老年男性冠心病患者同型半胱氨酸、载脂蛋白B/A1等相关因素分析

Analysis of Hcy,ApoB/A1 and other Relevant Risk Factors in Old Man Patients with CHD

目的:探讨同型半胱氨酸、载脂蛋白B/A1等因素与冠心病的相关性及与冠心病严重程度的关系。方法:140例老年男性冠心病患者,按病变程度分为稳定型心绞痛(SAP,53例)、不稳定型心绞痛(UAP,50例)、急性心肌梗死(AMI,37例),与同期健康体检老年男性140例作对照,检测各组同型半胱氨酸(Hcy)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B100(ApoB100)、载脂蛋白B/A1(ApoB/A1),分析其与冠心病及冠心病病变程度相关性。结果:冠心病组Hcy、UA、TC、TG、LDL-C、ApoB100、ApoB/A1等各项生化指标均高于对照组,HDL-C、ApoA1低于对照组(P<0.05);冠心病各亚组Hcy等指标进行比较,AMI组较UAP组、UAP组较SAP组Hcy、UA、TC、TG、LDL-C、ApoB100、ApoB/A1明显增高(P<0.01)。SAP组、UAP组、AMI组两两比较Hcy等指标间存在显著差异性(P<0.01);Spearman相关分析示冠心病病变程度与Hcy、TC、LDL-C、ApoB100、ApoB/A1呈显著正相关(P<0.01);多元逐步回归分析显示Hcy、ApoB100、ApoB/A1为冠心病独立预测因素(P<0.01)。结论:Hcy、UA、TC、TG、LDL-C、ApoB100、ApoB/A1随冠状动脉病变程度增加呈升高趋势,Hcy、ApoB100、ApoB/A1为冠心病独立危险因素,联合检测这三个指标可预测冠状动脉病变的严重程度。

Objective：To study The effects of Hey, ApoB/Al and other factors and the correlation of coronary heart disease（CHD） and relationship with the severity of CHD. Methods： 140 cases of elderly male patients with CHD, according to the degree of pathological changes is divided into stable angina pectoris （SAP, 53cases）, unstable angina peetoris （UAP, 50 eases）, acute myocardial infarction （AMI, 37 cases）, compared with the control group（140 cases of healthy male）, test Hey, TC, TG, HDL-C, LDL-C, ApoAl, ApoBl00, ApoB/Al, analyze the correlation degree and pathological changes of CHD. Results： Hey, UA, TC, TG, LDL-C, ApoB100 and ApoB/Al in the CHD group were higher than the control group. HDL-C, ApoAl of the biochemical indicatorsis in the CHD group were lower than the control group （P〈0. 05）;the biochemical indicatorsis of each subgroup such as UA, TC, TG, LDL-C, ApoB100 and ApoB/Al, which in the AMI group is significantly higher than the UAP group, The UAP group is significantly higher than the SAP group（P〈0.01）. Spearman correlation analysis in coronary lesion severity and Hcy, TC, LDL-C, ApoB100 and ApoB/Al has significant positive correlation （P〈0. 01）. Multiple stepwise regression analysis showed that Hcy, ApoB100, ApoB/Al is independent predictors of coronary heart disease （P〈0. 01）. Conclusion： Hcy, UA, TC, TG, LDL-C,ApoB100 and ApoB/Al showed a trend of increase with increasing degree of coronary artery lesions. Hcy, ApoB100, ApoB/Al were independent risk factors for CHD,joint detection of the three indicators can predict the severity of coronary artery lesions.