中原地区人群血脂谱和ApoB/apoA-Ⅰ比值与颈动脉内膜中层厚度的相关性研究

Investigation of relationship between ApoB/apoA-Ⅰ ratio and lipid profile with carotid artery intima-media thickness on population in central plains region of China

目的分析中原地区人群血脂谱特征及ApoB/apoA-Ⅰ比值与颈动脉内膜中层厚度(cIMT)关系,为临床评价危险因素及药物疗效提供依据。方法 812例冠脉造影排除冠心病的人群进行血脂及载脂蛋白生化分析,B型超声测量cIMT,统计学分析性别分组和ApoB/apoA-Ⅰ比值分组血脂谱特征和cIMT的差异。多元回归分析cIMT和血脂谱的关系。结果①以性别分组的人群中,HDL-C、ApoA-Ⅰ、ApoB/apoA-Ⅰ、LDL/HDL、TC/HDL和cIMT在男女两组有显著差异(均P<0.05)。②以ApoB/apoA-Ⅰ比值分组(男性节点0.8,女性节点0.7)的人群,年龄和他汀治疗率在ApoB/apoA-I比值低的男女两组均高于比值高的组(均P<0.05),糖尿病发生率、吸烟、饮酒、cIMT和其他血脂谱指标在ApoB/apoA-I比值高的男女两组均高于比值低的组(均P<0.05)。③多元回归分析显示,仅ApoA-Ⅰ、ApoB和ApoB/apoA-Ⅰ回归系数有统计学差异(均P<0.05)。结论 cIMT是监测动脉粥样硬化进展和治疗效果的无创指标,与ApoB/apoA-Ⅰ比值显著相关。ApoB/apoA-Ⅰ比值结合cIMT是进行冠心病危险因素评估和治疗效果的更好指标。

Objective Characteristics of lipid profile and relationship between ApoB/apoA-I ratio and carotid artery intima-media thickness（cIMT） were analyzed on population in central plains region of China,which provided evidences of risk factor appraisal and efficiency of medicines therapy.Methods Totally 812 cases confirmed normal vessel by coronary angiography were chemical analyzed.B-mode Carotid Ultrasonography of cIMT was performed.The difference of lipid profile and cIMT in sex-based groups and ApoB/apoA-I ratio-based groups were analyzed.The relationship of cIMT and lipid profile was studied by multiple regression analysis.Results ①In the population divided into two groups by sex,HDL-C、ApoA-I、ApoB/apoA-I、LDL/HDL、TC/HDL and cIMT had significant difference in two groups（all P0.05）.②In the population divided by ApoB/apoA-I ratio（the cut-off value of male was 0.8 and that of female 0.7）,age and percentage of treatment with statins were higher in low ApoB/apoA-I ratio group than those in high group（P0.05）.While the percentage of diabetes mellitus,smoking,alcohol,cIMT and indexes of other lipid profile were higher in high ApoB/apoA-I ratio group than those in low group（P0.05）.③Multiple regression analysis showed only the regression coefficience of ApoA-I、ApoB and ApoB/apoA-I had significant difference（P0.05）.Conclusions cIMT was invasive index of predicting atherosclerotic progression and efficiency of medicines therapy,which was significant correlation with ApoB/apoA-I ratio.ApoB/apoA-I ratio,as well as cIMT,was excellent index to perform risk factor appraisal and efficiency of medicines therapy of CHD patients.