Objective To investigate the levels and clinical significance of the ratio of apolipoprotein B(apoB)and apolipoprotein A1(apoA1)in the patients with cerebral infarction,and to determine the critical value of apoB/apoA1 inthe patients with ischemic cerebral infarction.Methods 126 inpatients with cerebal infraction diagnosed by MRI enhancement scanning of the head in our hos-pital.From November 1,2012 to May 15,2013 were selected.Among them,51 cases were common carotid artery intima-media thickening(carotid artery intima-media >0.9 mm)and 75 cases were carotid artery intima-media non-thickening by the color ultra-sonic examination;81 cases had atherosclerosis plaque and 45 cases had no atherosclerosis plaque.57 individuals with healthy physi-cal examination were selected as the control group.The fasting serum samples were collected from all the research subjects.The in-dexes of TG,CHOL,HDL-C,LDL-C,apoB,apoA,etc.were detected.Then the independent t-test was adopted to analyze and com-pare the ratio of apoB/apoA1 and others related indictors(including TG,AIP,apoB,apoA1,etc.)in the various groups.The ROC curves were made,the area under the curve was read and the specificity and sensitivity of apoB/apoA1 for diagnosing ischemic cere-bral infarction were calculated.Results (1)AIP and the ratio of apoB/apoA1 in the ischemic cerebral infarction patients were high-er than those in the control group,the rise rate of apoB/apoA1 ratio in the ischemic cerebral infarction patients was 5.43 times of that in the control group,especially the patients with carotid atherosclerosis or carotid artery intima-media thickenning were more significant,while TG and apoB had no obvious changes.(2)the ratio of apoB/apoA1 had no obvious difference between the carotid artery intima-media thickening group and the carotid artery intima-media non-thickening group,while which in the atherosclerotic plaques group was significantly increased compared with no carotid atherosclerosis group and 1.6 times of that in the normal control group.So it could be considered that the apoB/apoA1 ratio was a specific indicator for atherosclerosis.(3)In the diagnosis of ische-mic cerebral infarction,the area under the apoB/apoA1ROC curve was 0.86.its specificity and sensitivity were higher than other in-dexes.Conclusion The apoB/apoA1 ratio is the most specific and sensitive index in the patients with ischemic cerebral infarction and has good correlation with ischemic cerebral infarction,especially in the presence of carotid atherosclerosis plaque it is more sen-sitive,and is a good index of laboratory diagnosis of ischemic cerebral infarction.%目的：探讨脑梗死患者载脂蛋白 B（apoB）与载脂蛋白 A1（apoA1）的比值的水平及临床意义，寻找 apoB／apoA1对缺血性脑梗死患者的临界值。方法选取2012年11月1日至2013年5月15日于该院就诊并行 MRI 头部增强扫描，诊断为缺血性脑梗死的住院患者126例，其中，彩色超声仪检测示颈总动脉内中膜增厚的51例，未增厚组75例（颈动脉内中膜大于0.9 mm视为增厚）；有粥样硬化斑块的81例，无粥样硬化斑块的45例，选取57例健康体检者作为对照组。收集所有纳入对象空腹血清标本，分别测定 TG、CHOL、HDL-C、LDL-C、apoB、apoA1等指标，并采用独立 t 检验分析比较各组 apoB／apoA1及各项相关指标（包括 TG、AIP、apoB、apoA1等）。制作 ROC 曲线，读取曲线下面积并计算 apoB／apoA1诊断缺血性脑梗死的特异度、灵敏度。结果（1）缺血性脑梗死患者的 AIP、apoB／apoA1较对照组高，且缺血性脑梗死患者 apoB／apoA1的升高率为健康对照组的5.43倍，尤其是伴有颈动脉粥样硬化或颈总动脉内中膜增厚升高更为明显，而 TG、apoB 则无明显变化。（2）颈动脉内中膜增厚组和未增厚组比较 apoB／apoA1无明显差异，而有粥样硬化斑块组较无颈动脉粥样硬化组的 apoB／apoA1明显增高，为对照组的1.6倍，认为 apoB／apoA1的比值是粥样硬化特异的指标。（3）对缺血性脑梗死患者的诊断，apoB／apoA1 ROC 曲线下面积为0.86，特异度和灵敏度较其他指标高。结论 apoB／apoA1是缺血性脑梗死患者最特异、敏感的指标，与缺血性脑梗死具有较好的相关性，且在有颈动脉粥样硬化斑块时更为敏感，是较好的实验室诊断缺血性脑梗死的指标。
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