调脂治疗后非高密度脂蛋白胆固醇、载脂蛋白B水平与冠心病预后的关系  

Relationship between Non-high Density Cholesterol and Apolipoprotein B Levels and Prognosis of Coronary Heart Disease after Lipid-regulation Therapy

作　　者：刘凌华 余仟 金涛 杨小乐 吴剑超 LIU Linghua;YU Qian;JIN Tao;YANG Xiaole;WU Jianchao(Shaoguan Third People’s Hospital,Shaoguan 512122,China;不详)

机构地区：[1]广东省韶关市第三人民医院,广东韶关512122

出　　处：《中国医学创新》2022年第7期163-167,共5页Medical Innovation of China

基　　金：韶关市卫生健康科研项目(Y21011)。

摘　　要：目的:分析调脂治疗后非高密度脂蛋白胆固醇(non-high-density lipoprotein cholesterol,non-HDL-C)、载脂蛋白B(apolipoprotein B,ApoB)水平与冠心病(coronary atherosclerotic heart disease,CHD)预后的关系。方法:选取2018年4月-2019年4月韶关市第三人民医院诊治的200例CHD患者进行研究。所有患者均接受调脂治疗12个月,并随访12个月,根据12个月内是否发生主要不良心血管事件(major adverse cardiovascular events,MACE)将患者分为MACE组(n=72)和对照组(n=128),比较两组患者治疗1、3、6、9、12个月时的non-HDL-C、ApoB水平变化,同时比较随访期间non-HDL-C水平>2.6 mmol/L和ApoB>1 g/L的例数占比,并且采用logistic多元回归模型分析non-HDL-C、ApoB水平与MACE的关系。结果:non-HDL-C和ApoB组间、时间点比较,差异均有统计学意义(P<0.05);MACE组治疗前的non-HDL-C和ApoB水平与对照组比较,差异均无统计学意义(P>0.05);MACE组治疗后各时间点的non-HDL-C和ApoB水平均高于对照组(P<0.05);且治疗1、3、6、9、12个月,MACE组和对照组的non-HDL-C、ApoB水平均呈下降趋势(P<0.05)。随访期间内,MACE组中nonHDL-C>2.6 mmol/L和ApoB>1 g/L的患者比例均高于对照组(P<0.05)。单因素分析结果显示,MACE组和对照组患者调脂治疗12个月后non-HDL-C、ApoB水平比较,差异均有统计学意义(P<0.05);两组的性别、年龄、吸烟酗酒史、糖尿病史、高血压史、体重指数比较,差异均无统计学意义(P>0.05)。多因素logistic回归分析结果显示,调脂治疗12个月后non-HDL-C、ApoB水平是影响CHD患者发生MACE的独立危险因素(P<0.05)。结论:调脂治疗后non-HDL-C和ApoB水平与CHD患者的预后密切相关。Objective: To analyze the relationship between the levels of non-high-density lipoprotein cholesterol(non-HDL-C), apolipoprotein B(ApoB) and the prognosis of coronary heart disease(CHD). Method: A total of 200 CHD patients treated in Shaoguan Third People’s Hospital from April 2018 to April 2019 were selected for this study. All patients received lipid-modulation treatment for 12 months and were followed up for 12 months.According to whether major adverse cardiovascular events(MACE) occurred within 12 months, patients were divided into MACE group(n=72) and control group(n=128). The levels of non-HDL-C and ApoB were compared between the two groups at 1, 3, 6, 9 and 12 months after treatment, and the proportion of cases with non-HDL-C level >2.6mmol/L and ApoB >1 g/L during follow-up were compared, logistic multiple regression model was used to analyze the relationship between non-HDL-C, ApoB levels and MACE. Result: There were significant differences between non-HDL-C and apoB at groups and time points(P<0.05);there were no significant differences in the levels of nonHDL-C and ApoB between MACE group and control group before treatment(P>0.05);the levels of non-HDL-C and ApoB in MACE group were higher than those in control group at all time points after treatment(P<0.05);the levels of non-HDL-C and ApoB in MACE group and control group decreased after 1, 3, 6, 9 and 12 months of treatment(P<0.05). During the follow-up period, the proportions of patients with non-HDL-C >2.6 mmol/L and ApoB >1 g/L in MACE group were higher than those in control group(P<0.05). Univariate analysis showed that there were significant differences in the levels of non-HDL-C and ApoB between MACE group and control group after lipidlowering treatment for 12 months(P<0.05);there were no significant differences in gender, age, smoking, drinking history, diabetes history, hypertension history and body mass index between the two groups(P>0.05). Multivariate logistic regression analysis showed that the levels of non-HDL-C and ApoB were independe

关 键 词：非高密度胆固醇 载脂蛋白B 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]