血清载脂蛋白水平对急性冠脉综合征患者预后的预测价值  

Predictive Value of Apolipoprotein to Cardiovascular Outcome in Patients With Coronary Heart Disease

作　　者：管文娟[1] 严晓伟[1] 王晋峰[1] 范中杰[1] 方全[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院心内科,北京市100730

出　　处：《中国循环杂志》2008年第2期94-97,共4页Chinese Circulation Journal

摘　　要：目的:回顾性研究急性冠脉综合征患者住院时载脂蛋白(Apo)Al、ApoB、ApoB/ApoAl与出院后再发心血管事件的相关性。方法:入选确诊的急性冠脉综合征患者589例。免疫比浊法测定的ApoAl、ApoB、ApoB/ApoAl、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和甘油三酯(TG)。并对上述患者进行追踪随访。统计学采用X^2检验、t检验、Logistic多元回归及ROC曲线分析等方法。结果:①ApoB、ApoB/ApoAl在再发生和未发生心血管事件患者间的差异具有统计学意义(P<0.01);②Logistic回归中OR值大于1的参数由大到小排列:ApoB、ApoB/ApoAl、TC、LDL-C;OR值<1的参数:ApoAl和HDL-C的OR值小于1;③ROC曲线下面积由大到小排列:ApoB>LDL-C>TC>TG,ApoAl≈HDL-C。结论:急性冠脉综合征患者发病后24h内ApoAl、ApoB和ApoB/ApoAl比值与出院后再发心血管事件具有显著的相关性。Objective： This retrospective cohort study was designed to analyze the correlation of apolipoprotein（Apo） A1, ApoB, ApoB/ ApoA1 to cardiovascular events of coronary heart disease （CHD） in patients admitted to our hospital from 2000 to 2004. Methods： Serum ApoA1, ApoB and ApoB/ApoA1 of 589 in-patients with definite diagnosis of CHD were measured during hospitalization. At the same time total cholesterol （TC）, hig-density lipoprotein cholesterol（HDL-C） ,low-density lipoprotein cholesterol （ LDL-C ） and triglycerides （TG） were tested. Results： ①ApoB and ApoB/ApoA1 had significant difference between groups with and without events during following-up （P 〈 0. 01 ）. ②In logistic regression analysis, ApoB 〉 ApoB/A1 〉 TC 〉 LDL-C （ OR 〉 1 ）, ApoA1 〉 HDL-C （ OR 〈 1 ）. ③ROC area under the curve： ApoB 〉 LDL-C 〉 TC 〉 TG, ApoA1≈HDL-C. Conclusion： ApoA1, ApoB and ApoB/ApoA1 are prior to TC, TG, LDL-C and HDL-C in predicting cardiovascular events in patients with acute coronary syndrome,

关 键 词：载脂蛋白A1 载脂蛋白B 急性冠脉综合征 预后 

分 类 号：R541[医药卫生—心血管疾病]