中原地区冠心病患者ApoB/ApoAI比值预测冠状动脉病变的价值研究  

ApoB/ApoAI ratio predicts the stenosis of coronary artery in patient with coronary heart disease in central region of China

作　　者：刘静静[1] 高传玉[1] 王宪沛[2] 李牧蔚[2] 刘军[2] 王地[2] 

机构地区：[1]郑州大学第一附属医院心内科,郑州450052 [2]郑州大学附属人民医院心内科

出　　处：《临床心血管病杂志》2013年第9期671-674,共4页Journal of Clinical Cardiology

摘　　要：目的：探讨中原地区载脂蛋白ApoB/ApoAI比值与冠心病冠脉动脉（冠脉）狭窄程度的相关性。方法：对1 015例拟诊冠心病患者行冠脉造影,将其分为冠脉组（770例）和对照组（245例）,Gensini积分（GS）系统评价冠脉病变程度。分析血脂特点及其与GS积分的相关性。结果：①LDL-C、LDL-C/HDL-C、ApoB、ApoB/ApoAI、Lp（a）冠心病组中显著高于对照组（P〈0.05）。②ApoB/ApoAI（r=0.186）、LDL-C（r=0.149）、Lp（a）（r=0.194）、ApoB（r=0.166）与GS积分呈显著正相关（P〈0.05）。③ApoB/ApoAI（B=30.129,P=0.021）,Lp（a）（B=0.355,P=0.023）进入GS方程,是GS独立决定因子。④Logistic多元回归分析ApoB/ApoAI,Lp（a）的OR分别为12.410,1.029（P〈0.05）,是冠心病的独立预测因素。⑤ApoB/ApoAI的ROC曲线面积最大（0.647;95%CI,0.559~0.735;P=0.002）,此研究人群诊断冠心病的最佳分界点0.885。结论：ApoB/ApoAI能预测中原地区冠心病的发生、评估冠脉粥样硬化严重程度。Objective： To explore whether ApoB/ApoAI ratio was associated with the severity of coronary artery in patient with coronary heart disease （CHD） in central plains region of China. Method： The 1015 subjects who were suspected CHD underwent coronary angiography （CAG） and were divided into CHD group （n = 770） and control group （n= 245）. The severity of coronary artery was evaluated by Gensini score （GS）. The feature of lipid profile and its correlation with GS were tested. Result： （i）LDI. C, LDL C/HDL C, ApoB, ApoB/ApoAI, Lipoprmein（a） in CHD group were significantly higher than those in control group （P〈0.05）. （2）GS was signifi- cantly associated with ApoB/ApoAI （r =0.186）, LDL-C （r=0.149）, Lp（a） （r=0.194）, ApoB （r 0.166） （P〈0.05）. （3）OnlyApot3/ApoAI ratio （B：30.129, P：0.021） and Lp（a） （B=0.355, P=0.023） remained independently associated with GS in a multiple linear stepwise regression analysis after adjusting for confounder. （4）Logistie multivariate regression analysis showed that ApoB/ApoAI （OR=12. 410）, Lp（a） （OR=1. 029） were remained as independent predictors in the present of CHD. （5）ApoB/ApoAI had the highest receiver operator char- acteristic curve （ROC） area （0.647; 95%CI： 0.559--0.735; P：0.002）. The best cutoff level for the subjects was 0. 885 in predicting CHD. Conclusion： ApoB/ApoAI ratio could predict the incidence of CHD and the extension of coronary atheroselerosis in the central plains region of China.

关 键 词：冠心病 APOB APOAI GENSINI积分 冠脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]