载脂蛋白A-1及高密度脂蛋白在冠心病中作用的比较  

Comparing the role of apolipoprotein A-1 and high density lipoprotein in coronary heart disease

作　　者：胡晓蔚 孙建琦[1] 章锡林[1] 汪靖[1] 胡剑平[1] HU Xiaowei;SUN Jianqi;ZHANG Xilin;WANG Jing;HU Jianping(Department of Cardiovascular Diseases,People′s Hospital of Huangshan City,Huangshan 245000,China)

机构地区：[1]黄山市人民医院心内科,安徽黄山245000

出　　处：《皖南医学院学报》2019年第1期60-63,共4页Journal of Wannan Medical College

基　　金：黄山市科技计划项目(2018Z-02)

摘　　要：目的:评估载脂蛋白(Apo A-1)在冠心病(CAD)中的作用及其与传统高密度脂蛋白(HDL)的比较。方法:将262名冠状动脉造影证实的CAD患者与193名造影证实无CAD患者的血清生物标志物进行比较。结果:对照组血浆Apo A-1水平为(1.25±0.18) g/L,CAD组为(1.01±0.18) g/L。对照组血清HDL水平为(1.05±0.29) mmol/L,CAD组为(0.97±0.27) mmol/L。差异均有统计学意义(P<0.01)。CAD组大部分Apo A-1处于异常范围(63%),对照组仅有12%异常,CAD组HDL有55%异常,而对照组中48%异常。Apo A-1检测CAD的灵敏度为63%,而HDL为55%。Apo A-1检测CAD的特异度为88%,而HDL则为52%。绘制ROC曲线时,Apo A-1比HDL具有更大的曲线下面积。结论:Apo A-1作为CAD的预测指标可能比HDL更敏感,但其血清水平及临床应用需要进一步研究。Objective: To compare the role of apolipoprotein(Apo A-1)and high density lipoprotein(HDL) as a biomarker in predicting coronary artery disease. Methods :262 patients with coronary artery disease and 193 patients without coronary artery disease(CAD) confirmed by angiography were included in observational group and control group,and the levels of Apo-A-1 and HDL were compared between groups. Results :Apo A-1 level and HDL level were (1.25±0.18)g/ L,(1.01±0.18)g/L);(1.05±0.29)mmol/L,(0.97±0.27)mmol/L,respectively for patients in the observational group and control group.The difference was significant( P< 0.01).Abnormal ApoA-1 level was seen in 63% patients in the observational group,and 12% in the controls.Abnormal HDL level was found in 55% patients in the observational,and in 48% in the control group.Sensitivity and specificity in detection of CAD was 63% and 88% by ApoA-1,and 55% and 52% by HDL,respectively.Receiver operating characteristic (ROC) curve indicated larger area for Apo A-1than for HDL. Conclusion :Our findings suggest that HDL level can be more sensitive than Apo-A-1 as serum biomarker in assessing CAD,yet the clinical role of the two biomarkers needs further investigation.

关 键 词：载脂蛋白A-1 高密度脂蛋白 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]