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1、LABORATORYEVALUATIONOFTHEROSCLEROSISANDACUTECORONARYSYNDROMER.MohammadiBiochemist(Ph.D.)FacultymemberofMedicalFacultyCORONARYHEARTDISEASECORONARYARTERYOBSTRUCTIONMAINCOMPONENTSOF VASCULARWALLINTIMALTHICKENINGMAJORCOMPONENETSOF ATHEROMATOUSPLAQUEPATHOGENESISOFAT
2、HERSCLEROSISCELLULAREVENTS& CELLULARINTERACTIONSRISKFACTORSFORCHDClinicalRiskFactorsLaboratoryRiskFactorsCLINICALRISKFACTORSLABORATORYRISKFACTORSCommonLipidMarkersIncludingTC,HDL-C,LDL-C&TGUncommonLipidMarkersIncludingLp(a),beta-VLDL,ApoA-I&ApoB-100NonlipidMark
3、ersIncludingHomocysteine&hsCRPSOURCESOFRESULTVARIABILITYINLIPIDMEASURMENTAnalyticalErrorPhysiologicVariationFastingDiseasesDrugsPostureVenousvs.CapilarySamplesPlasmavs.SerumStorageANALYTICALERROR%TotalError=%Bias+1.96(%CV)BIOLOGICALVARIATIONSDuetoAge,Gender,Die
4、t,SeasonFASTINGFastingforatLeast9HoursIsNecessaryforTGFastingIsNotNecessaryforTCSlightDecreaseofLDL-C&HDL-CAfterEatingDIEASESMyocardialInfarctionShockTraumaSurgeryWeightloseFeverThyroidDiseaseLiverDiseaseKidneyDiseaseDRUGSOralContraceptiveIncreasesVLDLAnabolics
5、teroidsIncreaseVLDL&DecreaseHDLPOSTURE&OCCLUSIONTG,TC&LipoproteinsIncreaseinStandingPositionProlongedVenousOcclusionHasSimilarEffectVenousvs.CapilaryMeasurementsinCapilaryBloodSampleSeemtoBeaLittleLowerThanVenousSamplePLASMAvsSERUMSerum&PlasmaCanbeUsedPlasmaIsP
6、referredforElectrophoresis&UltracentrifugationEDTAIsPreferred,ButtheResultsAreLowerHeparinCanAlsoBeUsedProteinAggregationOccursInPlasmaSTORAGEItIsRecommendedtoAnalyzeatDayofSampleCollectionSamplesCanBeStoredinRefrigeratororFreezerANALYTICALAPPROACH INLIPIDSABNO
7、RMALITIES1)LIPIDSDETERMINATIONS2)LIPOPROTEINANALYSISLIPIDSDETERMINATIONCholesterolsTriglyceridesPhospholipidsFreeFattyAcids(FFAs)TotalSerumLipidsCHOLESTEROLDETERMINATIOMChemicalLiberman-BurchardSchoenheimer-SperryAbell-KendalCHOLESTEROLDETERMINATIOMEnzymaticCho
8、lesterylEsterCholesterol+FFACholesterol+O2OixidizedCholesterol+H2O2H2O2+ChromogenColoredComplex+H2OChoesterylEsteraseChoesterolOxidasePeroxidaseCHOLESTEROLDETERMINATIOMSampl
