血清载脂蛋白A-1、载脂蛋白B和脂蛋白(a)与冠心病相关性的临床分析  

Clinical analysis of the correlation of serum apoA-1,apoB and lipoprotein(a) with coronary heart disease

作　　者：王晓晨[1] 徐岩[1] 程自平[1] 许邦龙[1] 陈斌[1] 陈旭华[1] 伍梦佐[1] 林先和[1] 朱润硕[1] 

机构地区：[1]安徽医科大学第一附属医院心内科,合肥230022

出　　处：《安徽医科大学学报》2009年第3期395-398,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的研究血清载脂蛋白A-1(apoA-1)、载脂蛋白B(apoB)和脂蛋白(Lp)(a)与冠心病(CHD)的关系。方法检测血清总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、apoA-1、apoB和Lp(a)浓度。采用logistic回归及偏相关方法分析apoA-1、apoB和Lp(a)与CHD的关系。结果CHD组血清apoB(0.97±0.26vs0.85±0.20g/L,P<0.01)、Lp(a)(194.88±15.46vs144.56±12.07mg/L,P<0.01)。浓度和apoB/apoA-1比值(0.91±0.31vs0.76±0.22,P<0.05)显著性高于对照组,apoA-1则相反(1.11±0.20vs1.14±0.20g/L,P<0.05)。多因素Logistic回归分析提示在血脂指标中只有apoB(OR4.67,95%CI1.67-13.06,P<0.01)、TG(OR1.34,95%CI1.08-1.80,P<0.01)和Lp(a)(OR1.03,95%CI1.01-1.05,P<0.01)是CHD的独立危险因子。偏相关分析发现apoB、Lp(a)及apoB/apoA-1值与冠脉病变支数及积分正相关,而apoA-1与之无关。结论血清apoB和Lp(a)是CHD的独立危险因子,且与冠脉病变的严重程度相关,apoA-1与CHD没有相关性。Objective To evaluate the correlation of serum apolipoproteinA-1 （ apoA-1 ）, apolipoproteinB （apoB） and lipoprotein （Lp） （a） with coronary heart disease （CHD）. Methods Serum total cholesterol （ TC ）, triglycerides（ TG）, low-density lipoproteins（ LDL）, high-density lipoproteiu（ HDL）, apoA-1, apoB and Lp（a） levels were measured. Logistic regression and partial correlation were used to find the correlation of serum apoA-1 , apoB, and Lp（a） with CHD. Results apoB（0. 97±0. 26 vs 0. 85±0.20 g/L,P 〈0.01）,Lp （a） （194.88±15.46 vs 144. 56±12. 07 mg/L,P 〈0. 01 ） level and apoB/apoA-1 ratio （0. 91±0. 31 vs 0. 76±0. 22,P 〈0. 01 ） were significantly higher in the CHD group than in the control group. But the apoA-1 level（ 1.11±0. 20 vs 1.14±0. 20 g/ L,P 〈0. 05） was significantly lower in the CHD group. Multivariate logistic regression analysis found that among lipid factors, only apoB （ OR 4. 67,95% CI 1.67 - 13.06, P 〈 0. 01 ）, TG （ OR 1.34,95 % CI 1.08 - 1.80, P 〈 0. 01 ）and Lp （a） （OR 1.03,95% CI 1.01 - 1.05 ,P 〈0. 01 ） were independently associated with CHD. The result of partial correlation analysis evaluated that apoB, apoB/apoA-1 ratio and Lp （a） were positively correlated to the number of lesions and gensini score of CHD. Conclusion Serum apoB and Lp （a） level are independent risk factors for CHD and significantly correlated with the severity of CHD. But apoA-1 is not associated with CHD.

关 键 词：载脂蛋白A-1类/血液 载脂蛋白B类/血液 脂蛋白A类/血液 冠状动脉病/病因学 

分 类 号：R543.3[医药卫生—心血管疾病] R341.35[医药卫生—内科学]