高密度脂蛋白功能改变对心血管疾病和围手术期心血管保护的影响
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(1.哈尔滨医科大学,黑龙江省哈尔滨市150081;2.中山大学附属第一医院心脏外科,广东省广州市 510080;3.血管疾病诊治技术国家地方联合工程实验室(广东) 国家卫健委辅助循环重点实验室(中山大学) 广东省血管疾病诊治工程技术研究中心 广东省脑功能与脑疾病重点实验室,广东省广州市 510080;4.中山大学附属第一医院高血压血管病科,广东省广州市 510080)

作者简介:

区乐淳,研究方向为临床医学,E-mail为lechunou@163.com。通信作者欧志君,博士,主任医师,研究方向为心血管疾病,E-mail为Zhijunou@163.com。

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基金项目:

国家自然科学基金项目(81670392、81830013、81970363);国家科技部国际合作专项(2015DFA31070);广东省自然科学基金研究团队项目(2015A030312009)


Effects of high density lipoprotein function change on cardiovascular diseases and perioperative cardiovascular protection
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1.Harbin Medical University, Harbin, Heilongjiang 150081, China;2.Division of Cardiac Surgery, Heart Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China;3.National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases & NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University) & Guangdong Provincial Engineering and Technology Center for Diagnosis and Treatment of Vascular Diseases & Guangdong Provincial Key Laboratory of Brain Function and Disease, Guangzhou, Guangdong 510080, China;4. Division of Hypertension and Vascular Diseases, Heart Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China)

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    摘要:

    高密度脂蛋白(HDL)成分复杂,功能容易发生变异。正常HDL是一种保护性脂蛋白,有保护心血管的功能。但最近研究发现HDL成分和功能不但在冠心病、心脏瓣膜病变、动脉瘤、心功能不全等心血管疾病状态下发生改变,而且在心血管手术围手术期也发生改变。正常人的HDL趋炎指数很低,但心血管疾病状态下HDL趋炎指数变得很高,损伤血管内皮功能,影响心脏手术后血流动力学的稳定。载脂蛋白A-Ⅰ模拟肽、辛伐他汀等可部分改善HDL功能。如何改善HDL的功能,使其恢复保护心血管的作用,预防心血管疾病和增强围手术期心血管保护是将来的研究方向。

    Abstract:

    The composition of high density lipoprotein (HDL) is complex and its function is prone to change. Normal HDL is a protective lipoprotein, which can protect cardiovascular function. However, recent studies have found that HDL composition and function change not only in coronary heart disease, heart valve disease, aneurysm, heart failure, heart transplantation and other cardiovascular diseases, but also in the cardiovascular perioperative period. The HDL proinflammatory index in normal people is very low, but it becomes very high under the condition of cardiovascular disease, which impairs vascular endothelial function and affects the stability of hemodynamics after cardiac surgery. Apolipoprotein A-Ⅰ mimetic peptide and simvastatin can partially improve HDL function. Therefore, how to improve the function of HDL, and restore its protective cardiovascular effect to prevent cardiovascular diseases and enhance cardiovascular protection in perioperative period need to be studied in the future.

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区乐淳,彭月明,欧志君.高密度脂蛋白功能改变对心血管疾病和围手术期心血管保护的影响[J].中国动脉硬化杂志,2020,28(10):856~860.

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  • 收稿日期:2020-04-07
  • 最后修改日期:2020-08-25
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  • 在线发布日期: 2020-10-20