、恶性肿瘤等疾病与正常对照比较，差异有显著性(P＜0.05)，糖尿病(血脂正常)、慢性肾炎与正常对照比较，差异无显著性(P＞0.05)。急性心肌梗死与冠心病、脑出血、脑梗塞恢复期比较，差异有显著性(P＜0.05)，而冠心病、脑出血、脑梗塞恢复期之间相互比较，差异无显著性(P＞0.05)。结论 血清Lp(a)由肝脏合成，因此重症肝病及肝硬化患者的血清Lp(a)降低。血清Lp(a)受白细胞介素-6(IL-6)的调控，而IL-6则主要由内皮细胞分泌，因此疾病状态下血管(或微血管)的炎症或损伤可能就是这些疾病血清Lp(a)升高的共同原因。肿瘤细胞合成和分泌肿瘤坏死因子、γ-干扰素及IL-6等异常，这可能就是肿瘤患者血清Lp(a)升高的原因。

 

　　【关键词】 脂蛋白(a)；IL-6；血管损伤

 

　　The relationship between serum lipoprotein(a) and disease

 

　　　　【Abstract】 Objective To consult the relationship between lipoprotein(a) ［Lp(a)］ and disease.Methods Collected 64 normal persons as control group,determined their serum Lp(a).Collected perianal abscess 32 cases,hypertension 58 cases,coronary heart disease 25 cases,acute myocardial infarction 6 cases,cerebral hemorrhage 10 cases,convalescence of cerebral infarction 13 cases,diabetes millitus 38 cases (normal blood pressure 32 cases,abnormal blood pressure 6 cases),chronic nephritis 7 cases,chronic renal failure 27 cases,grave hepatitis or hepatocirrhosis 15 cases,malignancy 58 cases,determined their serum Lp(a),and compared them with control one.Acute renal failure 1 case determined it Lp(a) and Cr in time.Results Compared the perianal abscess,hypertension,coronary heart disease,acute myocardial infarction,cerebral hemorrhage,convalescence of cerebral infarction,diabetes mellitus (abnormal blood pressure),chronic renal failure,grave hepatitis or hepatocirrhosis,malignancy with the control group,there had distinctive defference between them (P＜0.05).Compared the diabetes mellitus(normal blood pressure) and chronic nephritis with control group,there had no distinctive defference between them (P＞0.05).Compared acute myocardial infarction with coronary heart disease,cerebral hemorrhage,convalescence of cerebral infarction,there had distinctive defference between them (P＜0.05),but there had no distinctive defference amount coronary heart disease,cerebral hemorrhage and convalescence of cerebral infarction (P＞0.05).Conclusion The serum Lp(a) is synthesize at liver,so the serum Lp(a) of grave hepatitis or hepatocirrhosis are decrease.Serum Lp(a) is controlled by IL-6,and IL-6 is excreted mainly from endothelium,so the inflammation or damage of blood vessel (or capillary vessel) in disease may be the reason of the increase serum Lp(a) in all this disease.Tumor cell synthesized and excreted tumor necrosis factor (TNF),interferon-γ(IFN-γ) and IL-6 abnormally,it may be the reason why the serum Lp(a) increase in tumor.