载脂蛋白B/载脂蛋白A1比值在糖尿病合并冠心病患者冠状动脉病变评估中的作用  

The Role of Apolipoprotein ApoB/ApoA1 Ratio in the Assessment of Coronary Artery Lesion in Patients with Diabetes and Coronary Heart Disease

作　　者：陈严[1] 吕晶[1] 董艾艾[1] 陈进[1] CHEN Yan;LV Jing;DONG Ai-ai(ZheJiang hospital,Zhejiang 310013,China)

机构地区：[1]浙江医院,310013

出　　处：《心脑血管病防治》2018年第5期376-378,384,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：浙江省卫生科研项目(编号:2013KYB001);浙江医院重点培植学科-<智能化慢病健康管理学>

摘　　要：目的通过分析明确载脂蛋白B/载脂蛋白A1(ApoB/ApoA1比值在评估糖尿病合并冠心病患者冠状动脉病变严重程度中的作用。方法选择行冠状动脉造影确诊的糖尿病合并冠心病的患者(n=261),依据ApoB/ApoA1比值的均值分为高比值组(n=125)和低比值组(n=136),比较两组间一般临床资料、生化、冠状动脉Syntax评分等指标,分析ApoB/ApoA1比值与冠状动脉病变严重程度的关系。结果 (1)两组患者基本特征差异无统计学意义,ApoB/ApoA1高比值组低密度脂蛋白胆固醇(LDL-C)和血清总胆固醇(TC)高于低比值组(P> 0. 05),而ApoA1水平低于低比值组(P <0. 05),同时,中重度冠状动脉病变多于低比值组(P <0. 05)。(2)随着冠状动脉病变程度的加重,TC、LDL-C、ApoB、ApoB/ApoA1比值逐渐升高,ApoA1逐渐降低,P <0. 05。(3)糖尿病合并冠心病人群的血管病变Syntax评分与ApoA1水平呈负相关(r=-0. 42,P <0. 05),与TC、LDL-C、ApoB、ApoB/ApoA1比值呈正相关(r=0. 47,0. 51,0. 62,0. 66,P <0. 05)。结论糖尿病合并冠心病患者ApoB/ApoA1比值升高,与冠状动脉Syntax评分呈正相关,能较好地反映冠状动脉病变严重程度。Objective To assess the role of apolipoprotein ApoB/ApoA1 ratio in the assessment of coronary artery lesion in patients with diabetes and coronary heart disease.Methods Patients with diabetes mellitus and coronary heart disease diagnosed by coronary angiography from January 2010 to July 2016 were enrolled in the study （n=261）. The patients were divided into high ratio group （125 cases）and low ratio group （136 cases） according to the mean value of ApoB/ApoA1 ratio.The general clinical data, biochemistry and coronary Syntax score between the two groups were compared, to analyze the relationship between ApoB/ApoA1 ratio and severity of coronary artery disease.Results （1）There was no significant difference in the basic characteristics between the two populations （ P 〉0.05）. The LDL-C and TC in the high ratio group were higher than those in the low ratio group （P 〈0.05）, but the level of ApoA1 was lower than that in the low ratio group（ P 〈0.05）, and the moderate and severe coronary lesions were found more than in the low ratio group （ P 〈0.05）. （2）As coronary artery disease aggravated, the level of TC, LDL-C, ApoB, ApoB /ApoA1 ratio gradually increased while ApoA1 decreased （ P 〈0.05）. （3）The Syntax score of diabetic patients with coronary heart disease was negatively correlated with ApoA1 level （ r =-0.423, P 〈0.05）, positively correlated with TC, LDL-C, ApoB, ApoB/ApoA1 ratio （ r =0.465,0.513,0.616,0.658, P 〈0.05）.Conclusions The ratio of ApoB/ApoA1 in diabetic patients with coronary heart disease was increased, which positively correlated with coronary Syntax score,could reflect the severity of coronary artery disease.

关 键 词：载脂蛋白A1 载脂蛋白B ApoB/ApoA1比值 SYNTAX评分 

分 类 号：R587.1[医药卫生—内分泌] R541.4[医药卫生—内科学]