Superko H R, Haskell W L, Di Ricco C D
Lipid Research Clinic, Stanford University School of Medicine, California.
Am J Cardiol. 1990 Nov 1;66(15):1131-4. doi: 10.1016/0002-9149(90)90517-5.
Atherosclerosis is the leading obstacle to long-term survival in cardiac transplant patients. Increases in plasma triglycerides and lipoprotein cholesterol levels occur after transplantation that may contribute to transplant atherosclerosis. The etiology of this increase is unclear. We investigated the interaction of immunosuppressive medications with plasma triglycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, the HDL subclasses HDL2 and HDL3 cholesterol, and hepatic and lipoprotein lipase activity in 72 consecutive cardiac transplant patients compared to 51 healthy control subjects. In the transplantation group, greater concentrations of plasma triglyceride (80%, p less than 0.001), LDL cholesterol (16%, p less than 0.005) and hepatic lipase activity (100%, p less than 0.001) were noted, whereas lipoprotein lipase activity was noted to be significantly lower (124%, p less than 0.001). No difference was detected in HDL, HDL2, or HDL3 cholesterol. Cyclosporine dose was significantly associated with hepatic lipase activity (r = 0.33, p less than 0.02) and inversely associated with lipoprotein lipase activity (r = -0.28, p less than 0.05). Lipoprotein lipase activity after transplantation correlated inversely with triglycerides (r = -0.36, p less than 0.002) and positively with HDL cholesterol (r = 0.23, p less than 0.05) and HDL2 cholesterol (r = 0.29, p less than 0.05). Hepatic lipase activity correlated inversely with LDL cholesterol (r = -0.21, p less than 0.08). In multiple regression analysis, cyclosporine dose was the major source of variation in hepatic lipase activity.
动脉粥样硬化是心脏移植患者长期生存的主要障碍。移植后血浆甘油三酯和脂蛋白胆固醇水平升高，这可能导致移植相关性动脉粥样硬化。这种升高的病因尚不清楚。我们研究了72例连续的心脏移植患者与51名健康对照者相比，免疫抑制药物与血浆甘油三酯、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇、HDL亚类HDL2和HDL3胆固醇以及肝脂酶和脂蛋白脂酶活性之间的相互作用。在移植组中，血浆甘油三酯（80%，p<0.001）、LDL胆固醇（16%，p<0.005）和肝脂酶活性（100%，p<0.001）的浓度更高，而脂蛋白脂酶活性显著降低（124%，p<0.001）。HDL、HDL2或HDL3胆固醇未检测到差异。环孢素剂量与肝脂酶活性显著相关（r = 0.33，p<0.02），与脂蛋白脂酶活性呈负相关（r = -0.28，p<0.05）。移植后脂蛋白脂酶活性与甘油三酯呈负相关（r = -0.36，p<0.002），与HDL胆固醇（r = 0.23，p<0.05）和HDL2胆固醇（r = 0.29，p<0.05）呈正相关。肝脂酶活性与LDL胆固醇呈负相关（r = -0.21，p<0.08）。在多元回归分析中，环孢素剂量是肝脂酶活性变化的主要来源。
