老年冠心病患者血清Lp(a)及ApoA-1与ApoB的表达及临床意义

Expression and clinical significance of serum LP(a)and ApoA-1 ApoB in elderly patients with coronary heart disease

目的探讨老年冠心病患者血清脂蛋白(a)[Lp(a)]及载脂蛋白A1(ApoA-1)、载脂蛋白B(ApoB)的表达及临床意义。方法回顾性分析2017年1月至2019年1月本院收治的82例老年冠心病患者作为A组,另选取同期收治的非冠心病患者50例作为B组。两组均在入院后测定血清Lp(a)、ApoA-1、ApoB的表达水平,并进行对比分析;使用Logistic回归分析血清Lp(a)、ApoA-1、ApoB是否为引发冠心病的危险因素;并绘制ROC曲线,使用曲线下面积(AUC)评估血清Lp(a)、ApoA-1、ApoB预测冠心病的价值。结果A组血清Lp(a)、ApoB水平均高于B组,ApoA-1水平低于B组,差异有统计学意义(P<0.05);将冠心病血清Lp(a)、ApoA-1、ApoB水平作为自变量,将患者是否发生冠心病作为因变量,经Logistic回归分析检验得到方程:血清Lp(a):Y=-3.562+0.433X;ApoA-1:Y=-3.562-0.614X;ApoB:Y=-3.562+0.609X,提示血清Lp(a)、ApoB水平高及ApoA-1水平低是引发冠心病的危险因素(OR>1,P<0.05);ROC曲线结果显示,血清Lp(a)、ApoA-1、ApoB及联合检测诊断冠心病的AUC分别为0.764、0.641、0.622、0.876,其中联合检测的预测价值最高。结论血清Lp(a)和ApoB表达升高及ApoA-1表达降低为老年冠心病患者的影响因素,且将血清Lp(a)、ApoA-1、ApoB联合用于冠心病的临床诊断中的诊断价值较高。

Objective To investigate the expression of serum lipoprotein(a)[LP(a)],apolipoprotein A1(ApoA-1)and apolipoprotein B(ApoB)in elderly patients with coronary heart disease and its clinical significance.Methods The clinical data of 82 elderly patients with coronary heart disease admitted to this hospital from January 2017 to January 2019 were selected and included in group A,and 50 patients without coronary heart disease admitted to this hospital during the same period were included in group B.After admission,the expression levels of serum LP(a),ApoA-1 and ApoB in both groups were measured and contrastively analyzed.Logistic regression was used to analyze whether serum LP(a),ApoA-1 and ApoB were risk factors for coronary heart disease.The ROC curve was plotted,and the area under the curve(AUC)was used to evaluate the value of serum LP(a),ApoA-1 and ApoB in predicting coronary heart disease.Results The levels of serum Lp(a)and ApoB in group A were higher than those in group B,and the level of ApoA-1 was lower than that in group B,and difference was statistically significant(P<0.05).Serum Lp(a),ApoA-1 and ApoB of patients with coronary heart disease were taken as independent variables,and whether the patients had coronary heart disease or not was taken as dependent variable.Logistic regression analysis was used to test the equation,serum Lp(a):Y=-3.562+0.433x;ApoA-1:Y=-3.562-0.614X;ApoB:Y=-3.562+0.609X,suggesting that high serum Lp(a),high levels of ApoB and low levels of ApoA-1 were risk factors for coronary heart disease(OR>1,P<0.05).ROC curve results showed that the AUC of serum LP(a),ApoA-1,ApoB and combined detection in the diagnosis of coronary heart disease were 0.764,0.641,0.622 and 0.876,respectively,among which the combined detection had the best predictive value.Conclusion The increased expression of serum LP(a)and ApoA-1 and the decreased expression of ApoA-1 are the influencing factors for the elderly patients with coronary heart disease,and the combined application of serum LP(a),ApoA-1 and ApoA-1 has better value in the clinical diagnosis of coronary heart disease.