载脂蛋白B、AⅠ及二者比值与缺血性卒中患者颅内动脉粥样硬化性狭窄的相关性  

Association of ApoB, ApoA Ⅰ and ApoWApoA Ⅰ ratio with intracranial atherosclerotic stenosis in patients with ischemic stroke

作　　者：李焕敏[1] 李春光[2] 潘速跃[3] 

机构地区：[1]南方医科大学第三附属医院神经内科,广州510630 [2]南方医科大学珠江医院神经内科,广州510280 [3]南方医科大学南方医院神经内科,广州510515

出　　处：《国际脑血管病杂志》2015年第1期27-31,共5页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨载脂蛋白（apolipoprotein B，ApoB）、载脂蛋白AⅠ（apolipoprotein AⅠ，ApoAⅠ）和ApoB／ApoAⅠ比值与缺血性卒中患者颅内动脉粥样硬化性狭窄（intracranial atherosclerotic stenosis，ICAS）的关系。方法回顾性收集大动脉粥样硬化性卒中患者，基于血管影像学资料将患者分为ICAS组和非ICAS组，收集血压、血脂、血糖、ApoB、ApoAⅠ、ApoB／ApoAⅠ比值以及人口统计学资料，比较上述指标在两组之间的差异。结果共纳入360例大动脉粥样硬化性卒中患者，ICAS组177例（49．2％），非ICAS组183例（50．8％）。两组之间高血压、糖尿病和冠心病的患者构成比以及低密度脂蛋白胆固醇、ApoB、ApoAⅠ水平和ApoB／ApoAⅠ比值存在显著性差异（P均〈0．05）。多变量logistic回归分析显示，高血压[优势比（odds ratio，OR）1．75，95％可信区间（confidence interval，CI）1．04—2．93；P=0．035]、糖尿病（OR 2．09，95％CI 1．31～3．32；P=0．002）、冠心病（OR2．68，95％CI 1．09—6．57；P=0．031）以及ApoB≥0．84g／L（0．84～1．00g／L;OR 2．68，95％CI 1．30～5．56；1．00～1．16g／L：OR3．95，95％CI1．87～8．40；〉1．00g／L：OR6．41，95％CI 2．82～14．49）和ApoB／ApoAⅠ比值≥0．60（0．60～0．73：OR1．92，95％CI 1．14～3．24；0．74～0．91：OR1．79，95％CI 1．06～3．02；〉0．91：OR3．30，95％CI 1．92～5．67）为ICAS的独立危险因素，而ApoAⅠ〉1．28g／L为ICAS的独立保护因素（OR0．39，95％CI 0．16～0．98；P=0．044）。结论在急性缺血性卒中患者中，ApoB水平和ApoB／ApoAⅠ比值增高是ICAS的独立危险因素，而ApoAⅠ水平增高为ICAS的独立保护因素。ApoB／ApoAⅠ比值可作为中国人群缺血性卒中患者ICAS的生物学标记物。Objective To investigate the relationship between apolipoprotein B （ApoB）, apolipoprotein AⅠ （ApoAⅠ ） and their ratios and intracranial cerebral atherosclerotic stenosls （ICAS） in patients with acute ischemic stroke. Methods The patients with large artery atherosclerotic stroke were enrolled retrospectively. The patients were divided into either an ICAS group or a non-ICAS group based on their vascular imaging data. The blood pressure, blood lipids, blood glucose, ApoB, ApoAⅠ, and ApoB/ApoAⅠ ratios and demographic data were collected. The differences of the above indicators were compared between the two groups. Results A total of 360 patients with large artery atherosclerotic stroke were enrolled. There were 177 patients in the ICAS group （49. 2%） and 183 in the non-ICAS group （50. 8%）. There were significant differences in the constituent ratios of the patients with hypertension, diabetes and coronary heart disease, as well as the levels of low-density lipoprotein cholesterol, ApoB and ApoAⅠ and ApoB/ApoAⅠ ratios between the 2 groups （all P 〈0. 05）. Multivariable logistic regression analysis showed that hypertension （odds ratio [ OR ] 1.75, 95 % confidence interval [CI] 1.04 - 2.93; P = 0. 035）, diabetes mellitus （OR 2.09, 95 % CI 1.31 -3.32; P=0. 002）, coronary heart disease （OR 2.68, 95% CI 1.09- 6.57; P=0. 031）, ApoB ≥ 0. 84 g/L （0.84 - 1.00 g/L： OR 2. 68, 95% CI 1.30 - 5.56; 1.00 - 1.16 g/L： OR 3.95, 95% CI 1.87 -8.40; 〉 1.00 g/L： OR 6. 41, 95% CI 2. 82 - 14. 49） and ApoB/ApoAⅠ ratio ≥0. 60 （0. 60 - 0. 73： OR 1.92,95% CI 1.14-3.24; 0.74-0.91： OR 1.79, 95% CI 1.06-3.02; 〉0.91： OR 3.30, 95% CI 1.92 - 5.67） were the independent risk factors for ICAS, while ApoAⅠ 〉 1.28 g/L was an independent protective factor for ICAS （OR 0. 39, 95% CI 0. 16 - 0.98; P = 0. 044）. Conclusions The increased ApoB level and ApoB/ApoAⅠ ratio are the independent risk factors for ICAS, and the increased ApoAⅠ level is an independent protective f

关 键 词：载脂蛋白B 载脂蛋白A-Ⅰ 卒中 脑缺血 颅内动脉硬化 生物学标记 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]