载脂蛋白与家族性高胆固醇血症家系成员冠心病患病关系的研究  

Research on relationship between apolipoprotein and coronary heart disease in family members with familial hypercholesterolemia

作　　者：颜丽[1] 何津春[2] 王志禄[3] 刘永铭[4] 杨静[5] 王世文[6] 高秉仁[7] 王沁[8] 

机构地区：[1]兰州大学 第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院医学检验中心,甘肃兰州730000 [3]兰州大学第一医院心血管内科,甘肃兰州730000 [4]兰州大学第一医院老年病科,甘肃兰州730000 [5]兰州大学第二医院心理行为科,甘肃兰州730030 [6]甘肃省第二人民医院急诊科,甘肃兰州730000 [7]兰州大学第二医院心外科,甘肃兰州730030 [8]兰州大学第一医院干部保健科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2016年第5期31-35,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：国家“十五”重大科技专项(2002BA711A08-17);教育部科技基础平台建设项目(505015);甘肃省自然科学基金项目(1308RJZA218,1302FKDA034)

摘　　要：目的 分析家族性高胆固醇血症（FH）家系成员血脂水平与冠心病的相关性,并探讨载脂蛋白与FH家系成员冠心病发病的关系。方法 对血脂异常患者及其家属进行家系咨询、体检筛查、填写调查表及实验室检测,选取符合FH诊断标准的6个家系共30名家系成员纳入本研究,将其分为正常组、高胆固醇组和冠心病组,比较各组总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白AI（Apo AI）、载脂蛋白B（Apo B）和脂蛋白a（LP（a））水平,分析各项指标与冠心病发病的相关性以及对冠心病发病的预测价值。结果 冠心病组血清TC、TG、LDL-C、Apo B及Apo B/Apo AI水平明显高于正常组（P〈0.01）,LP（a）水平也明显高于正常组（P〈0.05）;冠心病组血清LDL-C、Apo B、Apo B/Apo AI及LP（a）水平明显高于高胆固醇组（P〈0.05）,均与冠心病的发病呈正相关（r=0.533,P〈0.05;r=0.548,P〈0.01;r=0.604,P〈0.01;r=0.527,P〈0.05）。受试者工作特征曲线分析结果显示,曲线下面积（AUC）最大的是Apo B/Apo AI（AUC=0.850,95%CI为0.667~1.000）,对冠心病发病的最佳预测截断点为0.75（灵敏度为0.875,特异度为0.700）,其次是LDL-C、Apo B和LP（a）。结论 血清LDLC、Apo B、Apo B/Apo AI、LP（a）均与冠心病的发病相关,Apo B/Apo AI较其他血脂指标对FH家系成员发生冠心病具有更高的预测价值。Objective To analyze the correlation of lipid profiles and coronary heart disease in family members with familial hypercholesterolemia （FH）, and investigate the relationship between apolipoprotein and coronary heart disease （CHD） in FH family members. Methods Family counseling, medical screening, questionnaire and laboratory tests were made for the dyslipidemia patientsand their families at First Hospital of Lanzhou University. Then six FH families which met the diagnosis criteria of FH were selected, and 30 members were recruited. All subjects were divided into three groups： normal group, high cholesterol group and CHD group. The levels of total cholesterol （TC）, triglycerides （TG）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C）, apolipoprotein AI （Apo AI）, apolipoprotein B（Apo B） and lipoprotein （a） （LP（a）） were compared among all groups, and the correlation between the indicators and the incidence of CHD and the predictive value of indicators for CHD were assessed. Results The levels of TC, LDL-C, TG, Apo B and Apo B/Apo AI were significantly higher in the CHD group than those in the normal group （P 〈 0.01）, as well as LP（a） level （P 〈 0.05）. The levels of LDL-C, Apo B, Apo B/Apo AI and LP（a） in CHD group were significantly higher than those in high cholesterol group （P 〈 0.05）, and were positively correlated with coronary heart disease （r= 0.533, P 〈 0.05; r= 0.548, P 〈 0.01; r= 0.604, P 〈 0.01 and r=0.527, P 〈 0.05, respectively）. The analysis of receiver operating characteristic curve showed Apo B/Apo AI occupied the largest area under the curve （AUC=0.850, 95% C1 0.667-1.000）, and the optimal cutoff point was 0.75, while the specificity and sensitivity of which were 0.700 and 0.875, followed by LDL-C, Apo B and LP （a）. Conclusion The levels of LDL-C, Apo B, Apo B/Apo AI and LP（a） are closely associated with coronary heart disease. Apo B/Apo AI has higher value than othe

关 键 词：家族性高胆固醇血症 冠心病 载脂蛋白 

分 类 号：R589.2[医药卫生—内分泌]