Miwa K, Nakagawa K, Suzuki K, Inoue H
The Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
Clin Cardiol. 2001 Mar;24(3):219-24. doi: 10.1002/clc.4960240309.
Dyslipidemia in patients with coronary vasospasm has been characterized by a low level of high-density lipoprotein (HDL) cholesterol without elevation of low-density lipoprotein (LDL) cholesterol, distinct from patients with organic coronary artery disease.
Disordered triglyceride-rich lipoprotein metabolism may be linked to the genesis of coronary artery spasm.
The incidence of the "midband" lipoprotein observed between very low-density lipoprotein (VLDL) and LDL bands in the polyacrylamide disc gel electrophoretic analysis was determined in 48 patients with coronary spastic angina (CSA), in 50 patients with stable effort angina and a significant fixed coronary stenosis (SEA), and in 40 control subjects without coronary artery disease (Control).
The incidence was significantly (p<0.05) higher in CSA (71%) than in SEA (50%) and Control (25%). Smoking was significantly (p < 0.05) more prevalent in CSA (77%) than in SEA (50%) and Control (50%). In SEA, serum levels of triglyceride and apoproteins C-II, C-III, and E were all significantly higher, and the serum level of HDL cholesterol was significantly lower in the midband-positive than in the midband-negative subgroup. In CSA, no significant differences were found in these serum levels between the midband-positive and -negative subgroups, except for a significantly (p < 0.05) lower level of HDL cholesterol in the former. However, a significantly (p < 0.05) higher incidence of diabetes mellitus or impaired glucose tolerance was noted in the midband-positive (41%) than in the midband-negative subgroup (7%) in CSA. The incidence of the detected midband lipoprotein was significantly decreased in the blood samples obtained from 20 of CSA after a > 6-month angina-free period (70-->25%, p < 0.05).
The midband lipoprotein was frequently detected in patients with coronary vasospasm, suggesting that dyslipidemia with disordered triglyceride-rich lipoprotein metabolism may be linked to the genesis of coronary artery spasm.
与有机性冠状动脉疾病患者不同，冠状动脉痉挛患者的血脂异常表现为高密度脂蛋白（HDL）胆固醇水平低，而低密度脂蛋白（LDL）胆固醇不升高。
富含甘油三酯的脂蛋白代谢紊乱可能与冠状动脉痉挛的发生有关。
在48例冠状动脉痉挛性心绞痛（CSA）患者、50例稳定劳力性心绞痛且有明显固定冠状动脉狭窄（SEA）的患者以及40例无冠状动脉疾病的对照者（对照组）中，测定聚丙烯酰胺圆盘凝胶电泳分析中在极低密度脂蛋白（VLDL）和LDL条带之间观察到的“中带”脂蛋白的发生率。
CSA组（71%）的发生率显著高于SEA组（50%）和对照组（25%）（p<0.05）。CSA组（77%）吸烟的发生率显著高于SEA组（50%）和对照组（50%）（p<0.05）。在SEA组中，中带阳性亚组的血清甘油三酯、载脂蛋白C-II、C-III和E水平均显著更高，而高密度脂蛋白胆固醇血清水平显著低于中带阴性亚组。在CSA组中，除了前者的高密度脂蛋白胆固醇水平显著更低（p<0.05）外，中带阳性和阴性亚组之间在这些血清水平上未发现显著差异。然而，CSA组中带阳性亚组（41%）的糖尿病或糖耐量受损发生率显著高于中带阴性亚组（7%）（p<0.05）。在20例CSA患者无心绞痛超过6个月后的血样中，检测到的中带脂蛋白发生率显著降低（70%-->25%，p<0.05）。
冠状动脉痉挛患者中经常检测到中带脂蛋白，提示富含甘油三酯的脂蛋白代谢紊乱的血脂异常可能与冠状动脉痉挛的发生有关。
