高密度脂蛋白组分中血浆淀粉样蛋白A与载脂蛋白A-Ⅰ比值在冠心病诊断中的价值

The Diagnostic Value of HDL Associated Serum Amyloid A to Apolipoprotein A-I Ratio in Patients With Coronary Artery Disease

目的：探讨高密度脂蛋白（HDL）组分中血浆淀粉样蛋白A（SAA）与载脂蛋白A-Ⅰ（apoA-Ⅰ）比值在冠心病诊断中的价值。方法：入选我院冠状动脉造影患者152例，按冠状动脉狭窄程度分为冠心病组77例，对照组75例。密度梯度超速离心法分离提取血浆HDL，酶联免疫吸附法分别检测HDL及血浆中SAA与apoA-Ⅰ的含量。结果：与对照组相比，冠心病组HDL组分中SAA（HDL-SAA）显著升高（P〈0．001），HDL组分中apoA-Ⅰ（HDL—apoA-Ⅰ）显著降低（P〈0．001）。多因素logistic回归分析显示HDL—SAA／HDL—apoA—Ⅰ比值与冠心病风险独立相关（比值比：9．521，95％可信区间：3．345～27．100，P〈0．001）。受试者工作特征曲线分析显示HDL—SAA／HDL—apoA—Ⅰ比值具有中等程度诊断冠心病的能力（曲线下面积：0．712，95％可信区间：0．632～0．793，P〈0．001），最佳诊断临界点为3．27。血浆中SAA／apoA—Ⅰ比值与HDL-SAA／HDL—apoA-Ⅰ比值呈显著正相关（r=0．857，P〈0．001），诊断冠心病的能力相似（曲线下面积：0．676，95％可信区间：0．591～0．761，P〈0．001），诊断的最佳临界点为8.3。

Objective： To investigate the diagnostic value of high-density lipoprotein （HDL） associated serum amyloid A （SAA） to apolipoprotein A-Ⅰ （apoA-Ⅰ） ratio （SAA/apoA-Ⅰ） in patients with coronary artery disease （CAD）. Methods： A total of 152 patients who received coronary degree of coronary stenosis, the patients were divided into 2 was isolated by density gradient ultracentrifugation and the examined by ELISA. angiography in our hospital were studied. According to the groups. CAD group, n=77 and Control group, n=75. HDL levels of SAA and apoA-Ⅰ both in HDL and plasma were Results： Compared with Control group, CAD group had increased ratio of HDL-SAA/HDL-apoA-Ⅰ, P〈0.001. Multivariate logistic regression analysis indicated that the ratio of HDL-SAA/HDL-apoA-Ⅰ was independently related to the risk of CAD （OR=9.521, 95% CI 3.345-27.100, P〈0.001）. Receiver operating characteristic curve （ROC） analysis presented that the ratio of HDL-SAA/HDL-apoA-Ⅰ had the medium value for CAD diagnosis （AUC=0.712, 95% CI 0.632-0.793, P〈0.001）, the best cut-off value was at 3.27. The plasma ratio of SAA/apoA-Ⅰ was positively related to the ratio of HDL-SAA/HDL-apoA-Ⅰ （r=0.857, P〈0.001）, the ratio of SAA/apoA-Ⅰ had the similar value for CAD diagnosis （AUC=0.676, 95% CI 0.591-0.761, P〈0.001）, the best cut-offvalue was at 8.3. Conclusion： The ratio of SAA/apoA-Ⅰ in HDL is positively related to the risk of CAD, it might be become a potential diagnostic marker in patients with CAD.