ApoA1/ApoB与ST段抬高型心肌梗死病人冠脉病变程度的相关性

RELATIONSHIP BETWEEN APOA1-TO-APOB RATIO AND THE SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

目的探讨载脂蛋白A1/载脂蛋白B比值(ApoA1/ApoB)评估ST段抬高型心肌梗死(STEMI)病人冠状动脉(冠脉)病变程度的价值。方法回顾性分析我院就诊的STEMI病人566例,根据造影结果对冠脉病变程度进行Gensini(GS)评分,通过Logistic回归分析及绘制受试者工作特征(ROC)曲线,分析ApoA1/ApoB评估STEMI病人冠脉病变程度的价值。结果高危组ApoA1/ApoB明显低于低危组(Z=-8.953,P<0.001)。多因素Logistic回归分析显示,ApoA1/ApoB是冠脉病变程度的独立保护因素(OR=0.423,95%CI=0.282~0.633,P<0.001),中性粒细胞和淋巴细胞比值(NLR)高是冠脉病变程度的独立危险因素。ROC曲线分析显示,ApoA1/ApoB评估冠脉病变程度的曲线下面积(AUC)为0.720(95%CI=0.676~0.763,P<0.01)。结论ApoA1/ApoB评估冠脉病变程度与NLR一样具有较好的敏感性和特异性,是冠脉病变程度的独立保护因素。

Objective To explore the value of the apolipoprotein A1-to-apolipoprotein B(ApoA1/ApoB)ratio in asses-sing the severity of coronary artery disease in patients with ST-segment elevation myocardial infarction(STEMI).Methods A retrospective analysis was performed on 566 patients with STEMI treated in our hospital.The severity of coronary artery disease was assessed by Gensini scoring based on angiogram results.The value of the ApoA1/ApoB ratio for evaluating the severity of co-ronary artery disease was analyzed by Logistic regression analysis and receiver operating characteristic(ROC)curve analysis.Results The ApoA1/ApoB ratio in the high-risk group was significantly lower than that in the low-risk group(Z=-8.953,P<0.001).The multivariable Logistic regression analysis showed that the ApoA1/ApoB ratio was an independent protective factor against coronary artery disease(OR=0.423,95%CI=0.282-0.633,P<0.001),and the neutrophil-to-lymphocyte ratio(NLR)was an independent risk factor for coronary artery disease.The area under the ROC curve for ApoA1/ApoB assessing the severity of coronary artery disease was 0.720(95%CI=0.676-0.763,P<0.01).Conclusion The ApoA1/ApoB ratio is an independent protective factor against coronary artery disease,which is as sensitive and specific as NLR in predicting the severity of coronary artery disease.