低密度脂蛋白胆固醇的检测方法与标准化研究

:100730,　　··鄢盛恺　宋耀虹　　、,(LDL-C)(AS)、(CHD),LDL-CCHD。(NCEP)LDL-C。,LDL-C。、LDLLDL,(d)1.006～1.063kg/L。LDL(CE)、(PL)、(Pro)、(TG)38%、22%、21%、11%8%。LDL3,。LDLLDL(26nm),(1.04～1.06kg/L),LDL(small,denseLDL),BLDL;LDL(27nm),(1.02～1.03kg/L),LDL(large,buoyantLDL),ALDL;LDL[1]。LDLCHD,LDL,LDLAS,HDLTG。、LDL-CLDL-C、、apoB,、、、LDL,LDL。,。1.:(CDC)LDL-C(Beta-quantification,β-),NCEP[2,3]。HDL-C。VLDL(d1.006kg/L),d1.006kg/L(Chol),HDL-C。:[LDL-C]=[d1.006kg/LChol]-[HDL-C]。LDL-C,(a)[Lp(a)](IDL),。LDL-C。β-、、,。2.Friedewald:LDL-C,VLDL(VLDL-C/TG=0.2,mg/dl),、、。:(1)LDL-C=TC-HDL-C-TG/2.2(mmol/L)。(2)LDL-C=TC-HDL-C-TG/5(mg/dl)。LDL-CTC、TGHDL-C。FriedewaldLDL-C9.5%,TC、TGHDL-C[2]。,,。Friedewald:(1)CM。(2)TG4.52mmol/L(400mg/dl)。(3)β[Ⅲ(HLP)][3]。Planella[4]apoB、TCTGLDL-C,TG,。Planella:LDL-C=0.41TC-0.32TG+1.70apoB-0.27(TC、TGmmol/L,apoBg/L)。LDL-C1.45%,Friedewald(2.97%),β-。,β-96.8%,Friede-wald(93.0%)。TG,Friedewald。·328·ChinJMedLabSci,November1998,Vol21,No.6apoB,。3.:-、(PVS)。LDL,CholHDL-CVLDL-C,TCCholLDL-C。PVS,,pH3～8PVSChol,PVS。PVSLDL-C[5]。IDLLp(a)。Lp(a)LDL、,Lp(a)30%,Lp(a),LDL-CLp(a)×0.3(mg/L)。LDL-C,LDL-CLp(a),Lp(a),LDL-C[6]。。TG(4.52mmol/L),LDL。ReferenceDiagnosticsLDL-C,37°C10,,LDL。TCLDL-CLDL-C[7]。,,(、CV2.5%),Friedewald(r=0.942),β-。TG,。4.(ImmunoseparationMethod):Leary[8]1993,GenzymeDiagnos-ticsLDL-C。Sigma。200μlPEGapoE、apoAⅠ30μl(200nm),5～10,HDL(apoAⅠ/E)、IDL(apoE)、VLDL(apoE)CM(apoAⅠ/E);1200～12000×g(2200×g)5;,;,LDL-C。[2,8～10]。(、CV3%),,LDL-C。β-,TG,。,,。,LDL-C25%,50%～75%。Levinson[11],TG4.52mmol/LTG1.70～2.83mmol/L,FriedewaldLDL-C。TG4.52mmol/LLDL-C,ⅢHLPLDL-C。5.(Homogeneousassay):LDL-C,,。,,。(1)[12～14]:,。:11HDL、CMVLDL,Chol,,H2O2,LDL。2(2DSBmT),LDLChol,Trinder,Chol,LDL-C[12,13]。(Daiichi)DA-6101、GenzymeDiagnosticsN-genousTMLDL-C。(3μl),(、CV2.5%),4.52mmol/L,90%～110%,β-(r=0.958～0.992),VitC、、γ。TC、TG14.7mmol/L,20.5mmol/L,LDL-C。1α-、(DS500)、MgCl2、EMSEMOPS,2CHER、CHOD、、4-AA、POE-·329·199811216POPMOPS。α-DSMg2+,CMVLDL。-(POE-POP)HDL。LDL-C[14]。TG0.3～22.6mmol/Lβ-,15.5mmol/L,0.005mmol/L,97%～105%,、0.6812.9mmol/L,LDL-C10%7.8%,。(2)[15]:BoehringerMannheimPAMPSLDL。1HDL、CMVLDL(TG)。2[(PAMPS)],Mg2+,LDLPAMPSLDL-,LDL-C。β-(r=0.97),CV0.9%～5.7%(LDL-C1.25～8.40mmol/L),1.3～10.4mmol/L,CV4.7%,、,TG4.52mmol/L,31。Technicon。(3)PEG:PEG(CHER/PEG,CHOD/PEG)。1LDL,HDL、VLDL、CM,Chol,H2O2。2,LDL-C,LDL-C。(Kyowa)。。6.:,,()。HDL,Lp(a)、VLDLLDL,LDL,。TC,LDL-C[16]。HelenaREPLDL-C,VLDL-C、HDL-CLp(a)-C,。LDL-C,Lp(a),TG4.52mmol/LLDL-C。10.4mmol/L,0.065mmol/L。LDL-CCV1.3%～2.7%,CV3.7%,β-(r=0.998),6.0%。LDL-C13.3%,NCEP12.0%。、LDL-CLDL-C,LDL-C。LDL-C,。LDL-C、。