血瘀型冠心病患者冠脉病变情况与Apo-B和Apo-A1比值的相关性  

Correlation Between Coronary Artery Lesions and the Ratio of Apo-B and Apo-A1 in Patients with Coronary Heart Disease of Blood Stasis Type

作　　者：赵丹丹 赵华云[2] 何明丰[2] 袁康 陈景利[2] 罗智敏 ZHAO Dan-Dan;ZHAO Hua-Yun;HE Ming-Feng;YUAN Kang;CHEN Jing-Li;LUO Zhi-Min(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Guangzhou 528000 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学附属佛山市中医院,广东佛山528000

出　　处：《广州中医药大学学报》2023年第9期2136-2140,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20203009)。

摘　　要：【目的】探讨血瘀型冠心病患者冠脉病变情况与载脂蛋白B和载脂蛋白A1比值(Apo-B/Apo-A1)的相关性。【方法】调查分析136例血瘀型冠心病患者的高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、Apo-B、Apo-A1和脂蛋白a(Lp-a)及冠脉造影结果。运用Gensini评分进行冠脉严重程度评估,根据Gensini评分高低将<20分为低Gensini评分组,20~49分为中Gensini评分组,≥50分为高Gensini评分组;根据病变支数差异分为冠脉无明显狭窄组、单支病变组、双支病变组和多支病变组。运用相关统计学方法分析各血脂指标与冠脉不同狭窄程度及病变支数之间的关系。【结果】(1)不同冠脉严重程度与LDL-C、Apo-B、Apo-B/Apo-A1、Lp-a存在一定的关系,不同病变支数与Apo-B和Apo-B/Apo-A1存在一定的关系,差异均有统计学意义(P<0.01)。(2)运用受试者工作特征曲线(ROC)分析后发现,使用Apo-B/Apo-A1筛选血瘀型冠心病患者多支病变的曲线面积是0.651(0.558,0.744),最佳cutoff值为1.38,此时的特异度为0.918,灵敏度为0.305。使用Apo-B/Apo-A1筛选高Gensini评分的曲线面积是0.668(0.572,0.763),最佳cutoff值为1.40,此时的特异度为0.975,灵敏度为0.327。【结论】血瘀型冠心病患者冠脉病变情况与Apo-B/Apo-A1有一定的相关性,Apo-B/Apo-A1越高,冠脉狭窄程度越重,冠脉病变支数越多。Objective To investigate the correlation between coronary artery lesions and the ratio of apolipoprotein B and apolipoprotein A1(Apo-B/Apo-A1)in patients with coronary heart disease(CHD)of blood stasis type.Methods The levels of high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDLC),Apo-B,Apo-A1 and lipoprotein a(Lp-a)and coronary angiography results of 136 patients with CHD of blood stasis type were investigated and analyzed.The Gensini score was used to assess the stenosis severity of coronary arteries,and then the coronary artery lesions was classified into low Gensini score group(Gensini score<20),medium Gensini score group(Gensini score being 20-49),and high Gensini score group(Gensini score≥50).According to the affected coronary branches,the coronary artery lesions were classified into stenosisabsent group,single-branch lesion group,double-branch lesion group and multi-branch lesion group.The correlation of blood lipid indicators with stenosis severity of coronary arteries and the count of the affected coronary branches was analyzed by using relevant statistical methods.Results(1)The stenosis severity of coronary arteries was correlated with LDL-C,Apo-B,Apo-B/Apo-A1 ratio and Lp-a,and the count of the affected coronary branches was correlated with Apo-B and Apo-B/Apo-A1 ratio,the difference being statistically significant(P<0.01).(2)The analysis of receiver operating characteristic curve(ROC)showed that using Apo-B/Apo-A1 ratio to screen multi-branch coronary lesion in patients with CHD of blood stasis type,the area under the curve(AUC)was 0.651(0.558,0.744),and the optimal cutoff value was 1.38,with the specificity of 0.918 and the sensitivity of 0.305;using Apo-B/Apo-A1 ratio to screen high Gensini scores in patients with CHD of blood stasis type,the AUC was 0.668(0.572,0.763),and the optimal cutoff value was 1.40,with the specificity of 0.975 and the sensitivity of 0.327.Conclusion There is a correlation between the coronary artery lesions and Apo-B/Apo-A1 ratio in patien

关 键 词：血瘀型 冠心病 冠脉病变情况 Apo-B/Apo-A1 相关性 

分 类 号：R259.414[医药卫生—中西医结合]