apoB/apoA1与冠状动脉病变的相关性及对不良心血管事件预测价值的分析  

作　　者：李洋 黄杰[1] 张小薇[1] 

机构地区：[1]浙江省丽水市中心医院,323000

出　　处：《浙江临床医学》2025年第3期409-411,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨载脂蛋白B(apoB)/载脂蛋白A1(apoA1)与冠状动脉病变的相关性及其对不良心血管事件的预测价值。方法回顾性分析2021年1月至2023年4月本院收治的109例冠心病患者临床资料。患者入院次日检测apoB、apoA1水平,分析apoB/apoA1与冠状动脉狭窄程度相关性,比较不同冠状动脉病变支数、易损性斑块和非易损性斑块患者apoB/apoA1水平。采用受试者操作特征曲线(ROC)评估apoB/apoA1对冠心病患者出院后不良心血管事件的预测价值。结果重度狭窄患者apoB、apoB/apoA1水平高于中度和轻度狭窄患者,apoA1水平低于中度和轻度狭窄患者,差异有统计学意义(P<0.05)。冠状动脉狭窄程度与apoB(r=0.279)、apoB/apoA1(r=0.648)水平呈正相关,与apoA1(r=-0.617)水平呈负相关(P<0.05)。多支冠状动脉病变患者apoB、apoB/A1水平高于单支冠状动脉病变患者,apoA1水平低于单支冠状动脉病变患者(P<0.05)。易损性斑块患者apoB、apoB/A1水平高于非易损性斑块患者,apoA1水平低于非易损性斑块患者(P<0.05)。ROC曲线分析结果显示,apoA1和apoB/apoA1的AUC分别为0.753(95%CI:0.649~0.857,P<0.05)、0.851(95%CI:0.767~0.934,P<0.05)。结论apoB/apoA1与冠状动脉狭窄程度、多支病变、斑块易损性密切相关,对6个月内不良心血管事件具有较好的预测价值。Objective To explore the correlation between apolipoprotein B/apolipoprotein A1(apoB/apoA1)and the degree of coronary artery disease,and its predictive value for adverse cardiovascular events.Methods A retrospective study was conducted on 109 patients with coronary heart disease treated in our hospital from January 2021 to April 2023.All patients were tested for apoB and apoA1 levels the day after admission to analyze the correlation between apoB/apoA1 and the degree of coronary artery disease.The apoB/apoA1 levels were compared among patients with different numbers of coronary artery disease branches,vulnerable plaques,and non vulnerable plaques.Draw receiver operating characteristic(ROC)curves to evaluate the predictive value of apoB/apoA1 for adverse cardiovascular events in coronary heart disease patients within 6 months after discharge.Results The apoB and apoB/A1 of patients with severe stenosis were higher than those with moderate and mild stenosis,and apoA1 was lower than those with moderate and mild stenosis,with statistical significance(P<0.05).Spearman test analysis showed that the degree of coronary artery stenosis was positively correlated with apoB(r=0.279)and apoB/apoA1(r=0.648),and negatively correlated with apoA1(r=-0.617)(P<0.05).ApoB and apoB/apoA1 were higher in patients with multiple coronary artery disease than in patients with single coronary artery disease,and apoA1 was lower in patients with single coronary artery disease(P<0.05).Vulnerable plaques apoB and apoB/A1 were higher than non vulnerable plaques,while apoA1 was lower than non vulnerable plaques(P<0.05).The ROC curve analysis showed the area under the curve(AUC)of apoA1 was 0.753(95%CI:0.649~0.857,P<0.05)and the AUC of apoB/apoA1 was 0.851(95%CI:0.767~0.934,P<0.05).Conclusion ApoB/apoA1 is closely related to the degree of coronary stenosis,multi vessel lesions,and plaque vulnerability,and has significant predictive value for adverse cardiovascular events.

关 键 词：载脂蛋白B 载脂蛋白A1 冠状动脉病变 不良心血管事件 相关性分析 

分 类 号：R541.4[医药卫生—心血管疾病]