载脂蛋白A、载脂蛋白B/载脂蛋白A比值与冠脉病变严重程度的相关性  

Correlation of Apo-A and Apo-B/Apo-A ratio with the degree of coronary artery stenosis in patients with coronary heart disease

作　　者：韩秀[1] 田雨灵[1] 卓小桢[1] 薛倩 杨春[1] 朱雯瑾[1] 张涛[1] 王顺[1] 马爱群[1] HAN Xiu;TIAN Yu-ling;ZHUO Xiao-zhen;XUE Qian;YANG Chun;ZHU Wen-jin;ZHANG Tao;WANG Shun;MA Ai-qun(Department of Cardiovascular Medicine,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院心内科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2019年第2期255-258,共4页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：科技部科技惠民计划项目(No.2012GS610101)~~

摘　　要：目的探讨载脂蛋白A(Apo-A)及载脂蛋白B/载脂蛋白A(Apo-B/Apo-A)比值与冠脉病变严重程度之间的相关性。方法选取冠心病并行冠脉造影(CAG)的患者234例,收集血脂指标并计算血脂比值(非HDL-C、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C及Apo-B/Apo-A),并根据CAG结果计算Gensini积分。采用Spearman相关分析各指标与Gensini积分之间的相关性,采用多元线性回归分析有意义指标与冠脉狭窄程度的相关性。结果各Gensini积分组间在年龄、高血压史、糖尿病史及吸烟指数上均无统计学差异,中积分组病程长于低积分组及高积分组(P=0.023,P=0.002)。Apo-A水平在3组间两两比较均有统计学差异(P=0.009,P<0.001,P=0.013)。高积分组的TC、Apo-B及LPα水平低于低积分组(P=0.008,P=0.001,P=0.002),中积分组及高积分组的HDL-C与Apo-B/Apo-A比值低于低积分组(P=0.008,P=0.001)。各危险因素与Gensini积分的Spearman相关分析结果发现HDL-C、Apo-A与Gensini积分呈负相关,相关系数分别为(r=-0.166,r=-0.294),LDL-C/HDL-C及Apo-B/Apo-A与Gensini积分呈正相关,相关系数分别为(r=0.159,r=0.170)。Gensini积分的多因素线性回归分析,Apo-A与Gensini积分呈负相关(β=-62.249),Apo-B/Apo-A比值与Gensini积分呈正相关(β=31.311)。结论 Apo-A及Apo-B/Apo-A比值是冠心病冠脉病变狭窄程度的独立危险因素,是判断冠心病发病风险的可靠预测指标。Objective To investigate the correlation of Apo-A and Apo-B/Apo-A ratio with the degree of coronary artery stenosis(CHD)in patients with coronary heart disease.Methods Totally 234 patients with coronary heart disease examined with coronary angiography were collected.We collected blood lipid and calculated blood lipid ratio,such as non-HDL-C,TG/HDL-C,TC/HDL-C,LDL-C/HDL-C,and Apo-B/Apo-A.Gensini score was calculated according to the result of CAG.We analyzed the correlation between the blood lipid indicators and the Gensini score with the Spearman correlation analysis.Linear regression analysis was made of the correlation between those meaningful indicators and the Gensini score.Results There were no significant differences in age,hypertension,diabetes or smoking index between all Gensini score groups.The illness course in middle-score group was longer than that in low-score group and high-score group(P=0.023,P=0.002).There was a significant difference in Apo-A between the groups(P=0.009,P<0.001,P=0.013).The levels of TC,Apo-B and LPαin high-score group were lower than those in low-score group(P=0.008,P=0.001,P=0.002).The levels of HDL-C and Apo-B/Apo-A ratio in both middle-score and high-score group were lower than those in low-score group(P=0.008,P=0.001).The Spearman correlation analysis between various risk factors and Gensini score found that HDL-C and Apo-A had negative correlation with Gensini score(r=-0.166,r=-0.294),the ratios of LDL-C/HDL-C and Apo-B/Apo-A were positively correlated with Gensini score(r=0.159,r=0.170).By multi-factor linear regression,Apo-A was negatively related with Gensini score(β=-62.249),and Apo-B/Apo-A ratio was positively associated with Gensini score(β=31.311).Conclusion Apo-A and Apo-B/Apo-A ratios are the independent risk factors for the stenosis degree of coronary artery in patients with CHD.They are reliable predictors for the risk of CHD.

关 键 词：Apo-A ApoB/ApoA比值 冠心病 冠脉病变严重程度 GENSINI积分 

分 类 号：R541.4[医药卫生—心血管疾病]