载脂蛋白B水平与急性心肌梗死患者预后的相关性分析

Effect of Apolipoprotein B on One Year Prognosis in Patients With Acute Myocardial Infarction

目的:评价载脂蛋白B(ApoB)水平对急性心肌梗死(AMI)患者1年预后的影响。方法:回顾分析107例住院的急性心肌梗死患者临床资料,根据ApoB是否大于980mg/L,分成ApoB升高组(n=44例)和ApoB正常组(n=63例)。对所有患者进行为期1年的临床随访,记录代谢指标,治疗依从性及心脏不良事件(再发心肌梗死、心绞痛、心源性死亡,缺血性卒中)发生情况。结果:ApoB升高组糖尿病患者所占比例高于ApoB正常组(40.9%与22.2%),差异有统计学意义(P=0.038),而两组患者在年龄,性别,高血压史,入院时心功能分级,总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平、冠心病治疗药物和治疗依从性等方面差异无统计学意义(P>0.05)。1年随访发现,ApoB升高组心脏不良事件发生率高于ApoB正常组(52.3%与31.7%),差异有统计学意义(P=0.033)。其中,ApoB升高组心绞痛发生率显著高于ApoB正常组(45.5%与27.0%),差异有统计学意义(P=0.048)。结论:高载脂蛋白B水平是AMI患者心脏不良事件的预测因素,提示积极控制ApoB可能改善AMI患者预后。

Objective ：To evaluate the effect of blood level of apolipoprotein B （ApoB） on one year prognosis in patients with acute myocardial infarction （AMI）. Methods ：We recruited 107 AMI patients who were admitted and treated in our hospital. The normal value of blood ApoB was defined as 980 mg/L. The patients were divided into two groups, Normal ApoB group, n = 63, and Abnormal ApoB group, n = 44. All patients were followed-up for one year with their lipid metabolism, treatment with the compliance, and the major adverse cardiac events （MACE） including myocardial re-infarction, pectoris angina, cardiac death and cerebral vascular events. Results ： There were more diabetes patients found in Abnormal ApoB group than that in Normal ApoB group （40. 9% vs. 22. 2% , P = 0. 038 ）. At the admission time, no significant difference was found from the age, gender, cardiac function, blood lipids of TC, TG and LDL-C, treatment with the compliance and the history of hypertension between two groups （ P 〉 0. 05 respectively）. During the follow-up period of time, patients in Abnormal ApoB group presented the more occurrence rate of MACE and angina attack than those in Normal ApoB group（52. 3% vs. 31.7% ,P =0. 033 and 45.5% vs. 27.0% ,P =0. 048）. Conclusion ： The blood level of ApoB was a valuable predictor for the occurrence of MACE for one year prognosis in patients with AMI.