血清非高密度脂蛋白胆固醇水平对冠心病的临床诊断价值

目的：探讨血清非高密度脂蛋白胆固醇以及载脂蛋白B水平对冠心病的临床应用价值。方法检测118例冠心病（CHD）患者血清三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1（apoAl）和载脂蛋白B（apoB）水平，并计算出非高密度脂蛋白胆固醇（non-HDL-C）及apoB/apoA1比值，分析各血脂指标与冠心病的关系。结果 CHD患者血清TG、non-HDL-C和apoB/apoA1比值均高于对照组（P〈0.01），HDL-C和apo Al水平均低于对照组（P〈0.01），差异有统计学意义。 HDL-C和apoA1的诊断灵敏度明显高于TC和LDL-C，而non-HDL-C、apoB以及apoB/apoA1的特异度均较高。结论血清non-HDL-C及apoB/apoA1比值的升高与心血管事件发生危险性明显正相关，其预警价值高于传统指标LDL-C和TC，与冠状动脉粥样硬化病变关系密切，尤其对于LDL-C和TC已经达标者控制其non-HDL-C和apoB水平在冠心病的防治中有重要意义。

Clinical value of non-HDL-cholesterol in coronary heart disease diagnoses

Objective To investigate the clinical value of non-high-density lipoprotein cholesterol （non-HDL-C） and apolipoprotein B （apoB） in patients with coronary heart disease （CHD）. Methods The concentrations of serum triglyceride （TG）,to-tal cholesterol （TC）, high-density lipoprotein cholesterol （HDL-C）, low-density lipoprotein cholesterol （LDL-C）, apolipoprotein A1 （apoA1） and apoB in 118 patients with CHD were detected. Non-HDL-C levels and apoB/apoA1 ratios were calculated. All the results were analyzed with statistical methods. Results The concentrations of serum TG, non-HDL-C and the ratio of apoB/apoA1 in patients with CHD were significantly higher than those of healthy people（P〈0.01）, while HDL-C and apoA1 were lower（P〈0.01）. Serum HDL-C and apoA1 have higher diagnostic sensitivity in CHD than serum TC and LDL-C, while serum non-HDL-C, apoB and apoB/apoA1 had higher specificity. Conclusions Serum non-HDL-C and apoB/apoA1 have positive correlation with CHD and their early warning value are better than serum LDL-C and TC. In patients with normal serum LDL-C and TC, controlling their serum non-HDL-C and apoB will have more significance in prevention of CHD.