冠心病冠脈病變程度與Apo AI/Apo B、同型半胱氨酸、血脂指標的相關性

李琳　宋婷婷

[摘要] 目的 探究與分析冠心病冠脈病變程度與載脂蛋白AI/載脂蛋白B（Apo AI/Apo B）、同型半胱氨酸、血脂指標的相關性。 方法 選取2016年12月～2018年12月遼寧中醫藥大學附屬第二醫院（以下簡稱“我院”）收治的67例經過冠脈造影（CAG）確診的冠心病患者作為觀察組，另選擇我院同時期收治的63名健康體檢者作為對照組。根據Gensini評分將冠心病患者分為低危組（n = 23）、中危組（n = 22）及高危組（n = 22）。比較各組Apo AI/Apo B、同型半胱氨酸、低密度脂蛋白、膽固醇、三酰甘油水平，探討冠心病冠脈病變程度與Apo AI/Apo B、同型半胱氨酸、血脂指標的相關性。 結果 低危組、中危組、高危組的膽固醇、三酰甘油水平比較，差異無統計學意義（P > 0.05）。低危組、中危組、高危組的膽固醇、三酰甘油水平均高于對照組，差異有統計學意義（P < 0.05）。中危組、高危組Apo AI/Apo B低于低危組，但同型半胱氨酸及低密度脂蛋白水平高于低危組，差異有統計學意義（P < 0.05）;高危組Apo AI/Apo B低于中危組，但同型半胱氨酸及低密度脂蛋白水平高于中危組，差異有統計學意義（P < 0.05）。低危組、中危組、高危組的同型半胱氨酸及低密度脂蛋白水平均高于對照組，Apo AI/Apo B低于對照組，差異有統計學意義（P < 0.05）。Apo AI/Apo B與冠心病冠脈病變程度呈負相關（r = -0.189，P < 0.05），同型半胱氨酸、低密度脂蛋白冠心病冠脈病變程度呈正相關（r = 0.072～0.095，P < 0.05）。 結論 Apo AI/Apo B、同型半胱氨酸與低密度脂蛋白水平與冠心病冠脈病變程度具有一定的相關性，能夠用于對疾病的預測及判斷。

[關鍵詞] 冠心病;冠脈病變;載脂蛋白AI/載脂蛋白B;同型半胱氨酸;血脂指標

[中圖分類號] R541.4? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-7210（2019）06（b）-0035-04

Correlation between the degree of coronary artery disease and Apo AI/Apo B， homocysteine and blood lipids

LI Lin1? ?SONG Tingting2

1.Second Department of Cardiology， Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine， Liaoning Province， Shenyang? ?110033， China; 2.First Department of Cardiology， Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine， Liaoning Province， Shenyang? ?110033， China

[Abstract] Objective To investigate and analyze the correlation between the severity of coronary artery disease and apolipoprotein AI/apolipoprotein B （Apo AI/Apo B）， homocysteine and blood lipids. Methods From December 2016 to December 2018， 67 patients with coronary heart disease diagnosed by coronary angiography （CAG） admitted to the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine （“our hospital” for short） were selected as the observation group. A total of 63 healthy medical examiners admitted to our hospital at the same time served as the control group. According to the Gensini score， patients with coronary heart disease were divided into low-risk group （n = 23）， intermediate-risk group （n = 22） and high-risk group （n = 22）. The levels of Apo AI/Apo B， homocysteine， low density lipoprotein， cholesterol and triglyceride in each group were compared to explore the correlation between the severity of coronary artery disease and the indexes of Apo AI/Apo B， homocysteine and blood lipids. Results There were no significant differences in cholesterol and triglyceride levels between the low-risk group， the intermediate-risk group and the high-risk group （P > 0.05）. The levels of cholesterol and triglyceride in the low-risk group， the intermediate-risk group and the high-risk group were higher than those in the control group， the differences were statistically significant （P < 0.05）. The Apo AI/Apo B in the intermediate-risk group and the high-risk group were lower than the low-risk group， but the homocysteine and low-density lipoprotein levels were higher than the low-risk group， the differences were statistically significant （P < 0.05）; Apo AI /Apo B in the high-risk group was lower than the intermediate-risk group， but homocysteine and low density lipoprotein levels were higher than the intermediate-risk group， the differences were statistically significant （P < 0.05）. The levels of homocysteine and low density lipoprotein in the low-risk group， the intermediate-risk group and the high-risk group were higher than those in the control group， and the Apo AI/Apo B was lower than that in the control group， the differences were statistically significant （P < 0.05）. Apo AI/Apo B was negatively correlated with coronary artery disease （r = -0.189， P < 0.05）， and positively correlated with homocysteine and low-density lipoprotein coronary heart disease （r = 0.072-0.095， P < 0.05）. Conclusion Apo AI/Apo B， homocysteine and low density lipoprotein levels are correlated with the severity of coronary artery disease， which can be used to predict and judge the disease.

[Key words] Coronary heart disease; Coronary artery disease; Apolipoprotein AI/apolipoprotein B; Homocysteine; Blood lipid index

冠心病作為臨床上一類由冠狀動脈器質性阻塞或者是狹窄而引起的心肌缺血缺氧疾病，隨著疾病的進展可引起心肌壞死，也被臨床工作者稱之為缺血性心臟病，具有并發癥較高，難治愈，死亡率較高等特點，對患者的生命健康已經造成了嚴重的威脅[1]。目前臨床工作中用于評價冠狀動脈粥樣硬化的金標準仍為冠狀動脈造影術（CAG），原因是此種方法能夠明確冠狀動脈病變及血管狹窄程度兩個方面，但其具有一定的弊端，比如手術操作風險較高或者價格昂貴等[2]。現隨著醫療技術的不斷進步，發現可以使用某些危險因素以及預測因子等對冠心病的發生發展以及冠脈病變程度進行評價，其中就包括了載脂蛋白AI/載脂蛋白B（Apo AI/Apo B）、同型半胱氨酸、血脂等指標。本研……