糖尿病合并冠心病患者血脂水平及载脂蛋白B/载脂蛋白A1比值与患者预后相关性分析  

The association of serum levels of lipids and apolipoprotein B to apolipoprotein A1 ratio with prognosis in patients with diabetes mellitus and coronary heart disease

作　　者：唐仁强 张肃川 肖勇强[3] TANG Ren-qiang;ZHANG Su-chuan;XIAO Yong-qiang(Laboratory Department,Traditional Chinese Medicine Hospital of Zigong,Zigong 643000,China;Laboratory Department,Zigong First People's Hospital,Zigong 643000,China;Cardiology Department,Zigong First People's Hospital,Zigong 643000,China)

机构地区：[1]四川省自贡市中医医院检验科,四川自贡643000 [2]四川省自贡市第一人民医院检验科,四川自贡643000 [3]四川省自贡市第一人民医院心内科,四川自贡643000

出　　处：《实用医院临床杂志》2019年第5期242-244,共3页Practical Journal of Clinical Medicine

摘　　要：目的分析2型糖尿病(T2DM)合并冠心病(CHD)患者血脂水平及载脂蛋白B(ApoB)/载脂蛋白A1(ApoA1)比值(ApoB/ApoA1)与患者预后相关性。方法回顾性分析经皮冠状动脉介入治疗(PCI)的120例T2DM合并CHD患者临床资料,根据其预后情况[术后12个月内是否发生主要心血管不良事件(MACE)]将其分为MACE组(n=38)和非MACE组(n=82)。比较两组血脂指标、ApoB、ApoA1水平和ApoB/ApoA1差异,分析T2DM合并CHD患者血脂水平及ApoB/ApoA1与其预后相关性。结果MACE组年龄、TG、LDL-C、ApoB水平及ApoB/ApoA1高于非MACE组(P<0.05)。T2DM合并CHD患者LDL-C、ApoB水平及ApoB/ApoA1与其术后发生MACE密切相关(P<0.05)。LDL-C预测ROC曲线显示AUC 0.747,临界值为2.49 mmol/L,敏感性、特异性分别为0.767、0.667。ApoB/ApoA1预测ROC曲线显示AUC 0.841,临界值为0.88,敏感性、特异性分别为0.837、0.854。二者联合预测ROC曲线显示AUC为0.971,敏感度、特异度分别为0.878、0.946,优于各自单独预测(P<0.05)。结论DM合并CHD患者LDL-C水平及ApoB/ApoA1与其不良预后密切相关,二者联合检测对预测患者预后有一定价值。Objective To analyze the association of serum lipids levels and apolipoprotein B(ApoB)to apolipoprotein A1(ApoA1)ratio(ApoB/ApoA1)with prognosis in patients with type 2 diabetes mellitus(T2DM)complicated with coronary heart disease(CHD).Methods The clinical data of 120 patients with T2DM and CHD who underwent percutaneous coronary intervention(PCI)in our hospital were retrospectively analyzed.According to whether the main cardiovascular adverse events(MACE)occurred within 12 months after surgery,the patients were divided into MACE group(n=38)and non-MACE group(n=82).The serum lipids indexes,ApoB,ApoA1 and ApoB/ApoA1 were compared between the two groups,and the association of blood lipids levels and ApoB/ApoA1 with prognosis was analyzed.Results Age,levels of TG,LDL-C and ApoB and ApoB/ApoA1 in the MACE group were higher than those in the non-MACE group(P<0.05).The levels of LDL-C and ApoB and ApoB/ApoA1 in the T2DM patients with CHD were closely related to occurrence of postoperative MACE(P<0.05).The AUC of LDL-C of ROC was 0.747,the critical value was 2.49 mmol/L,and the sensitivity and specificity were 0.767 and 0.667,respectively.The AUC of ApoB/ApoA1 of ROC was 0.841,the critical value was 0.88,and the sensitivity and specificity were 0.837 and 0.854,respectively.The AUC of combined the two indexes for prediction was 0.971,and the sensitivity and specificity were 0.878 and 0.946,respectively that were better than those of separate prediction(P<0.05).Conclusion The LDL-C level and ApoB/ApoA1 in patients with T2DM and CHD are closely related to the poor prognosis.The combined detection of these two indexes has certain value in predicting the prognosis of patients.

关 键 词：糖尿病合并冠心病 血脂 载脂蛋白 预后 相关性 

分 类 号：R466.1[医药卫生—临床医学]