载脂蛋白B/载脂蛋白A1比值与青年冠心病患者冠状动脉病变严重程度的研究  

The relationship between ApoB to ApoA1 ratio and the severity of coronary artery disease in young patients with coronary heart disease

作　　者：苏广胜 付茜 庞文跃[1] SU Guangsheng;FU Xi;PANG Wenyue(Third Department of Cardiology,Shengjing Hospital of China Medical University,Shenyang,110004,China;Fourth Department of Cardiology,Shengjing Hospital of China Medical University,Shenyang,110004,China)

机构地区：[1]中国医科大学附属盛京医院第三心血管内科,沈阳110004 [2]中国医科大学附属盛京医院第四心血管内科

出　　处：《临床心血管病杂志》2021年第7期663-667,共5页Journal of Clinical Cardiology

基　　金：国家自然科学基金项目(No:81901418)。

摘　　要：目的:分析载脂蛋白B/载脂蛋白A1(ApoB/ApoA1)比值与青年冠心病患者冠状动脉(冠脉)病变程度的相关性。方法:将179例青年冠心病患者(15~44周岁)作为病例组。77例无全身动脉粥样硬化性疾病、冠脉造影也无冠脉粥样硬化的青年患者作为对照组。以Gensini积分评估病例组患者冠脉病变程度,分为高Gensini积分组(Gensini评分≥60)、低Gensini积分组(Gensini评分1~59)。计算ApoB/ApoA1比值。结果:病例组ApoB/ApoA1比值高于对照组[(0.88±0.29)∶(0.76±0.28),P<0.05];高Gensini积分组的ApoB/ApoA1比值高于低Gensini积分组[(0.95±0.32)∶(0.82±0.24),P<0.05];病例组患者冠脉病变Gensini积分与ApoB/ApoA1值呈正相关(r=0.404,P<0.05)。ROC曲线分析证实ApoB/ApoA1比值诊断高Gensini积分的曲线下面积(AUC)为0.77,敏感性为0.77,特异性为0.69,AUC高于其他单项血脂指标。结论:ApoB/ApoA1比值与青年冠心病患者冠脉病变程度具有相关性,与Gensini积分呈正相关。Objective: To analyze the relationship between apolipoprotein B/apolipoprotein A1 ratio and the severity of coronary artery disease in young patients with coronary heart disease. Methods: The case group was consisted of 179 young patients with coronary heart disease(15-44 years old), and the control group was consisted of 77 young patients with no systemic atherosclerotic disease and coronary atherosclerosis in angiogram. Gensini score(GS) was used to evaluate the degree of coronary artery disease for the patients in the case group, with GS 1-59(91 cases) as the Low GS Group and GS≥60(88 cases) as the High GS Group. We calculated the ratio of ApoB/ApoA1 and drawed receiver operating characteristic(ROC) curve. Results: The ratio of apolipoprotein B/apolipoprotein A1 in the case group was higher than that in the control group(0.88±0.29 vs 0.76±0.28, P<0.05);the ratio of apolipoprotein B/apolipoprotein A1 in the High GS Group was higher than that in the Low GS Group(0.95±0.32 vs 0.82±0.24, P<0.05). Correlation analysis showed that for the case group, the Gensini score was positively correlated with apolipoprotein B/apolipoprotein A1 ratio(r=0.404, P<0.05). ROC curve analysis confirmed that AUC was 0.77 with specificity of 0.69 and sensitivity of 0.77 for apolipoprotein B/apolipoprotein A1 ratio in prediction high Gensini score, and the AUC was higher than other single blood lipid indicators. Conclusion: The ratio of apolipoprotein B/apolipoprotein A1 correlates with the degree of coronary artery disease among young patients with coronary heart disease, which positively correlated with Gensini score.

关 键 词：冠心病 血脂 载脂蛋白B/载脂蛋白A1 青年 

分 类 号：R541.4[医药卫生—心血管疾病]