老年冠心病患者血清脂蛋白A-1、胱抑素C、同型半胱氨酸水平与冠状动脉粥样硬化的相关性分析

Correlation between lipoprotein A-1, cystatin C, homocysteine levels and coronary atherosclerosis in elderly patients with coronary heart disease

目的 分析老年冠心病(CHD)患者血清脂蛋白A-1(apoA-1)、胱抑素C(Cys C)、同型半胱氨酸(Hcy)水平与冠状动脉粥样硬化的相关性。方法 选取本院2019年11月-2021年9月收治的110例CHD患者为观察组,另选取同期同院110例体检健康者为对照组。根据Gensini积分将观察组患者分为轻度硬化组(n=30)、中度硬化组(n=35)及重度硬化组(n=45)。比较2组患者血清apoA-1、Cys C、Hcy水平;比较不同冠状动脉粥样硬化患者血清apoA-1、Cys C、Hcy水平;分析Gensini积分与血清apoA-1、Cys C、Hcy水平的相关性。结果 与对照组相比,观察组患者血清apoA-1水平均明显降低,而Cys C、Hcy水平明显升高(P<0.05)。与轻度硬化组相比,中度硬化组及重度硬化组患者血清apoA-1水平均较低,而Cys C、Hcy水平较高;与中度硬化组相比,重度硬化组患者血清apoA-1水平均较低,而Cys C、Hcy水平较高(P<0.05)。与轻度硬化组相比,中度硬化组及重度硬化组患者Gensini积分较高;与中度硬化组相比,重度硬化组患者Gensini积分较高(P<0.05)。Gensini积分与血清apoA-1水平均成负相关(r=-0.883,P<0.001),与Cys C、Hcy水平成正相关(r=0.846、r=0.848,P<0.001)。apoA-1、Cys C、Hcy为老年冠心病独立预测因素(P<0.05)。结论 血清apoA-1、Cys C、Hcy水平与老年CHD患者冠脉病变程度均存在不同程度相关性,低水平apoA-1及高水平的Cys C、Hcy均可增加老年人发生CHD风险,临床通过检测血清apoA-1、Cys C、Hcy水平可有效预测老年CHD的发生。

Objective This paper aims to analyze the correlation between serum lipoprotein A-1(apoa-1), Cystatin C(Cys-C), homocysteine(Hcy) and coronary atherosclerosis in elderly patients with coronary heart disease(CHD). Methods A total of 110 patients with CHD admitted to our hospital from November 2019 to September 2021 were selected as the observation group, and 110 healthy subjects during the same period were selected as the control group. According to Gensini score, the patients in the observation group were divided into mild sclerosis group(n=30), moderate sclerosis group(n=35) and severe sclerosis group(n=45). The serum levels of apoA-1, Cys-C and Hcy were compared between the two groups;the serum levels of apoA-1, Cys-C and Hcy in patients with different coronary atherosclerosis were compared. The correlation between Gensini score and serum apoA-1, Cys-C and Hcy levels was analyzed. Results Compared with the control group, the serum level of apoA-1 in the observation group was significantly lower, while the levels of Cys-C and Hcy were significantly higher(P<0.05). Compared with mild sclerosis group, the serum levels of apoA-1 in moderate sclerosis group and severe sclerosis group were lower, while the levels of Cys-C and Hcy were higher;Compared with the moderate sclerosis group, the serum levels of apoA-1 in the severe sclerosis group were lower, while the levels of Cys-C and Hcy were higher(P<0.05). Compared with mild sclerosis group, the Gensini scores of patients in moderate sclerosis group and severe sclerosis group were higher;compared with the moderate sclerosis group, the Gensini score in the severe sclerosis group was higher(P<0.05). Gensini score was negatively correlated with serum apoA-1 level(r=-0.883, P<0.001), and positively correlated with Cys-C and Hcy levels(r=0.846, r=0.848, P<0.001). apoA-1, Cys-C and Hcy were independent predictors of coronary heart disease in the elderly(P<0.05). Conclusion The serum levels of apoA-1, Cys-C and Hcy are correlated with the degree of coronary artery disease in elderly patients with CHD. Low levels of apoA-1 and high levels of Cys-C andHcy can increase the risk of CHD in the elderly. The detection of serum apoA-1, Cys-C and Hcy can effectively predict the occurrence of CHD in the elderly.