血浆载脂蛋白水平及apoB/apoA1与急性冠脉综合征的相关性研究

目的探讨血浆载脂蛋白A1,B（apoA1,B）水平及apoB/apoA1比值与急性冠综合征（ACS）的相关性。方法入选我院经冠脉造影检查的119例可疑冠心病患者,其中不稳定型心绞痛组（UA组）54例,急性心肌梗死组（AMI组）33例,冠脉造影阴性者设为对照组32例。分别测定血浆总胆固醇（TC）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）及apoA1、apoB,计算apoB/apoA1比值,比较各组各项测定指标及apoB/apoA1的水平变化,并进行多因素logistic回归分析。结果 UA组与AMI组apoA1分别为（1.10±0.12）mmol/L,（1.07±0.14）mmol/L,与对照组（1.19±0.17）mmol/L相比显著偏低（P均〈0.01）;UA组与AMI组apoB分别为（1.00±0.14）mmol/L,（1.10±0.13）mmol/L,与对照组（0.92±0.14）mmol/L相比显著偏高（P〈0.05,P〈0.01）;UA组与AMI组的apoB/apoA1分别为0.91±0.19,0.97±0.18,与对照组（0.79±0.18）相比显著偏高（P〈0.05,P〈0.01）。多因素logistic回归分析示apoB/apoA1（OR=4.462,95%CI2.153～9.255,P〈0.001）及apoB（OR=2.764,95%CI1.174～6.511,P〈0.001）与ACS显著相关。结论 apoB与apoB/apoA1均是ACS的独立危险因素,而apoB/apoA1是ACS最显著的独立危险因素。

Association between the level of apolipoprotein and apoB/apoA1 ratio with acute coronary syndrome

Objective To explore the relation between plasma apolipoprotein and apoB/apoA1 ratio with acute cornary syndrome.Methods A total of 119 patients treated in our hospital who were doubted coronary heart disease and examined by coronary angiography（CAG） were studied.The patients were divided into 3 groups as unstable angina（UA） group,n=54;acute myocardial infarction（AMI）group,n=33;and control group,n=32,the patinets CAG showed no evidence of coronary artery disease.Total cholesterol（TC）,high density lipoprotein cholesterol（HDL-C）,and low density lipoprotein cholesterol（LDL-C） and apolipoprotein A1（apoA1）,apolipoprotein B（apoB） were measured,apoB/apoA1 ratio was calculated.Multivariate logistic regression analysis were performed.Results ①The values of apoA1 in UA group（1.10±0.12）mmol/L and AMI group（1.07±0.14）mmol/L were significantly lower than that in control group [（1.19±0.17）mmol/L,all P0.01].The values of apoB in UA group（1.00±0.14）mmol/L and AMI group（1.10±0.13）mmol/L were significantly higher than that in control group [（0.92±0.14）mmol/L,P0.05,P0.01].The values of apoB/apoA1 ratio in UA group（0.91±0.19） and AMI group（0.97±0.18） were significantly higher than that in control group（0.79± 0.18,P0.05,P0.01）.②Multivariate logistic regression analysis（forward method） indicated that both apoB/apoA1 ratio（OR= 4.462,95%CI 2.153～9.255,P0.001） and apoB（OR=2.746,95%CI 1.174～6.511,P0.001） were interrelated with ACS.Conclusion Both apoB and apoB/apoA1 are the powerful independent risk factors for diagnosing ACS,and the apoB/apoA1 is more powerful.