载脂蛋白B、载脂蛋白AⅠ及其比值与急性冠脉综合征的相关性

摘要

目的 探讨载脂蛋白B(ApoB)、载脂蛋白AⅠ(ApoAⅠ)及其比值载脂蛋白B/载脂蛋白AⅠ(ApoB/ApoAⅠ)在急性冠脉综合征(ACS)患者血清中的变化及其相关性.方法 对30例急性心肌梗死(AMI)患者、30例不稳定性型心绞痛(UA)患者、30例经冠脉造影检查除外冠心病的患者,清晨空腹采血,分离血清,应用美国贝克曼库尔特公司UniCelDxC800全自动生化分析仪测定上述90例患者血清中ApoB、ApoAⅠ水平并计算两者比值ApoB/ApoAⅠ.结果 AMI组与对照组ApoB水平有显著性差异(P＜0.05),UA组与对照组ApoB水平有显著性差异(P＜0.05),AMI组与UA组ApoB水平无统计学差异(P＞0.05).AMI组与对照组ApoA水平有显著性差异(P＜0.05),UA组与对照组ApoA水平有显著性差异(P＜0.05),AMI组与UA组ApoA水平无统计学差异(P＞0.05).AMI组与对照组ApoB/ApoAⅠ有显著性差异(P＜0.01),UA组与对照组ApoB/ApoAⅠ有显著性差异(P＜0.05),AMI组与UA组ApoB/ApoAⅠ水平有显著性差异(P＜0.01).经多因素Logistic相关性分析显示,ApoB、ApoB/ApoAⅠ的风险比值(OR值)均大于1,是ACS的危险因素,ApoA偏回归系数为负值,与ACS呈负相关.结论 ApoB、ApoB/ApoAⅠ水平在ACS患者中明显升高,ApoA水平与ACS呈负相关,ApoB、ApoB/ApoAⅠ升高是ACS的危险因素,ApoA是抗冠状动脉粥样硬化因素.%Objective To investigate the correlation between ApoB,ApoA,ApoB/ApoA Ⅰ with acute coronary syndrome.Methods The ApoB,ApoA Ⅰ were measured in 30 patients with acute myocardial infarction(AMI),30 patients with acute unstable angina (UA) and 30 normol control group by autom atic biochem istry analyzer and their ratio was com putered.Results Serum ApoB was sig nificantly increased in both AMI group and UA group com pared with those in control group( P＜ 0.05 ).But there was no statistical difference between AMI group and UA group( P＞0.05 ).Serum ApoA was significantly decreased in both AMI group and UA group com pared with those in control group (P＜ 0.05 ).But there was nostatistical difference between AMI group and UA group(P ＞ 0.05).The ratio of A poB/A poA Ⅰ was significantly increased in AMI group com pared with that in control group(P＜0.01), the ratio of A poB/ApoA Ⅰ was significantly increased in UA group com pared with that in control group(P＜0.05),and the ratio of ApoB/ApoA Ⅰ was significantly increased in AMI group com pared with that in UA group(P＜0.01).Logistic regression analysis showed that the odds ratio(OR)ofApoB,ApoB/ApoA I was more than 1 ,indicating that ApoB,ApoB/ApoA-Ⅰwere risk factors of ACS,the partial regression coefficient of ApoA was nagative value, indicating that ApoA was negatively correlated with coronary atheroscleross.Conclu sion ApoB,ApoA/ApoA Ⅰ are increased in patients with ACS and their rises are the risk factors of ACS,ApoA Ⅰare inversely associat ed to ACS,ApoA was the protective factors of coronary atheroscosis.