apoB/apoA-1、LDH及ALP水平与冠心病患者主要不良心血管事件的关系

Relationship between apoB/apoA-1,LDH and ALP levels and main adverse cardiovascular events in patients with coronary heart disease

目的分析载脂蛋白B/载脂蛋白A1(apoB/apoA-1)、乳酸脱氢酶(LDH)及碱性磷酸酶(ALP)水平与冠心病(CHD)患者主要不良心血管事件(MACE)的关系。方法选取2017年5月至2018年5月本院收治的115例冠心病患者作为研究组,根据患者预后情况将发生MACE者设为A组(n=28),未发生MACE者设为B组(n=87),另选取120例同期疑似冠心病住院而经冠状动脉造影术证实非冠心病者为对照组。比较各组apoB/apoA-1、LDH及ALP水平差异,采用Logistic回归分析影响冠心病患者发生MACE的危险因素,采用ROC曲线分析apoB/apoA-1、LDH及ALP水平对冠心病患者发生MACE的预测价值。结果研究组apoB/apoA-1、LDH及ALP水平高于对照组,差异均有统计学意义(P<0.05)。A组患者血清apoB/apoA-1、LDH及ALP水平高于B组,差异均有统计学意义(P<0.05)。Logistic回归模型分析显示:患者GRACE评分为高危、左心室射血分数为≥50%、合并高血压、糖尿病、apoB/apoA-1、LDH及ALP水平异常升高为影响冠心病患者出现MACE的危险因素(P<0.05)。ROC曲线分析显示:apoB/apoA-1、LDH及ALP水平三者联合约登指数及曲线下面积最大,分别为:0.788、0.961。结论apoB/apoA-1、LDH及ALP水平异常变化与冠心病患者出现MACE有着密切联系,联合三个指标检测对评估患者病情及MACE预测有着重要作用。

Objective To analyze the relationship between apolipoprotein B/apolipoprotein A1(apoB/apoA-1),lactate dehydrogenase(LDH)and alkaline phosphatase(ALP)levels and the main adverse cardiovascular events(MACE)in patients with coronary heart disease.Methods 115 patients with coronary heart disease admitted to this hospital from May 2017 to May 2018 were selected as the study group.According to the prognosis of the patients,the patients with adverse cardiovascular events were set as group A(n=28),those without adverse cardiovascular events were set as group B(n=87),and another 120 patients admitted to this hospital for suspected coronary heart disease during the same period and did not have non-coronary heart disease confirmed by coronary angiography were selected as the control group.The differences in the levels of apoB/apoA-1,LDH and ALP in each group were compared.Logistic regression was used to analyze the risk factors MACE in patients with coronary heart disease.The ROC curve was used to analyze the value of apoB/apoA-1,LDH and ALP levels in predicting MACE in patients with coronary heart disease.Results The levels of apoB/apoA-1,LDH and ALP in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of serum Cys-c,SAA and CRP in group A were higher than those in group B,and the differences were statistically significant(P<0.05).Logistic regressionmodel analysis showed that the patient.s GRACE score was high risk,the left ventricular ejection fraction was≥50%,hypertension,diabetes,and the abnormal increasing in apo B/apo A-1,LDH and ALP levels were risk factors affecting MACE in patients with coronary heart disease(P<0.05).ROC curve analysis showed that the Youden index and the area under the curve of combined apo B/apo A-1,LDH and ALP levels were the largest,which were 0.788 and 0.961,respectively.Conclusion Abnormal changes in apo B/apo A-1,LDH and ALP levels are closely related to the occurrence of MACE events in patients with coronary heart disease.The combined detection of the threeplays an important role in assessing the patient.s condition and predicting MACE.