冠心病病人HDL-C/LDL-C、ApoA1/ApoB、Lp(a)变化及与冠脉病变程度支数的关系分析  

Changes of HDL-C/LDL-C,ApoA1/ApoB and Lp(a) and their relationshipwith the degree/number of coronary artery lesions in patients with coronary heart disease

作　　者：武毅 班向阳 李彬彬 余兆文 WU Yi;BAN Xiangyang;LI Binbin;YU Zhaowen(Department of Cardiology,West District,The First People′s Hospital of Hefei,Hefei Anhui 236000;Department of Internal Medicine,Huaining County Hospital of Traditional Chinese Medicine,Anqing Anhui 246121,China)

机构地区：[1]安徽省合肥市第一人民医院西区心内科,236000 [2]安徽省怀宁县中医医院内科,安徽安庆246121

出　　处：《蚌埠医学院学报》2024年第8期1034-1038,共5页Journal of Bengbu Medical College

摘　　要：目的:探究冠心病(CHD)病人高密度脂蛋白胆固醇/低密度脂蛋白胆固醇(HDL-C/LDL-C)、载脂蛋白A1/载脂蛋白B(ApoA1/ApoB)、脂蛋白a[Lp(a)]变化及与冠脉病变程度支数的关系。方法:选取冠心病病人90例作为CHD组,同期体检健康者100名作为对照组,比较2组及不同病变程度支数病人的HDL-C/LDL-C、ApoA1/ApoB及Lp(a)水平。结果:CHD组病人的HDL-C/LDL-C、ApoA1/ApoB水平低于对照组(P<0.01和P<0.05),Lp(a)水平高于对照组(P<0.05);90例CHD病人中,26例病人为单支病变,30例为双支病变,34例为多支病变,随着病变支数的增加,病人的HDL-C/LDL-C和ApoA1/ApoB水平呈降低趋势(P<0.01),Lp(a)水平呈升高趋势(P<0.01);Pearson相关性分析结果显示,病变支数与HDL-C/LDL-C、ApoA1/ApoB水平成负相关(r=-0.474、-0.501,P<0.01),与Lp(a)水平成正相关(r=0.379,P<0.01)。ROC结果显示,上述3项指标联合(并联)评估CHD病人双支及以上病变程度支数的AUC及敏感度均高于单一指标诊断(P<0.01),3项指标对诊断两支及以上病变的切点值分别为0.405、1.425、273.120 mg/L。结论:HDL-C/LDL-C、ApoA1/ApoB及Lp(a)水平与CHD病人冠状动脉病变程度支数密切相关,三者联合检测对评估CHD病人冠脉病变支数程度具有较高的价值相关性,建议临床密切监测。Objective:To investigate the changes of high-density lipoprotein cholesterol/low-density lipoprotein cholesterol(HDL-C/LDL-C),apolipoprotein A1/apolipoprotein B(ApoA1/ApoB)and lipoprotein a[Lp(a)]in patients with coronary heart disease(CHD),and their relationship with the degree/number of coronary artery lesions.Methods:Ninety patients with CHD and 100 healthy subjects were divided into the CHD group and control group,respectively.The levels of HDL-C/LDL-C,ApoA1/ApoB and Lp(a)were compared between two groups,and among the patients with different degree/number of coronary artery lesions.Results:The levels of HDL-C/LDL-C and ApoA1/ApoB in the CHD group were lower than those in control group(P<0.01 and P<0.05),and the Lp(a)levels were higher than those in control group(P<0.05).Among the 90 patients with CHD,26 patients had single vessel lesions,30 patients had double vessel lesions,and 34 patients had multi-vessel lesions.With the increase of the number of lesions,the levels of HDL-C/LDL-C and ApoA1/ApoB showed a decreasing trend(P<0.01),and the level of Lp(a)showed an increasing trend(P<0.01).The results of Pearson correlation analysis showed that the number of lesions was negatively correlated with levels of HDL-C/LDL-C and ApoA1/ApoB(r=-0.474,-0.501,P<0.01),and positively correlated with Lp(a)level(r=0.379,P<0.01).The results of ROC showed that the AUC and sensitivity of the combined evaluation of three indexes in CHD patients with two or more branches of lesions were higher than that of the single index diagnosis(P<0.01),and the cut-off values of three indexes for the diagnosis of two or more branches of lesions were 0.405,1.425 and 273.120 mg/L,respectively.Conclusions:HDL-C/LDL-C,ApoA1/ApoB and Lp(a)levels are closely related to the degree/number of coronary artery lesions in patients with CHD.The combined detection of the three has a high value correlation in evaluating the degree/number of coronary artery lesions in CHD patients,and which is worthy of close monitoring in clinical practice.

关 键 词：冠心病 高密度脂蛋白胆固醇 低密度脂蛋白胆固醇 载脂蛋白A1 载脂蛋白B 脂蛋白A 病变程度支数 

分 类 号：R541.4[医药卫生—心血管疾病]