摘要
目的探讨载脂蛋白B/A-1比值及同型半胱氨酸(Hcy)与老年冠心病的相关性。方法选取行冠状动脉造影的280例老年患者,分为3组,急性冠脉综合征(ACS组)组134例,稳定性心绞痛组(SAP组)66例,经冠状动脉造影检查阴性组(对照组)80例,检测各组患者血常规、肝肾功能、血脂、血清Hcy、心肌酶谱及凝血功能,根据冠状动脉造影结果对冠心病患者进行Gensini评分,并采用Logistic回归分析分析血清ApoB/A-1比值及血清Hcy与老年冠心病的关系。结果 3组患者基本资料比较,冠心病患者的高血压病史、糖尿病史差异均有统计学意义(P<0.05);SAP组、ACS组患者血清ApoB、ApoB/A-1比值、血清Hcy水平明显高于对照组,差异有统计学意义(P<0.05)。Pearson直线相关分析显示冠心病患者ApoB/A-1比值与血清Hcy水平无明显相关性(r=0.124,P>0.05),Gensini积分与ApoB/A-1比值、自清Hcy水平呈正相关(r=0.82、0.78,均P<0.05)。多因素Logistic回归分析显示ApoB/A-1比值(OR=1.026,95%CI 0.825~1.792)和血清Hcy(OR=1.002,95%CI 0.748~1.548)均为老年冠心病新的独立危险因素。结论高水平ApoB/A-1比值及高水平Hcy均为老年冠心病新的独立危险因素,与冠状动脉狭窄程度呈正相关,也为老年冠心病患者的预测提供更多的理论依据。
Objective To investigate the correlation between apolipoprotein B/A-1 ratio or homocysteine（Hcy）and coronary heart disease（CHD）in elderly patients.Methods A total of 280 elderly patients who underwent coronary artery angiography in our hospital were divided into three groups：acute coronary syndrome（ACS group,n=134）,stable angina pectoris（SAP group,n=66）,and negative angiographic finding（control group,n=80）.Routine blood indexes,hepatorenal function,blood lipid,serum Hcy,myocardial enzymes and coagulation function were measured in all patients.Gensini scoring was performed according to the angiographic outcomes.Logistic regression analysis was used to analyze the relationships of serum ApoB/A-1 ratio and Hcy to coronary heart disease.Results There were significant differences in the history of hypertension and diabetes among the three groups（P〈0.05）.Serum levels of ApoB,ApoB/A-1 and Hcy in SAP group and ACS group were higher than those in control group（P〈0.05）.Pearson＇s linear correlation analysis showed no correlation between ApoB/A-1 ratio and Hcy level（r=0.124,P〉0.05）.However,Gensini score was positively correlated with serum ApoB/A-1 ratio and Hcy level（r=0.82 and 0.78,respectively;P〈0.05）.Multivariate logistic regression analysis showed that ApoB/A-1 ratio（OR=1.026,95% CI 0.825-1.792）and Hcy（OR=1.002,95% CI 0.748-1.548）were the new independent risk factors for CHD in elderly patients.Conclusion The high ApoB/A-1 ratio and Hcy level are the new independent risk factors for CHD in elderly patients.Furthermore,they are positively correlated with coronary stenosis and provide more theoretical basis for the prediction of CHD in elderly patients.
作者
喻文琴
肖明生
YU Wen-qin;XIAO Ming-sheng(Department of Cadre Ward,the 94th Hospital of PLA, Nanchang 330001, China)
出处
《南昌大学学报（医学版）》
CAS
2018年第2期60-63,共4页
Journal of Nanchang University：Medical Sciences
