原发性高血压患者血清apoB水平与冠心病发病风险的相关性

Relationship between serum apolipoprotein B level and the risk of coronary heart disease in patients with primary hypertension

目的：探讨原发性高血压患者血清载脂蛋白 B（apoB）水平与冠心病发病风险的相关性。方法入选2011年1月至2015年5月住院接受冠状动脉造影的原发性高血压患者785例，根据冠状动脉造影结果分为单纯性高血压组264例和高血压合并冠心病组521例，所有患者均检测空腹血脂和血糖。比较原发性高血压患者中不同水平血清 apoB 的冠心病发病率；运用多因素逐步 logistic 回归分析血清 apoB 与原发性高血压患者冠心病发病风险的相关性；并通过偏相关分析研究血清 apoB 水平与冠状动脉病变支数的相关性。结果伴有高水平血清 apoB 的原发性高血压患者冠心病的发病率最高（74．9％），明显高于低水平组（P ＜0．05）；进一步通过多因素逐步 logistic 回归分析发现，血清 apoB 为原发性高血压发生冠心病的独立危险因素（OR ＝8．584，95％CI：4．084～18．043，P ＜0．001）；应用偏相关分析发现，校正相关因素后发现，血清 apoB 水平与冠状动脉病变支数的相关性（r ＝0．240，P ＜0．001）。结论血清 apoB 对原发性高血压患者的冠心病发病风险以及冠状动脉病变支数的评估有一定的临床意义。

Objective To explore the relationship between serum apolipoproteinB（apoB）level and the risk of coronary heart disease （CHD）in patients with primary hypertension.Methods In total,785 patients with primary hypertension hospitalized from January 2011 to May 2015 were enrolled and classified into a simple hypertension group （264 cases）and a hypertension combined with CHD group （521 cases）according to the results of coronary angiography.All the patients had fasting lipid profile and fasting blood glucose test.The incidence rate of CHD was analyzed according to the different levels of serum apoB in patients with primary hypertension.Mul-tivariate logistic regression was applied to estimate the relationship between serum apoB and the risk of CHD in patients with primary hy-pertension.Partial correlation analysis was used to analyze the correlation of serum apoB level with the narrowing vessel number of coro-nary artery.Results The incidence rate of coronary heart disease in the group of high serum apoB level was the highest （74.9%）,and significantly higher than that of low serum apoB level （P 〈0.05）in patients with primary hypertension.Multivariate logistic regression analysis showed that serum apoB was an independent risk factor for occurrence of CHD in patients with primary hypertension（OR =8.584,95%CI：4.084 ~18.043,P 〈0.001）.Partial correlation analysis showed that serum apoB level was positively related with the narrowing vessel number of coronary artery（r =0.240,P 〈0.001）after adjusting relevant factors.Conclusions Serum apoB may have some clinical significance in evaluating the risk of CHD and the narrowing vessel number of coronary artery in the patients with primary hypertension.