载脂蛋白B/A-Ⅰ、同型半胱氨酸与冠心病患者冠状动脉病变程度的相关性探讨

Investigation Correlation between Apolipoprotein B/ApoA-Ⅰ, Homocysteine and the Degree of Coronary Lesions in Patients with Coronary Heart Disease

目的:探讨冠心病患者载脂蛋白(Apo)B/ApoA-Ⅰ比值、同型半胱氨酸(Hcy)水平与冠状动脉病变的相关性。方法:选择我院心内科2017年3月—2019年3月收治的冠心病患者162例作为观察组,另选择同期由于胸痛、胸闷而入院行冠状动脉造影人员130例作为对照组。观察组患者根据Gensini评分分为轻度组、中度组和重度组。比较各组血脂各项指标及血清Hcy水平,分析冠心病患者ApoB/ApoA-Ⅰ、血清Hcy水平与Gensini评分的相关性,多元逐步Logistic回归分析评估影响冠状动脉病变严重程度的因素。结果:轻度组、中度组、重度组及对照组血脂各项指标及血清Hcy水平差异均有统计学意义(P<0.05,P<0.01),脂蛋白(a)[Lp(a)]、ApoB/ApoA-Ⅰ、Hcy各组间两两比较差异均有统计学意义(P<0.01);中度组、重度组TG、TC、LDL-C、ApoB均高于轻度组和对照组,轻度组、中度组、重度组ApoA-Ⅰ高于对照组,差异均有统计学意义(P<0.01)。Pearson相关性分析显示,冠心病患者ApoB/ApoA-Ⅰ、血清Hcy水平均与Gensini评分呈正相关(r=0.494、0.398,P均<0.05);多元逐步Logistic回归分析显示ApoB/ApoA-Ⅰ、Hcy均为冠心病患者冠状动脉病变程度的影响因素。结论:ApoB/ApoA-Ⅰ比值、血清Hcy水平与Gensini评分呈正相关,是影响冠状动脉病变程度的独立危险因素,可作为冠心病患者冠状动脉病变程度的评价指标。

Objective:To investigate the correlation between apolipoprotein(Apo)B/ApoA-Ⅰ,homocysteine and the degree of coronary lesions in patients with coronary heart disease.Methods:162 patients with coronary heart disease admitted to the department of cardiology of our hospital from March 2017 to March 2019 were selected as the observation group,and 130 patients admitted to the hospital for coronary angiography due to chest pain and chest distress were selected as the control group.Patients of the observation group were divided into mild group,moderate group and severe group according to Gensini score.The correlation between ApoB/ApoA-Ⅰ,Hcy and Gensini score was analyzed.The factors influencing the severity of coronary lesions were evaluated by multiple stepwise Logistic regression analysis.Results:There were significant differences in blood lipid indexes and serum Hcy levels between the mild group,the moderate group,the severe group and the control group(P<0.05,P<0.01),compared between the groups,there were significant differences in lipoprotein(a)[Lp(a)],ApoB/ApoA-Ⅰand Hcy(P<0.01).TG,TC,LDL-C,ApoB of the moderate group and the severe group were higher than those of the mild group and control group(P<0.01),ApoA-I in mild,moderate and severe groups were higher than those of the control group(P<0.01).Pearson correlation analysis showed that the levels of ApoB/ApoA-I and serum Hcy were positively correlated with Gensini score(r=0.494,0.398,P<0.05);multiple stepwise regression analysis showed that ApoB/ApoA-Ⅰand Hcy were the influencing factors of the degree of coronary lesions in patients with coronary heart disease.Conclusion:The ratio of ApoB/ApoA-Ⅰand the level of Hcy in serum are positively correlated with the Gensini score.They are independent risk factors that affect the degree of coronary lesions,and it can be used as an index to evaluate the degree of coronary lesions in patients with coronary heart disease.