女性冠心病患者胆红素血脂综合指数、ApoB水平与冠状动脉病变程度的相关性研究

Correlation of the Bilirubin Blood Lipid Comprehensive Index and Apolipoprotein B with the Severity of Coronary Lesions in Female Patients with Coronary Artery Disease

目的:研究女性冠心病患者胆红素血脂综合指数、ApoB水平与冠脉病变程度的关系。方法:选取2016年1月-2016年12月于我院行冠状动脉造影检查的女性患者共246例,按照两种不同方法分组:(1)按照冠状动脉造影结果分为冠心病组(n=105)和正常对照组(n=141);(2)按照Gensini评分系统定量评估所有冠心病患者的冠状动脉病变程度,分为第1四分位组(n=35)、第2四分位组(n=32)、第3四分位组(n=39)及第4四分位组(n=35)。测定所有患者的血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A/B(ApoA/B)水平,计算胆红素血脂综合指数[TC/(HDL-C+TBIL)、LDL-C/(HDL-C+TBIL)]。结果:(1)冠心病组TC、TG、LDL-C、ApoB较正常组高,HDL-C、ApoA、TBIL、DBIL、IBIL较正常组低,差异有统计学意义(P<0.05);与正常组相比,冠心病组胆红素血脂综合指数[TC/(HDL-C+TBIL)、LDL-C/(HDL-C+TBIL)]升高,差异有统计学意义(P<0.05)。(2)在不同Gensini评分四分位组中,TC、LDL-C、ApoB、TBIL、DBIL、IBIL、TC/(HDL-C+TBIL)、LDL-C/(HDL-C+TBIL)的差异均有统计学意义(P<0.05)。(3)相关性分析显示:TC/(HDL-C+TBIL)、LDL-C/(HDL-C+TBIL)、ApoB均与冠脉不同Gensini评分呈正相关(r=0.538,P<0.05;r=0.670,P<0.05;r=0.462,P<0.05);TBIL、DBIL、IBIL与冠脉不同Gensini评分呈负相关(r=-0.485,P<0.05;r=-0.564,P<0.05;r=-0.359,P<0.05)。结论:(1)女性冠心病患者血脂胆红素综合指数、ApoB较正常对照组患者显著升高,而TBIL、DBIL、IBIL降低;(2)女性冠心病患者胆红素血脂综合指数、ApoB水平与其冠脉病变程度呈显著正相关。

Objective： To investigate the relationship between Bilirubin blood lipid Comprehensive index and apolipoprotein B and the severity of coronary lesions of female patients with coronary artery disease（CAD）. Methods： A total of 246 cases of female patients with coronary angiography were divided into 2 sets of groups.（1）According to the results of coronary angiography, the female patients were divided into the CAD group（n=141） and normal control group（n=105）;（2）By Gensini scoring system, the female patients were divided into 4 quartile groups： 1 st quartile group（n=35）, 2 nd quartile group（n=32）, 3 rd quartile group（n=39） and 4 th quartile group（n=35）. The blood level of total bilirubin（TBIL）, direct bilirubin（DBIL）, indirect bilirubin（IBIL）, total cholesterol（TC）, triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）, high density lipoprotein cholesterol（HDL-C）, apolipoprotein A/B（ApoA/B） level were measured. Bilirubin blood lipid Comprehensive index [TC/（HDL-C＋TBIL）, LDL-C/（HDL-C＋TBIL）] were calculated. Results：（1） The levels of TC, TG, LDL-C and ApoB in CAD group were higher than those of the normal control group; the HDL-C, ApoA, TBIL, DBIL and IBIL were lower than those of the normal control group（P〈0.05）; Compared with the normal group, the ratios of TC/（HDL-C＋TBIL）and LDL-C/（HDL-C＋TBIL） were increased（P〈0.05）.（2）By Gensini scoring system, the level of TC, LDL-C, ApoB, TBIL, DBIL, IBIL,ratios of TC/（HDL-C＋TBIL） and LDL-C/（HDL-C＋TBIL） were different among 4 groups（P〈0.05）.（3）Correlation analysis showed that TC/（HDL-C＋TBIL）, LDL-C/（HDL-C＋TBIL） and ApoB were positively related to Gensini scoring system（r=0.538, P〈0.05; r=0.670, P〈0.05 and r=0.462, P〈0.05）. But TBIL, DBIL, IBIL were negatively related to Gensini scoring system（r=-0.485, P〈0.05; r=-0.564, P〈0.05 and r=-0.359, P〈0.05）. Conclusions：（1）Bilirubin blood lipid Comprehensive index and apolipoprotein B were significantly higher than the control group, while TBIL, DBIL, IBIL decreased.（2）Bilirubin blood lipid Comprehensive index and apolipoprotein B were positively related to the severity of coronary artery lesions of female CAD patients.