血清载脂蛋白B与冠脉病变程度的相关性研究

Correlation between Apolipoprotein B and Severity of Coronary Artery Stenosis

目的探讨血清载脂蛋白B(ApoB)水平与颈动脉斑块、冠状动脉粥样病变及其严重程度的关系。方法 248例行冠脉造影检查的住院患者根据冠脉造影结果分为单支病变组(59例)、多支病变组(107例)和对照组(82例),比较血清ApoB水平在各组中的变化,分析血清ApoB水平与颈动脉斑块、冠脉狭窄严重程度的相关性。结果①冠心病单支病变组血清ApoB(1.09±0.25 g/L vs 0.69±0.18 g/L,P<0.05)和多支病变组血清ApoB(1.99±0.11 g/L vs0.69±0.18 g/L,P<0.01)显著高于对照组,且多支病变组血清ApoB水平较单支病变组差异有统计学意义(1.09±0.25g/L vs 1.99±0.11 g/L,P<0.05);②冠心病单支病变组和多支病变组颈动脉易损斑块的发生率(20.3%、23.4%vs7.3%,P<0.05)与对照组相比明显增高;③血清ApoB水平与冠心病颈动脉易损斑块发生率(r=0.482,P<0.05)呈显著正相关,与冠脉积分(r=0.563,P<0.05)亦呈显著正相关。结论血清ApoB水平反映了动脉粥样硬化的程度,与冠脉病变严重程度密切相关。

Objective To investigate the correlation between apolipoprotein B （ApoB） and carotid artery plaque, the extent and severity of coronary artery lesion. Methods Two hundred and forty-eight patients underwent coronary angiography （CAG） were enrolled. The patients were divided into three groups by the results of CAG：control group （n = 82 ）, single-vessel group （n = 59 ） and multi-vessel group（ n = 107 ）. Plasma ApoB were measured in every patients, while the characters of carotid artery plaque were investigated by ultrasound. The results were compared between the three groups. Results ①The levels of plasma apoB were significantly higher in single-vessel group [ （ 1.09 ±0.25 ） g/L vs （0.69 ± 0.18 ） g/L, P 〈 0.05 ] and multi-vessel group [ （ 1.99 ± 0.11 ） g/L vs （0.69± 0.18 ） g/L, P 〈 0.01 ] than those of the control group, the levels were significantly higher in patients with multi-vessel disease group than those in single-vessel disease group [ （ 1.09 ± 0.25 ） g/L vs （ 1.99 ±0.11 ） g/L, P 〈 0. 05 ] ; ②The incidence of vulnerable plaque was significantly higher in patients in single-vessel group and multi-vessel group than that of the control（ 20.3%, 23.4% vs 7.3 %, P 〈 0.05 ） ;③the level of Plasma ApoB was correlated with the incidence of vulnerable plaque（r=0. 482,P〈0.05） and the degree of coronary artery stenosis（r=0.563,P 〈0.05）. Conclusion Plasma ApoB could reflect the situation of carotid atherosclerosis and had relationship with the extent and severity of coronary artery stenosis.