血浆脂蛋白a载脂蛋白A-I/载脂蛋白B比值在急性冠脉综合征合并2型糖尿病患者多支病变及严重冠状动脉病变中的预测价值  

Significance of plasma lipoprotein a,apolipoprotein A-I/apolipoprotein B ratio in type 2 diabetes patients with acute coronary syndrome

作　　者：邬晓丽 石磊 Wu Xiaoli;Shi Lei(Department of Laboratory Medicine,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海市中医药大学附属曙光医院检验科,201203

出　　处：《山西医药杂志》2024年第2期87-91,共5页Shanxi Medical Journal

摘　　要：目的分析急性冠脉综合征(ACS)合并2型糖尿病患者血浆脂蛋白a[lipoprotein(a),Lp(a)]及载脂蛋白A-I/载脂蛋白B(apolipoprotein A-I/apolipoprotein B,ApoA-I/ApoB)比值变化与临床特点。方法选取自2022年1月至2023年3月进行治疗的ACS患者213例,观察组(74例)为ACS合并2型糖尿病患者,对照组(139例)为单纯ACS患者,对2组Lp(a)及ApoA-I/ApoB比值进行分析。结果观察组体质指数及有高血压史构成比均高于对照组(P<0.05)。观察组中多支病变组Lp(a)水平高于单支病变组及双支病变组(P<0.05),多支病变组ApoA-I/ApoB比值低于单支病变组及多支病变组,差异有统计学意义(P<0.05)。对照组多支病变组Lp(a)水平高于单支病变组及双支病变组,ApoA-I/ApoB比值低于单支病变组及多支病变组(P<0.05)。观察组Gensini积分亚组中高分组Lp(a)水平高于低分组,ApoA-I/ApoB比值低于低分组(P<0.05)。对照组Gensini积分亚组中低分组与高分组Lp(a)水平与ApoA-I/ApoB比值差异无统计学意义(P>0.05)。观察组GRACE评分亚组中高危组ApoA-I/ApoB比值低于低危组及中危组,Lp(a)值高于低危组及中危组(P<0.05),观察组及对照组组中的低危险以及中危组ApoA-I/ApoB比值、Lp(a)值差异均无统计学意义(P>0.05)。Logistic回归分析结果表明Lp(a)水平升高为ACS合并2型糖尿病患者多支冠状动脉病变的危险因素,ApoA-I/ApoB比值升高均为ACS合并2型糖尿病患者多支冠状动脉病变及冠状动脉狭窄程度的保护因素(P<0.05)。结论检测Lp(a)水平及ApoA-I/ApoB比值能够为临床预测ACS患者合并2型糖尿病多支与严重冠状动脉病变提供指导。Objective To analyze the changes and clinical characteristics of plasma lipoprotein(a)[Lp(a)]and apolipoprotein A-I/apolipoprotein B(ApoA-I/ApoB)ratios in patients with acute coronary syndrome(ACS)and type 2 diabetes.Methods Two hundred and thirteen patients with ACS who were treated from January 2022 to March 2023 were selected in this study.The observation group(n=74)was ACS patients with type 2 diabetes,and the control group(n=139)was simple ACS patients.Lp(a)and ApoA-I/ApoB ratio of the two groups were analyzed.Results The body mass index and the proportion of individuals with a history of hypertension in the observation group were higher than those in the control group(P<0.05).The Lp(a)level in the multi-vessel lesion group was higher than that in the single vessel lesion group and the dual vessel lesion group(P<0.05),and the ApoA-I/ApoB ratio in the multi-vessel lesion group was lower than that in the single vessel lesion group and the multi-vessel lesion group with statistical significance(P<0.05).The Lp(a)level in the control group with multiple vessel lesions was higher than that in the single vessel lesion group and the dual vessel lesion group,and the ApoA-I/ApoB ratio was lower than that in the single vessel lesion group and the multi-vessel lesion group(P<0.05).In the observation group Gensini integral subgroup,the Lp(a)level in the high group was higher than that in the low group,and the ApoA-I/ApoB ratio was lower than that in the low group(P<0.05).There was no statistically significant difference in Lp(a)levels and ApoA-I/ApoB ratio between the low and high groups in the Gensini score subgroup of the control group(P>0.05).The observation group's GRACE score subgroup showed that the ApoA-I/ApoB ratio in the high-risk group was lower than that in the low-risk and medium-risk groups,and the Lp(a)value was higher than that in the low-risk and medium-risk groups(P<0.05).There was no statistically significant difference in the ApoA-I/ApoB ratio and Lp(a)value between the observation group and the contro

关 键 词：2型糖尿病 急性冠脉综合征 血浆 脂蛋白a 载脂蛋白A-I/载脂蛋白B 

分 类 号：R541.4[医药卫生—心血管疾病] R587.2[医药卫生—内科学]