急性冠脉综合征患者血清载脂蛋白A5水平及相关因素分析

Analysis of serum apolipoprotein A5 level and related factors for patients with acute coronary syndrome

目的对急性冠脉综合征(ACS)患者血清载脂蛋白A5(Apo A5)水平及相关因素进行分析。方法选取2014年7月—2015年6月在瑞金医院卢湾分院心内科就诊患者188例作为研究对象。按国际指南ACS诊断标准分为ACS组96例和非ACS组(对照组)92例,ELISA法检测血清Apo A5水平,同时测定血脂谱、血常规、肾功能、血糖、心肌肌钙蛋白I(cTn Ⅰ)及N末端脑钠肽前体(NT-pro BNP)水平,根据ACS组患者的冠脉造影结果计算Gensini评分,围绕Apo A5展开相关性分析。结果 ACS组血清Apo A5水平显著低于对照组(P=0.022)。总体样本中,Apo A5与三酰甘油、游离脂肪酸、cTnⅠ呈等级负相关,与高密度脂蛋白和Apo A1呈等级正相关。分组分析显示:在ACS组,Apo A5与c Tn Ⅰ和冠脉Gensini评分呈高度负相关(P=0.006 9,P=0.014);对照组Apo A5与c Tn Ⅰ无关联(P=0.079)。结论与非ACS患者比较,ACS患者血清Apo A5水平降低,且与心肌损伤和冠状动脉病变程度显著相关。

Objective To analyze the serum apolipoprotein A5 （ApoA5） level and related factors for patients with acute coronary syndrome （ACS）. Methods A total of 188 patients who visited the Department of Cardiology of Ruijin Hospital Luwan Branch from July, 2014 to June, 2015 were enrolled and assigned to the ACS group （ n =96） and the non-ACS group （control group, n =92） according to the international guideline for ACS diagnosis criteria. Serum ApoA5 level was measured by ELISA and lipid profile, hemogram, creatinine, uric acid, blood glucose, cardiac troponin I （cTn I）, and NT-proBNP were also detected. Gensini scores were calculated according to the results of coronary angiography for patients in the ACS group. Correlation analysis was performed based on ApoAS. Results The ApoA5 level in the ACS group was significantly lower than that in the control group （P=O. 022）. For all samples, ApoA5 was negatively correlated to TG, FFA, and cTn I and positively correlated to HDL and ApoA1. Subgroup analyses showed that ApoA5 was highly and negatively correlated to cTn I and coronary artery Gensini score in the ACS group （P=0. 006 9, P=0. 014）, whereas ApoA5 was not correlated to cTn I in the control group （P=0. 079）. Conclusion The serum ApoA5 level in ACS patients is significantly lower than that in the patients without ACS and ApoA5 is significantly correlated to myocardial injury and the degree of coronary artery disease.