ApoA1、ApoB、ApoB/ApoA1比值、LDL-C/HDL-C比值及CHOL水平与ACS患者Gensini积分、冠状动脉易损斑块的关系分析  

Analysis on relationship among ApoA1,ApoB,ApoB/ApoA1 ratio,LDL-C/HDL-C ratio and CHOL level with Gensini score and vulnerable plaque of coranary artery in patients with acute coronary syndrome

作　　者：王海东 王莉[1] 杨俐娜 赵龙斌 WANG Haidong;WANG Li;YANG Lina;ZHAO Longbin(Department of Clinical Laboratory,Second Affiliated Hospital of Xi′an Medical University,Xi′an,Shaanxi 710005,China;Department of Neurology,Second Affiliated Hospital of Xi′an Medical University,Xi′an,Shaanxi 710005,China)

机构地区：[1]西安医学院第二附属医院检验科,陕西西安710005 [2]西安医学院第二附属医院神经内科,陕西西安710005

出　　处：《检验医学与临床》2024年第19期2797-2801,2805,共6页Laboratory Medicine and Clinic

基　　金：西安医学院第二附属医院院级科研基金项目(23KY0112)。

摘　　要：目的分析载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、ApoB/ApoA1比值、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(LDL-C/HDL-C)比值及总胆固醇(CHOL)水平与急性冠脉综合征(ACS)患者Gensini积分、冠状动脉易损斑块的相关性。方法选取2022年3月至2023年10月该院收治的135例ACS患者为研究对象,其中不稳定型心绞痛患者(UAP组)70例,急性心肌梗死患者(AMI组)65例,均进行冠状动脉造影(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和易损斑块组,比较各组ApoA1、ApoB、ApoB/ApoA1比值、LDL-C/HDL-C比值及CHOL水平,分析ApoA1、ApoB、ApoB/ApoA1比值、LDL-C/HDL-C比值及CHOL水平与Gensini评分、冠状动脉易损斑块的相关性;采用受试者工作特征(ROC)曲线分析ApoA1、ApoB、ApoB/ApoA1比值、LDL-C/HDL-C比值及CHOL水平对冠状动脉易损斑块的预测价值。结果AMI组ApoB、ApoB/ApoA1比值、LDL-C/HDL-C比值、CHOL水平及Gensini评分均高于UAP组(P<0.05),ApoA1水平低于UAP组(P<0.05)。Pearson相关分析显示,Gensini评分与ApoB、ApoB/ApoA1比值、LDL-C/HDL-C比值、CHOL水平呈正相关(r=0.412、0.399、0.383、0.381,P<0.05),与ApoA1呈负相关(r=-0.405,P<0.05)。易损斑块组ApoB/ApoA1比值、LDL-C/HDL-C比值和CHOL水平均高于稳定斑块组(P<0.05),ApoA1水平低于稳定斑块组(P<0.05);两组ApoB水平比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,ApoA1水平降低及ApoB/ApoA1比值、LDL-C/HDL-C比值、CHOL水平升高均是ACS患者冠状动脉易损斑块的危险因素(P<0.05)。ROC曲线分析显示,ApoA1、ApoB/ApoA1比值、LDL-C/HDL-C比值、CHOL 4项联合预测ACS患者冠状动脉易损斑块的AUC为0.932(95%CI:0.875~0.968),均高于各指标单项预测ACS患者冠状动脉易损斑块的AUC(Z=3.279、3.108、3.117、3.344,P<0.05)。结论ApoA1、ApoB、ApoB/ApoA1比值、LDL-C/HDL-C比值及CHOL水平可评估ACS患者冠状动脉病变严重程度,ApoA1Objective To analyze the correlation among apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),ApoB/ApoA1 ratio,low-density lipoprotein cholesterol/high-density lipoprotein cholesterol(LDL-C/HDL-C)ratio and total cholesterol(CHOL)levels with Gensini score and vulnerable plaque of coranary artery in the patients with acute coronary syndrome(ACS).Methods A total of 135 patients with ACS admitted and treated in this hospital from March 2022 to October 2023 were selected as the research subjects,including 70 cases of unstable angina pectoris(UAP group)and 65 cases of acute myocardial infarction(AMI group).Coronary angiography(CAG)and intravascular ultrasound(IVUS)were performed,and the Gensini scoring was conducted.The patients with ACS were divided into the stable plaque group and vulnerable plaque group according to the results of CAG and IVUS.ApoA1,ApoB,ApoB/ApoA1 ratio,LDL-C/HDL-C ratio and CHOL levels were compared among the groups,and the correlation among ApoA1,ApoB,ApoB/ApoA1 ratio,LDL-C/HDL-C ratio and CHOL level with the Gensini score and vulnerable plaque of coronary artery was analyzed;the receiver operating characteristic(ROC)curve was used to analyze the predictive value of ApoA1,ApoB,ApoB/ApoA1 ratio,LDL-C/HDL-C ratio and CHOL level for vulnerable coronary plaques.Results The ApoB,ApoB/ApoA1 ratio,LDL-C/HDL-C ratio,CHOL level and Gensini score in the AMI group all were higher than those in the UAP group(P<0.05),while the ApoA1 level was lower than that in the UAP group(P<0.05).The Pearson correlation analysis showed that the Gensini score was positively correlated with ApoB,ApoB/ApoA1 ratio,LDL-C/HDL-C ratio and CHOL level(r=0.412,0.399,0.383,0.381,P<0.05),and negatively correlated with ApoA1(r=-0.405,P<0.05).The ApoB/ApoA1 ratio,LDL-C/HDL-C ratio and CHOL level in the vulnerable plaque group all were higher than those in the stable plaque group(P<0.05),while the ApoA1 level was lower that in the stable plaque group(P<0.05);there was no statistically significant difference in the ApoB level between the two

关 键 词：急性冠脉综合征 载脂蛋白A1 载脂蛋白B 胆固醇 GENSINI积分 易损斑块 相关性 

分 类 号：R446.11[医药卫生—诊断学] R541.1[医药卫生—临床医学]