血清淀粉样蛋白A和载脂蛋白B/A1水平与冠状动脉病变的相关性  

Correlation of serum amyloid A and apolipoprotein B/A1 ratio with coronary artery lesions

作　　者：黄远茂 黄洪磊 叶飞 叶桂云 朱家瑞 池细俤 Yuan-mao Huang;Hong-lei Huang;Fei Ye;Gui-yun Ye;Jia-rui Zhu;Xi-di Chi(Department of Laboratory,The First Hospital of Nanping,Fujian Medical University,Nanping,Fujian 353000,China;Department of Medical Imaging,The First Hospital of Nanping,Fujian Medical University,Nanping,Fujian 353000,China)

机构地区：[1]福建医科大学附属南平第一医院检验科,福建南平353000 [2]福建医科大学附属南平第一医院影像科,福建南平353000

出　　处：《中国现代医学杂志》2020年第22期42-47,共6页China Journal of Modern Medicine

摘　　要：目的探讨血清淀粉样蛋白A(SAA)和载脂蛋白B(ApoB)/载脂蛋白A1(ApoA1)比值(ApoB/A1)与冠状动脉病变的关系。方法选取2017年8月-2018年10月于福建医科大学附属南平第一医院就诊的胸痛患者520例。根据冠状动脉CT血管造影结果将患者分为冠状动脉正常组和冠状动脉增厚组。其中,冠状动脉正常组191例,冠状动脉增厚组329例。另选取该院健康体检者100例作为对照组。研究对象均进行一般情况调查,行冠状动脉CT血管造影检查,检测各组SAA、ApoB、ApoA1等,计算ApoB/A1。Pearson相关性分析和Logistic回归分析冠状动脉病变患者冠状动脉病变与各影响因素的相关性。结果冠状动脉增厚组收缩压、舒张压、ApoB/A1、SAA及超敏C-反应蛋白(hs-CRP)较冠状动脉正常组高(P<0.05),冠状动脉正常组较对照组高(P<0.05)。冠状动脉病变支数与hs-CRP、SAA、ApoB/A1及收缩压呈正相关(r=0.247、0.397、0.402和0.116,P<0.05),冠状动脉狭窄程度与hs-CRP、SAA、ApoB/A1及收缩压呈正相关(r=0.253、0.674、0.650和0.141,P<0.05),冠状动脉斑块与SAA、ApoB/A1呈负相关(r=-0.295和-0.279,P<0.05)。ApoB/A1[OR=24.768(95%CI:6.270,97.841),P<0.05]、SAA[OR=1.956(95%CI:1.446,2.647),P<0.05]是冠状动脉病变的影响因素。结论冠状动脉病变患者中SAA、ApoB/A1的表达与冠状动脉血管病变的发生一致,相关性强,是反映冠状动脉粥样硬化有意义的参考指标。Objective To investigate the relationship of SAA and apolipoprotein B/A1 ratio with coronary artery lesions.Methods A total of 520 patients with chest pain admitted to our hospital from August 2017 to October 2018 were enrolled,including 191 patients with normal coronary artery and 329 with coronary artery thickening.Another 100 healthy persons were selected as control group.All the subjects underwent general investigation and coronary computed tomography angiography(CCTA)examination.The levels of serum amyloid A(SAA),apolipoprotein B(ApoB),apolipoprotein A1(ApoA1)and other indexes were detected,and ApoB/A1 ratio was calculated.The correlation between the lesions of coronary artery and the levels of various indicators were analyzed by Pearson correlation analysis and Logistic regression.Results The systolic blood pressure,diastolic blood pressure,ApoB/A1 ratio,and levels of SAA and high-sensitivity C-reactive protein(hs-CRP)of the coronary artery thickening group were significantly higher than those of the normal coronary artery group,while those of the normal coronary artery group were higher than those of the control group(P<0.05).Pearson correlation analysis showed that the number of coronary artery lesions and the stenosis degree of coronary artery were positively correlated with hs-CRP level(r s=0.247,0.253,P<0.05),SAA level(r s=0.397,0.674,P<0.05),ApoB/A1 ratio(r s=0.402,0.650,P<0.05)and systolic blood pressure(r s=0.116,0.141,P<0.05),while CT values of coronary artery plaque were negatively correlated with SAA level(r s=-0.295,P<0.05)and ApoB/A1 ratio(r s=-0.279,P<0.05).Logistic regression analysis showed that the most significant affecting factors for the coronary artery lesions were ApoB/A1 ratio[O^R=24.768,(95%CI:6.270,97.841)]and SAA level[O^R=1.956,(95%CI:1.446,2.647)].Conclusions In coronary artery disease,the level of SAA and ApoB/A1 ratio are closely related to coronary arterial lesions and reflect the condition of coronary atherosclerosis.

关 键 词：冠状血管造影术 血清淀粉样蛋白A 载脂蛋白B类 载脂蛋白A类 

分 类 号：R814.43[医药卫生—影像医学与核医学]