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HDL颗粒、HDL-C与apoA-Ⅰ一致性评估冠心病严重程度的价值 被引量:18

The value of HDL particles, the concordance of HDL-C and apo A-Ⅰ in assessing the severity of coronary artery disease
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摘要 目的研究高密度脂蛋白(HDL)颗粒、高密度脂蛋白胆固醇(HDL-C)以及HDL-C与载脂蛋白A-Ⅰ(apo A-Ⅰ)一致性与冠脉狭窄程度的关系,并探讨三者对冠心病的预测价值。方法收集首次于南方医院行冠状动脉造影检查的患者591例,并进行Gensini评分。分别统计HDL颗粒、HDL-C、apo A-Ⅰ在冠心病组与非冠心病组、稳定性心绞痛组(SAP组)与急性冠脉综合征组(ACS组)以及在Gensini积分四分位分组(A、B、C、D组)的分布差异。按照HDL-C、apo A-Ⅰ中位数分为低高值并两两组合为四组,探讨HDL-C与apo A-Ⅰ一致性与冠心病严重程度的关系,通过ROC曲线分析三者对冠心病的预测价值。结果与非冠心病组比较,冠心病组的HDL颗粒大小、HDL-C和apo A-Ⅰ水平均降低(P<0.001);ACS组与SAP组比较得到以上类似结果;在A、B、C、D组中随着冠脉狭窄程度的加重,HDL颗粒大小、HDL-C和apo A-Ⅰ水平呈逐渐下降(P<0.001)。HDL-C与apo A-Ⅰ一致性与冠心病严重程度有关(P<0.001)。HDL颗粒的ROC曲线下面积(AUC)大于HDL-C、HDL-C与apo A-Ⅰ一致性。结论 HDL颗粒、HDL-C、HDL-C与apo A-Ⅰ一致性与冠心病严重程度相关。HDL颗粒对冠心病的预测价值优于HDL-C、HDL-C与apo A-Ⅰ一致性。 Objective The study was to analyze the relationship between HDL particles,the level of HDL-C and the concordance of HDL-C and apoA-Ⅰand the degree of coronary stenosis,then to explore their values inpredicting coronary artery disease. Methods 591 patients were collected for coronary angiography,and calculatedGensini score respectively. HDL particles and the level of HDL-C,apoA-Ⅰwere analyzed in coronary artery disease(CAD)group and non-CAD group,stable angina pectoris(SAP)group and acute coronary syndrome(ACS)groupand four groups divided by quartile of Gensini score(A,B,C,D). To investigate the relationship between the con-cordance of HDL-C and apoA-Ⅰand the severity of coronary artery disease,HDL-C,apoA-Ⅰwere divided into lowand high group according to the 50 percentile,then pair wise combination was done into four groups. Results Compared with non-CAD group,HDL particles,the level of HDL-C,apoA-Ⅰwere significantly reduced in CADgroup(P〈0.001). Compared with SAP group,similar results were found in ACS group. HDL particles,the levelof HDL-C,apoA-Ⅰwere decreased gradually in A,B,C,D group(P〈0.001). The concordance of HDL-C andapoA-Ⅰwas related to the risk of CAD(P〈0.001). The area under curve(AUC)of HDL particles was higher thanthat of HDL-C,the concordance of HDL-C and apoA-Ⅰ. Conclusions HDL particles,HDL-C,the concordanceof HDL-C and apoA-Ⅰwere related to coronary stenosis. The value of HDL particles in predicting CAD risk was su-perior to that of HDL-C,the concordance of HDL-C and apoA-Ⅰ.
作者 梁亚玲 郭凯 胡露 马煜盛 饶甲环 龙洁旎 郭志刚 LIANG Yaling;GUO Kai;HU Lu;MA Yusheng;RAO Jiahuan;LONG Jieni;GUO Zhigang(Division of Cardiology, Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China)
出处 《实用医学杂志》 CAS 北大核心 2018年第8期1267-1272,1277,共7页 The Journal of Practical Medicine
基金 国家自然科学基金面上项目(编号:81370380) 广东省普通高校省级重大科研项目(编号:2016KZDXM016) 广东省教育厅省级重大项目(编号:2014KZDXM020) 广州市科技计划科学研究专项一般项目(编号:201510010090) 南方医科大学临床培育项目(编号:LC2016PY002)
关键词 冠心病 HDL-C apoA-Ⅰ HDL颗粒 一致性 CAD HDL-C apoA-Ⅰ HDL particles concordance
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