摘要
目的:探讨载脂蛋白B/载脂蛋白A1(apoB/apoA1)比值与冠心病患者冠脉病变程度及预后的相关性。方法:回顾分析我院2014至2016年间512例疑似冠心病患者,根据冠脉造影结果分为冠心病组(n=381)和对照组(n=131),Gensini积分(Gensini score,GS)评估冠脉病变程度,比较2组间临床特征,分析冠心病组血脂与GS的相关性,并随访1年内主要不良心血管事件(major adverse cardiovascular events,MACE)发生率。结果:(1)冠心病组apoB/apoA1比值水平0.65(0.53~0.83)较对照组0.53(0.41~0.67)明显升高(P=0.000)。(2)二分类logistic回归结果示apoB/apoA1是冠心病的独立危险因素(OR=46.810,P=0.000)。(3)各血脂指标ROC曲线分析示apoB/apoA1的曲线下面积最大(AUC=0.698,P=0.000)。(4)冠心病组患者apoB/apoA1水平随GS增加而升高(P=0.000),其与GS相关性较余血脂指标强。(5)冠心病组高水平apoB/apoA1(>0.65)患者1年内MACE发生率升高(P=0.008)。结论:apoB/apoA1比值是冠心病的独立危险因素,与冠心病患者冠脉病变程度及预后密切相关。
Objective：To investigate the relationship between the apoB/apoA1 ratio and the severity of coronary artery lesions and prognosis in patients with coronary heart disease（CHD）. Methods：A retrospective study was conducted in 512 hospitalized patients who were suspected CHD from 2014 to 2016. According to coronary angiography,all patients were divided into CHD group（n=381）and control group（n=131）. Gensini score（GS）was used to assess the severity of coronary artery lesions. The clinical features of the two groups were compared. The features of lipid indices in CHD group and its correlation with GS were analyzed. The incidence of the major adverse cardiovascular events（MACE）followed up for one year was also analyzed. Results：（1）The level of apoB/apoA1 0.65（0.53 to 0.83）in CHD group was significantly increased than the level of apoB/apoA1 0.53（0.41 to 0.67）in control group（P=0.000）.（2）Only the apoB/Apo A1 ratio in lipid indices remained significantly associated with CHD according to binary logistic regression analysis after multivariable adjustment（OR=46.810,P=0.000）.（3）Area under the ROC curves of the apoB/apoA1 ratio for predicting CHD was 0.698（P=0.000）,which was the highest among other lipid indices.（4）The level of apoB/Apo A1 was continually rising with GS increased（P=0.000）. The apoB/apoA1 ratio showed the strongest correlation with GS among other lipid indices.（5） The patients of CHD group with a higher level of apoB/apoA1（〉0.65）had a higher incidence of MACE in 1 year（P=0.008）. Conclusion：The apoB/apoA1 ratio is an independent risk factor for predicting CHD,and it also has a close relationship with the severity of coronary artery lesions and prognosis for CHD.
作者
王晓旭
徐丹
Wang Xiaoxu;Xu Dan(Department of Cardiovascular Diseases, the First Branch, The First Affiliated Hospital of Chongqing Medical Universit)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2018年第8期1041-1046,共6页
Journal of Chongqing Medical University
