脂蛋白a及ApoA1/ApoB与急性冠脉综合征关系研究

The Study of the Relationship between Lipoprotein A,Apolipoprotein A1/B and Acute Coronary Syndrome

目的:探讨血浆脂蛋白(a)[LP(a)]、载脂蛋白A1/B[ApoA1/ApoB]水平在急性冠脉综合症、稳定型心绞痛患者的变化,以明确LP(a)、ApoA1/ApoB在冠心病发生、发展及急性冠状动脉事件中的作用。方法:2007～2008年行选择性冠脉造影(CAG)的患者中,根据造影结果及临床特点随机选取急性冠脉综合症50例、稳定型心绞痛50例、正常对照50例,再根据冠状动脉病变支数分为单支病变组54例、多支病变组46例。分别测定这些患者的LP(a)、血浆总胆固醇(TC)、甘油三酯(TG),高密度脂蛋白(HDL),低密度脂蛋白(LDL),ApoA1/ApoB的血浆浓度。结果:(1)急性冠脉综合症患者血浆LP(a)水平高于稳定型心绞痛及正常对照组(P<0.05),稳定型心绞痛患者血浆LP(a)水平与正常对照组差异无显著差异;(2)急性冠脉综合症及稳定型心绞痛患者ApoA1/ApoB水平高于正常对照组(P<0.05),急性冠脉综合症及稳定型心绞痛患者ApoA1/ApoB水平差异无显著性;(3)急性冠脉综合症及稳定型心绞痛患者LP(a)水平及ApoA1/ApoB水平与冠状动脉病变范围无明显相关性。结论:LP(a)、ApoA1/ApoB均为冠心病的预测因素,LP(a)与急性冠脉综合症的关系更为密切,LP(a)、ApoA1/ApoB与冠脉病变的范围无明显相关性。

Objective： To investigate the Changes of plasma lipoprotein （a） [LP（a）], apolipoprotein A1 / B [ApoA1/ApoB] levels in patients with acute coronary syndrome or stable angina in order to know the role of LP （a）, ApoA1/ApoB in coronary heart disease, development and acute coronary events. Method： 2007-2008 selective coronary angiography （CAG） of the patients, according to results of imaging and clinica] features of randomly selected 50 patients with acute coronary syndrome, 50 patients with stable angina, 50 patients with normal controls, and then According to coronary artery＇ disease with a few single-vessel is divided into single-vessel group of 54 cases, multi-vessel group of 46 cases. These were measured in patients with LP （a）, plasma total cholesterol （TC）, triglycerides （TG）, high-density lipoprotein （HDL）, low-density lipoprotein （LDL）, the plasma concentration of ApoA1/ApoB, respectively.Results： （1） LP（a） levels of Padents with acute coronary syndrome was higher than that of stable angina pectoris and normal control group （P 〈0.05）, there was no significant difference between LP （a） levels of patients with stable angina and the normal control group; （2） ApoA1/ApoB levels of patients with acute coronary syndrome or stable angina pectoris higher than the normal control group （P 〈0.05）, and no significant difference between patients with acute coronary syndrome and stable angina pectoris; （3） There-was no obvious correlation between the level of LP （a） or ApoA1/ApoB and that of coronary artery disease in patients with acute coronary syndrome or stable angina pectoris.Conclusions： LP（a）, ApoA1/ApoB are predictors of coronary heart disease, LP（a） and acute coronary syndrome in more closely related, LP（a）, ApoA1/ApoB and coronary artery disease had no relevance.