冠心病患者血清载脂蛋白与D-二聚体的变化及其相关性研究

The changes of apoplipoprotein and D-dimer in patients with coronary heart disease and their correlation

目的观察冠心病 (CHD)患者血清载脂蛋白AⅠ (ApoAⅠ )、载脂蛋白B(ApoB)与血浆D 二聚体 (DD)水平的变化特点 ,并探讨其相关性。方法CHD患者 12 4例和 2 6例正常对照组采用免疫散射比浊法测定ApoAⅠ、ApoB浓度 ,ELISA法测定DD水平。结果CHD患者中 ,急性心肌梗死 (AMI)和不稳定型心绞痛 (UAP)组患者ApoB浓度、DD水平均显著高于对照组 (P <0 .0 1) ;陈旧性心肌梗死 (OMI)和稳定型心绞痛 (SAP)组患者ApoB浓度高于对照组 ,ApoAⅠ浓度低于对照组 (P <0 .0 1) ,但DD水平无改变 (P >0 .0 5 )。 12 4例CHD患者相关分析显示 :ApoB与DD呈显著正相关 ,ApoAⅠ与DD呈显著负相关 (P <0 .0 0 1)。结论冠心病患者存在载脂蛋白代谢异常 ,AMI、UAP组患者DD水平增高 ,且载脂蛋白与DD有密切关系。

Objective To evaluate the changes of apolipoprotein AⅠ (ApoAⅠApo), apolipoprotein B (ApoB) and D-dimer (DD) in the patients with coronary heart disease (CHD) and their relationship. Methods ApoB, ApoB and DD were detected respectively by immunoturbidimetry and ELISA in 124 CHD patients and 26 normal controls. Results Among the patients of CHD, the concentration of ApoB and DD in patients with acute myocardial infarction (AMI) and unstable angina pectoris (UAP) were significantly higher than those of controls (P<0.01), while the concentration of ApoAI were lower than those of controls (P<0.01). In the patients of old myocardial infarction (OMI) and stable angina pectoris (SAP), the concentration of ApoB were higher than those of controls, while ApoAI were lower (P<0.01). The levels of DD had no significant difference, compared with controls (P>0.05). The analysis of 124 cases with CHD showed that ApoB was significantly positively correlated with DD and ApoAI was significantly negatively correlated with DD (P<0.001). Conclusion Abnormal metabolism of Apoprotein exists in CHD patients. DD is increased in AMI and UAP patients while Apoprotein is closely related to the DD level.