ApoA1、ApoB、ApoB/ApoA1比值及CHOL水平与ACS患者Gensini积分、斑块易损的相关性分析  

Correlation between ApoA1,ApoB,ApoB/ApoA1 ratio,CHOL level and Gensini score and plaque vulnerability in patients with ACS

作　　者：车思思 王兴祖 蔡媛媛[1] 方超兰 Che Sisi;Wang Xingzu;Cai Yuanyuan;Fang Chaolan(Department of Clinical Laboratory,the 910 Hospital of Joint Logistic Support Force,PLA,Quanzhou,Fujian 362000,China)

机构地区：[1]中国人民解放军联勤保障部队第910医院检验科,福建泉州362000

出　　处：《齐齐哈尔医学院学报》2024年第13期1245-1249,共5页Journal of Qiqihar Medical University

摘　　要：目的分析载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、ApoB/ApoA1比值及总胆固醇(CHOL)水平与急性冠状动脉综合征(ACS)患者冠脉病变Gensini积分、斑块易损的相关性。方法选择2020年12月—2022年12月本院收治的135例急性冠状动脉综合征(ACS)患者和50名健康者作为研究对象。按同期进行体检分为急性心肌梗死患者组(AMI组,65例)、不稳定型心绞痛患者组(UAP组,70例)和健康者为对照组(50名)三组。ACS患者行冠状动脉造影(CAG)和血管内超声(IVUS)检查,进行Gensini评分,依据CAG、IVUS结果将ACS患者分为稳定斑块组(45例)和易损斑块组(90例)两组。比较各组ApoA1、ApoB、ApoB/ApoA1比值及CHOL水平,分析ApoA1、ApoB、ApoB/ApoA1比值及CHOL水平与Gensini评分、易损斑块的相关性;采用ROC曲线分析ApoA1、ApoB、ApoB/ApoA1比值及CHOL水平对冠脉易损斑块的预测价值。结果AMI组患者的ApoB、ApoB/ApoA1比值和CHOL水平和Gensini评分均高于UAP组和对照组,而ApoA1低于UAP组和对照组,差异有统计学意义(P<0.05);UAP组患者的ApoB、ApoB/ApoA1比值和CHOL水平和Gensini评分高于对照组,而ApoA1低于对照组,差异有统计学意义(P<0.05);pearson相关分析显示,Gensini评分与ApoB、ApoB/ApoA1比值和CHOL水平呈正相关,与ApoA1呈负相关(P<0.05);易损斑块组患者ApoB、ApoB/ApoA1比值和CHOL水平高于稳定斑块组,而ApoA1低于稳定斑块组,差异有统计学意义(P<0.05);多因素Logistic逐步回归分析显示,ApoA1、ApoB、ApoB/ApoA1比值及CHOL水平是ACS患者易损斑块的独立危险因素(P<0.05);ROC曲线分析显示,ApoA1、ApoB、ApoB/ApoA1比值及CHOL水平联合预测ACS患者易损斑块的敏感度为94.45%,AUC为0.928,均高于单独检测(P<0.05)。结论通过ApoA1、ApoB、ApoB/ApoA1的比值以及CHOL水平可评估ACS患者冠脉病变严重程度,且ApoB、ApoB/ApoA1比值和CHOL水平的升高及ApoA1降低都是易损斑块的危险因素,对易损斑块具有预测价值。Objective To analyze the correlation between apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),ApoB/ApoA1 ratio,total cholesterol(CHOL)level and Gensini score and plaque vulnerability in patients with acute coronary syndrome(ACS).Methods A total of 135 patients with ACS who were admitted to the hospital from December 2020 to December 2022 and 50 healthy individuals were selected as the study subjects.According to the results of examination,the patients were divided into the acute myocardial infarction group(AMI group,n=65),the unstable angina pectoris group(UAP group,n=70),and the health individuals were enrolled in the control group(n=50).Patients with ACS received angiography(CAG)and intravascular ultrasound(IVUS)examination,and Gensini scoring was performed.According to CAG and IVUS results,patients with ACS were divided into the stable plaque group(n=45)and the vulnerable plaque group(n=90).ApoA1,ApoB,ApoB/ApoA1 ratio and CHOL level were compared among groups.The correlation between ApoA1,ApoB,ApoB/ApoA1 ratio,CHOL level and Gensini score and vulnerable plaque was analyzed.The ROC curve was used to analyze the predictive value of ApoA1,ApoB,ApoB/ApoA1 ratio and CHOL level for vulnerable coronary plaque.Results ApoB,ApoB/ApoA1 ratio,CHOL level and Gensini score in the AMI group were higher than those in the UAP group and the control group,while ApoA1 was lower than those in the UAP group and the control group,the differences were statistically significant(P<0.05).ApoB,ApoB/ApoA1 ratio,CHOL level and Gensini score in the UAP group were higher than those in the control group,while ApoA1 was lower than that in the control group(P<0.05).Pearson correlation analysis showed that Gensini score was positively correlated with ApoB,ApoB/ApoA1 ratio and CHOL level,and negatively correlated with ApoA1(P<0.05).ApoB,ApoB/ApoA1 ratio and CHOL level in the vulnerable plaque group were higher than those in the stable plaque group,and ApoA1 was lower than that in the stable plaque group(P<0.05).Multivariate logistic stepwise regr

关 键 词：急性冠状动脉综合征 载脂蛋白A1 载脂蛋白B GENSINI积分 斑块易损 相关性 

分 类 号：R541.4[医药卫生—心血管疾病]