冠心病患者血清载脂蛋白AI、载脂蛋白B与血浆D-二聚体水平变化及其相关性研究

Study on the changes of serum apolipoprotein AI, apolipoprotein B and plasma D-dimer in patients with coronary heart disease and its correlation

目的探讨冠心病（CHD）患者血清载脂蛋白AI（Apo AI）、载脂蛋白B（Apo B）与血浆D-二聚体水平变化及其相关性。 方法选取83例CHD患者为研究组，另选取26例同期体检健康者为对照组。抽取两组4 ml空腹静脉血，以酶联免疫吸附法测定血浆D-二聚体水平，以免疫散射比浊法测定血清Apo AI及Apo B水平。对比两组D-二聚体、Apo AI及Apo B水平及不同CHD类型患者D-二聚体、Apo AI及Apo B水平。 结果研究组血浆D-二聚体、血清Apo B水平高于对照组，血清Apo AI水平低于对照组，差异有统计学意义（P〈0.05）。急性心肌梗死组、陈旧性心肌梗死组、不稳定型心绞痛组、稳定型心绞痛组血浆D-二聚体、Apo B水平高于对照组，Apo AI水平低于对照组。不稳定型心绞痛、急性心肌梗死组血清Apo B水平高于稳定型心绞痛组，急性心肌梗死组血清Apo B水平高于陈旧性心肌梗死组，不稳定型心绞痛、急性心肌梗死组血浆D-二聚体水平高于稳定型心绞痛组，陈旧性心肌梗死组血浆D-二聚体水平高于不稳定型心绞痛组，急性心肌梗死组血浆D-二聚体水平高于陈旧性心肌梗死组，差异均有统计学意义（P均〈0.05）；血清Apo AI水平和血浆D-二聚体间呈负相关性（r＝－0.57，P〈0.05），血清Apo B水平和血浆D-二聚体间呈正相关性（r＝0.68，P〈0.05）。 结论CHD患者血清Apo AI水平较低，血浆D-二聚体水平和血清Apo B水平较高，其中急性心肌梗死与不稳定型心绞痛更加明显，且血清载脂蛋白水平和血浆D-二聚体水平间具有明显相关性。

ObjectiveTo investigate the changes of serum apolipoprotein AI （Apo AI）, apolipoprotein B （Apo B） and plasma D-dimer levels in patients with coronary heart disease （CHD） and its correlation. MethodsEighty-three patients with CHD were selected as the study group, another 26 healthy subjects were selected as the control group. The plasma D-dimer levels were measured by enzyme-linked immunosorbent assay （ELISA）, serum Apo AI and Apo B levels were measured by immunoturbidimetric turbidimetric assay. The levels of D-dimer, Apo AI and Apo B in patients with different CHD types were compared. ResultsThe levels of plasma D-dimer and serum Apo B in the study group were higher than those in the control group, and the serum Apo AI level was lower than that in the control group （P〈0.05）. The levels of plasma D-dimer and Apo B in acute myocardial infarction group, old myocardial infarction group, unstable angina pectoris group and stable angina pectoris group were higher than those in the control group, Apo AI level was lower than that in the control group. The levels of serum Apo B in patients with unstable angina and acute myocardial infarction were higher than those in patients with stable angina pectoris. The serum Apo B levels in acute myocardial infarction group were higher than those in old myocardial infarction group, the level of plasma D-dimer in unstable angina pectoris and acute myocardial infarction group was higher than that in stable angina pectoris group, the level of plasma D-dimer in old myocardial infarction group was higher than that in unstable angina pectoris group and acute myocardial infarction group, and the differences were significant （P〈0.05）. There was negative correlation of serum Apo AI level with plasma D-dimer （r=-0.57, P〈0.05）, and positive correlation of serum Apo B level with plasma D-dimer （r=0.68, P〈0.05）. ConclusionsThe serum Apo AI level is low, the plasma D-dimer and serum Apo B level is higher in CHD patients, especially for patients with acute myocardial infarction and unstable angina pectoris is more obvious, and serum apolipoprotein levels is obviously correlatied with plasma D- dimer levels.