1.:LDL-C(CVb)(CVa),LDL-CCVb6%～11%(8.2%),CVa3%～7%(4%)。NCEPLDL-C,≤12%;CV≤4%,≤4%(β-)。2.:LDL-C,LDL-C。LDL-C1°,NCEPCDCβ-,2°CDC(NISTSRM1951a,CAPRM026)。CDC,(CRMLN)(LSP)CDC,。,(LDL),,。CDCLDL-C,LDL-C(1.6%),LDL-C,,LDL-C[17]。,,,LDL-C。·330·ChinJMedLabSci,November1998,Vol21,No.6,,LDL-C。LDL-C,。、,;。LDL-C。3.:NCEPLDL-C,LDL-C,LDL-C,、、。NCEPCDCβ-,Friedewald。(PVS)LDL-C,,,。TC,LDL-C。,。LDL-C,。:1HokansonJE,AustinMA,BrunzellJD.Measurementandclinicalsignificanceoflow-densitylipoproteinsubclasses.In:RifaiN,War-nickGR,DominiczakMH,eds.Handbookoflipoproteintesting.WashingtonDC:AACCPress,1997.267-282.2BachorikPS.Measurementoflow-densitylipoproteincholesterol.In:RifaiN,WarnickGR,DominiczakMH,eds.Handbookoflipoproteintesting.WashingtonDC:AACCPress,1997.145-160.3BachorikPS,RossJW.NationalCholesterolEducationProgramrecommendationsformeasurementoflow-densitylipoproteincholes-terol:executivesummary.ClinChem,1995,41:1414-1420.4PlanellaT,CortesM,Martinez-BruC,etal.CalculationofLDL-cholesterolbyusingapolipoproteinBforclassificationofnonchy-lomicronemicdyslipemia.ClinChem,1997,43:808-815.5.().,1995,18:381-382.6,,,.(a).,1995,23:421-423.7LawlorJ,PelczarD,SaneR.PerformancecharacteristicsoftheLi-pidirectmagneticLDLcholesterolreagent.ClinChem,1997,43:262-270.8LearyET,TjerslandG,WarnickGR.EvaluationoftheGenzymeimmunoseparationreagentfordirectquantitationofLDLcholes-terol.ClinChem,1993,39:1124-1131.9MaitraA,HiranySV,JialalI.Comparisonoftwoassaysformea-suringLDLcholesterol.ClinChem,1997,43:1040-1047.10PisaniT,GebskiCP,LearyET,etal.Accuratedirectdetermina-tionoflow-densitylipoproteincholesterolusinganimmunosepara-tionreagentandenzymaticcholesterolassay.ArchPatholLabMed,1995,119:1127-1135.11LevinsonSS,MaciejkoJJ.DirectmeasurementofLDLcholesterol.ClinChem,1996,42:780-781.12NakomuraM,TaniguchiY,YamamotoM,etal.HomogeneousassayofserumLDL-cholesterolonanautomaticanalyzer.ClinChem,1997,43:260-261.13HalloranP,PisaniT,LongS.AhomogeneousassayforthedirectmeasurementofLDL-cholesterolinserum.ClinChem,1997,43:254-258.14SugiuchiH,IrieT,UjiY,etal.Homogeneousassayformeasuringlow-densitylipoproteicholesterolinserumwithtrilockcopolymerandα-cyclodextrinsulfate.ClinChem,1998,44:522-531.15FujitaS,MoriwakiK,KatayamaY,etal.Evaluationofahomoge-neousassaymethodforserumLDL-cholesterol.ClinChem,1997,43:263-267.16WarnickGR,LearyET,GoetschJ.ElectrophoreticquantitationofLDL-cholesterolusingtheHelenaREP.ClinChem,1993,39:1122-1126.17,..,1998,21:13-15.(:1997-12-15　　:1998-06-09)(:)··　　19799,,。、,,、。、、、、。,1664,7.00,28.00,18-61。。:050017,361。:[phone]-6984;:[phone]