载脂蛋白B/A-1比值联合颈动脉斑块性质检查在冠心病患者危险性预测中的价值

目的探讨载脂蛋白B/A-l比值联合颈动脉斑块性质检查在冠状动脉粥样硬化性心脏病(CHD)患者危险性预测中的价值。方法选取CHD患者250,其中急性冠脉综合征(ACS组)患者190例,稳定性心绞痛患者(SAP组)60例,另选同期经冠状动脉造影检查阴性患者98例(对照组)。对3组患者行颈动脉彩超检查,根据斑块的声学特性判定颈动脉粥样硬化斑块性质,检测并比较各组载脂蛋白B(Apo B)、载脂蛋白A1(Apo A-1)含量及Apo B/Apo A-1比值,分析其与CHD患者危险因素的关系。结果 3组低密度脂蛋白-胆固醇(LDL-C)、高脂血症(TG)、总胆固醇(TC)水平比较无显著差异(P0.05),ACS组高密度脂蛋白胆固醇(HDL-C)水平显著高于对照组(P0.05)。ACS组Apo B、Apo B/A1比值显著高于对照组和SAP组(P0.05);3组Apo A1比较无显著差异(P0.05);ACS组、SAP组斑块总发生率显著高于对照组(P0.05);ACS组颈部动脉软斑块发生率显著高于SAP组及对照组(P0.05)。结论 CHD患者颈部动脉检出不稳定斑块,且Apo B、Apo B/A-1比值异常增高,提示CHD患者冠状动脉病变程度加重。

Value of apolipoprotein B/A-1 ratio combined with carotid plaque nature examination in predicting the risk of patients with coronary heart disease

Objective To explore the value of apolipoprotein B/A-1 ratio combined with carotid plaque nature examination in predicting the risk of patients with coronary heart disease.Methods A total of 250 patients with CHD were selected and divided into acute coronary syndrome group (ACS group,n=190) and stable angina pectoris group (SAP group,n=60).A total of 98 normal individuals by CAG were selected as control group.The carotid color ultrasound was performed for all the patients.The nature of carotid atherosclerostic plaque was estimated according to the acoustic characteristics of plaques.The ApoB and ApoA-1 contents as well as ApoB/A-1 ratio were detected and calculated,and correlations between indexes and risk factors were analyzed.Results There were no significant differences in levels of TC,TG,and LDL-C between the three groups (P>0.05).HDL-C level in the ACS group was significantly higher than that in the control group (P<0.05).ApoB and ApoB/A1 in the ACS group were significantly higher than those in the control group and ACS group (P<0.05).There was no significant difference in ApoA1 between the three groups (P>0.05).The total occurrence rates of plaques in ACS group and SAP group were significantly higher than the control group (P<0.05).The occurrence rate of carotid soft plaque in ACS group was significantly higher than SAP group and the control group (P<0.05).Conclusion Unstable plaques are able to detect by carotid ultrasound in CHD patients,and the ApoB level and ApoB/A-1 ratio increased abnormally,which indicates the severity of coronary artery lesions increases in CHD patients.