血清载脂蛋白A1与冠心病左心室收缩功能减退的相关性分析

Correlation analysis of serum apolipoprotein A1 and left ventricular systolic dysfunction in patients with coronary heart disease

目的 探讨血清载脂蛋白A1(Apo A1)与冠心病左心室收缩功能减退的相关性。方法 选取安徽省芜湖市中医医院2019年2月至2022年12月收治的冠心病患者160例,按照心脏超声检查的射血分数(EF)进行分组,EF<50%(有左心室收缩功能减退)的40例患者纳入研究组,EF≥50%(无左心室收缩功能减退)的120例患者纳入对照组。比较两组临床资料、生化指标[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(Hb A1c)、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、B型钠尿肽(BNP)];采用多因素logistic回归分析明确冠心病左心室收缩功能减退的危险因素。结果 两组年龄、性别、体重指数(BMI)、基础疾病、冠心病家族史、经皮冠状动脉介入治疗史、吸烟史、饮酒史、收缩压、舒张压及调脂药物的应用情况比较,差异无统计学意义(P>0.05)。两组TC、LDL-C、Hb A1c水平比较,差异无统计学意义(P>0.05);研究组血清hs-CRP、Hcy、BNP均高于对照组、ApoA1低于对照组,差异有统计学意义(P<0.05);多因素logistic回归分析结果显示,hs-CRP、Hcy、ApoA1、BNP是冠心病患者出现左心室收缩功能减退的影响因素(P<0.05)。结论 Apo A1水平异常降低可作为左心室收缩功能减退的预测指标,临床应定期监测,及时进行相关治疗。

Objective To investigate the association of serum apolipoprotein A1(ApoA1)and left ventricular systolic dysfunction in coronary heart disease.Methods A total of 160 patients with coronary heart disease admitted to Wuhu Hospital of Traditional Chinese Medicine of Anhui Province from February 2019 to December 2022 were selected and grouped according the ejection fraction(EF)detected by cardiac ultrasound.There were 40 patiens with EF<50%(left ventricular systolic dysfunction)as the study group,and 120 patiens with EF≥50%(no left ventricular systolic dysfunction)as the control group.Clinical data,biochemical parameters(total cholesterol[TC],low density lipoprotein-cholesterol[LDL-C],glycosylated hemoglobin[HbA1c],hypersensitive C-reactive protein[hs-CRP],homocysteine[Hcy],and B type natriuretic peptide[BNP])were compared between two groups.Multivariate logistic regression analysis was used to identify the risk factors of left ventricular systolic dysfunction in coronary heart disease.Results There were no significant differences in age,sex,body mass index(BMI),underlying diseases,family history of coronary heart disease,history of percutaneous coronary intervention,smoking history,drinking history,systolic blood pressure,diastolic blood pressure,and the use of lipid-regulating drugs(P>0.05).There were no significant differences in the levels of TC,LDL-C,and HbA1c between the two groups(P>0.05).The levels of serum hs-CRP,Hcy,and BNP in the study group were higher than those in the control group,and ApoA1 was lower than that in the control group,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that,hs-CRP,Hcy,ApoA1,and BNP were influencing factors for left ventricular systolic dysfunction in patients with coronary heart disease(P<0.05).Conclusion The abnormal decrease of ApoA1 level can be used as a predictor of left ventricular systolic dysfunction,which should be monitored regularly and treated in time.