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ID:39145711
大小:1.61 MB
页数:76页
时间:2019-06-25
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1、动脉粥样硬化性心脑血管病脂代谢相关性生物标记物Biomarkersrelatedtolipidmetabolism威海市立医院李振光10-10-2015动脉粥样硬化性心血管疾病(CVD)心血管疾病是全球的头号死因(约占31%);估计740万死于冠心病,670万人死于中风;3/4以上CVD死亡发生在低、中等收入国家;早期发现高危人群并予以管理是改善预后的关键生物标记物在期中扮演重要角色。TRADITIONALCARDIOVASCULARRISKFACTORSMajor,classicortraditionalriskfactorsarethosedefined
2、fromtheFraminghamstudies;TheFraminghamcohortsbeganin1948,andaremilestonesintheidentificationofcardiovascularfactors.Includingage;sex;totalcholesterol,LDL-CandHDL-Clevels;systolicpressure;smoking;highbloodglucose;bodyweight;dietaryhabits;andphysicalinactivity.Basedonthesefindings,ca
3、rdiovascularriskscalesweredevelopedinordertoevaluatetheriskofaneventinaten-yearperiod.EmergingbiomarkersItisestimatedthatabout10to20%oftheindividualsthatsufferfromaneventdonotpresenttraditionalriskfactors,andthat60%ofthempresenttwoorlessfactors.Thesefindingsemphasizetheimportanceof
4、searchingforevidencethatemergingbiomarkersmaybetteridentifyplaquesthataremorevulnerabletorupture.AtherosclerosisdevelopsActivationoftheendotheliumandrecruitmentofimmunecells;Monocytedifferentiationandfoamcellformation;Developmentoffibroticplaquesduetodeathoffoamcellsandmigrationand
5、proliferationofsmoothmusclecells(SMCs);Plaqueruptureandthrombosis.AtherosclerosisdevelopsSecreteextracellularmatrix(ECM)proteinsthatstabilizestheplaques(fibrouscap).InflammatorymarkersforASSeveralinflammatorymarkersareaffiliatedwithlipidslevelandtheprocessofatherosclerosis.Themostk
6、nownofthemare:interleukin6andinterleukin1β;C-reactiveprotein;tumornecrosisfactor-alpha;pentraxin3(PTX-3);serumamyloidA;sCD40;adhesionmolecules;monocytechemoattractantprotein-1;sEndoglin;PAPP-A;chemokine16;insulinlikegrowthfactor;lipoprotein-associatedphospholipaseA2;galectin3;Adipo
7、nectin(脂联素);myeloperoxidase(MPO,髓过氧化物酶)BiomarkersrelatedtolipidmetabolismBiomarkersrelatedtolipidmetabolism(8)1、ModifiedLDLparticles;2、ApolipoproteinAI(apoAI);3、ApolipoproteinB;4、Lipoprotein(a)[Lp(a)];5、Cholesterylestertransferprotein(CETP);6、SubtypesofLDLandHDLparticles;7、Lipoprot
8、ein-associatedphospholipas
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