Porušeno ravnovesje lipidov v serumu v povezavi s srčnim infarktom : diplomska naloga

Olup, Eva (author), Osredkar, Joško (mentor)

Preučevali smo serumske koncentracije označevalca srčnomišične poškodbe (troponin I) in maščob (celokupni holesterol, holesterol nizke in visoke gostote ter trigliceride). V študijo smo zajeli serume pacientov s sumom na akutni srčnomišični infarkt. Razdelili smo jih v dve skupini; 1. skupina obsega 75 pacientov, ki so imeli serumske koncentracije troponina I nižje od 0,1 μg/L; 2. skupina obsega 139 pacientov, ki so imeli koncentracije troponina I v serumu ≥ 0,1 μg/L. Analizo troponina I smo izvajali na aparatu ADVIA Centaur in ADVIA Centaur XP, analize maščob pa na aparatu »Roche/Hitachi 917«. Koncentracijo troponina I smo določali z imunokemijsko metodo z uporabo direktne kemiluminiscenčne tehnologije, koncentracije maščob pa z encimsko kolorimetrično metodo. 1. skupina pacientov je imela vrednosti troponina I znotraj normalnih vrednosti, akutnega srčnomišičnega infarkta laboratorijsko nismo potrdili. 2. skupina pacientov je imela vrednosti troponina I povišane, pri njih smo potrdili prisotnost infarktnega stanja. Paciente 1. in 2. skupine smo primerjali glede na izmerjene vrednosti posameznih maščobnih parametrov in njihovih razmerij. Skupina 1 je imela v primerjavi s skupino 2 po pričakovanju višje povprečne vrednosti holesterola visoke gostote v serumu in tudi manjšo pogostost prisotnosti znižanih vrednosti holesterola visoke gostote. Kljub relativno nizkim vrednostim celokupnega holesterola smo v 2. skupini izmerili tudi povprečno nižje vrednosti razmerja celokupni holesterol/holesterol visoke gostote. Znižane vrednosti holesterola visoke gostote predstavljajo manjše vrednosti celokupnega holesterola, zato so lahko meritve celokupnega holesterola zavajajoče in ne predstavljajo realnega stanja maščob v krvi. Za pravilno interpretacijo je potrebno imeti poleg meritve celokupnega holesterola tudi vrednost holesterola visoke gostote. Po pričakovanju smo določili tudi večjo pogostost prisotnosti normalnih vrednosti vseh maščobnih frakcij v skupini 1. Ugotovili smo, da dejavnik tveganja za razvoj srčno-žilnih bolezni predstavljajo predvsem znižane vrednosti holesterola visoke gostote (ter posledično zvišano razmerje celokupni holesterol/holesterol visoke gostote in znižano razmerje holesterol visoke gostote/holesterol nizke gostote). Z ustreznim uravnavanjem nivoja holesterola visoke gostote v krvi bi lahko pripomogli k zmanjšanju obolevanja in umrljivosti zaradi srčno-žilna obolenja.

• Language: Slovenian
• Keywords: srčno-žilne bolezni akutni srčnomišični infarkt srčni troponin lipidi metabolizem maščob analizni postopki dislipidemija zdravljenje
• Work type: Undergraduate thesis
• Typology: 2.11 - Undergraduate Thesis
• Organization: FFA - Faculty of Pharmacy
• Place of publishing: Ljubljana
• Publisher: [E. Voh Olup]
• Year: 2011
• Number of pages: 66 f.
• PID: 20.500.12556/RUL-121333
• UDC: 616-074
• COBISS.SI-ID: 3013745
• Publication date in RUL: 05.10.2020

Secondary language

• Language: English
• Title: Lipid imbalance in relation to heart attack

Abstract

We studied the concentrations of the serum marker of the heart muscle damage (cTn-I) and the concentration of lipids (HDL, LDL, TG and S-hol.). The study includes serums of patients with suspected AMI. We split them into two groups. First group consisted of 75 patients who had serum levels of cTn-I less than 0.1 mg / L; Second group consisted of 139 patients who had cTn-I concentrations in serum within ≥ 0.1 mg / L. CTn-I analysis was performed by the ADVIA Centaur apparatus and ADVIA Centaur XP. Fat analysis was performed on the "Roche / Hitachi 917" device. The CTn-I concentration was determined by immunochemical method, more precisely by using direct chemiluminescent technology. The concentrations of fat were determined by enzymatic colorimetric method. The cTn-I levels were within the normal range in the first group of patients and AMI was not laboratory confirmed. The second group of patients had the values of cTn-I increased and within this group we have confirmed the state of presence of infarction. We compared the measured values of individual fatty parameters and their relationships of the two groups. As expected, the first group had higher average levels of serum HDL than the second group and the first group also had lower frequency of the presence of reduced levels of HDL. We measured the lower values of the average ratio S-hol./HDL despite the relatively low levels of S-hol. Reduced levels of the HDL represent lower values of S-hol.. Therefore, the measurementns of the S-hol can be misleading and do not represent the realistic values of fat in the blood. In order to get correct interpretation of the data, we must always measure the value of HDL in addition to the measurement of S-hol. The relation between these two values is of great importance. We have also identified a higher frequency of normal levels of fatty fractions in the first group as expected. It has been established that the risk factor of atherosclerosis and cardiovascular disease are mainly reduced levels of HDL (and therefore increased ratio of S-hol./HDL and a reduced ratio of HDL / LDL). With the controlling of HDL levels in the blood we could help reduce the incidence and mortality caused by cardiovascular diseases.