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[动脉粥样硬化与青少年血脂异常]

[Atherosclerosis and juvenile dyslipidemias].

作者信息

Calvani M

机构信息

Divisione Pediatrica, Ospedale Regionale San Camillo de Lellis, USL RM/10, Roma.

出版信息

Recenti Prog Med. 1994 Mar;85(3):204-11.

PMID:8184205
Abstract

Large-scale and systemic epidemiological, pathological and experimental studies emphasized and documented the childhood origin of atherosclerosis. There is increasing consensus that lipid levels in children to a large extent determine the rate of coronary artery disease (CAD) in the adult population. Minimal sudanophilic intimal deposits, and the presence of intracellular and extracellular lipid, and a slight increase in interstitial ground substance in 3 years of age or older patients are found. In the Bogalusa Hearth Study aortic fatty streaks were strongly related the antemortem levels of both total cholesterol and low-density lipoprotein cholesterol (LDL-C) independent of race, sex, and age, and were negatively correlated with the ratio of high-density lipoprotein (HDL-C) to low-density plus very-low-density lipoprotein cholesterol (LDL-C+VLDL-C). The potential for primary prevention is real and the strongest piece of evidence for its is the remarkable trend in CHD mortality rates in recent times, rapidly downward in many western countries. A number of factors influence plasma levels of lipid and lipoproteins in newborn, in infants, in children and adolescents and their relevance as possible predictors of adult coronary artery disease. They are certain inherited disorders of dyslipoproteinemia (familial hypercholesterolemia, familial combined hyperlipidemia, hyperapobetalipoproteinemia, and hypoalphalipoproteinemia) and secondary causes of hyperlipidemia (congenital biliary atresia, glycogen storage diseases, hypothyroidism, diabetes mellitus and nephrotic syndrome, etc).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

大规模系统性的流行病学、病理学及实验研究强调并证实动脉粥样硬化起源于儿童时期。越来越多的共识认为,儿童时期的血脂水平在很大程度上决定了成年人群冠状动脉疾病(CAD)的发病率。在3岁及以上的患者中发现了最小的嗜苏丹内膜沉积物、细胞内和细胞外脂质的存在以及间质基质的轻微增加。在博加卢萨心脏研究中,主动脉脂肪条纹与生前总胆固醇和低密度脂蛋白胆固醇(LDL-C)水平密切相关,与种族、性别和年龄无关,且与高密度脂蛋白(HDL-C)与低密度加极低密度脂蛋白胆固醇(LDL-C+VLDL-C)的比值呈负相关。一级预防具有现实可能性,最有力的证据是近年来冠心病死亡率的显著趋势,在许多西方国家呈迅速下降趋势。许多因素会影响新生儿、婴儿、儿童及青少年的血脂和脂蛋白水平,以及它们作为成人冠状动脉疾病可能预测指标的相关性。这些因素包括某些遗传性脂蛋白异常血症(家族性高胆固醇血症、家族性混合性高脂血症、高载脂蛋白血症和低α脂蛋白血症)以及高脂血症的继发性病因(先天性胆道闭锁、糖原贮积病、甲状腺功能减退、糖尿病和肾病综合征等)。(摘要截选至250词)

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