[1]黄维华,吕田明,李焕敏,等.血清载脂蛋白AI、B及其比值与脑白质变性严重程度的相关性[J].南方医科大学学报,2018,(08):992.
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血清载脂蛋白AI、B及其比值与脑白质变性严重程度的相关性()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2018年08期
页码:
992
栏目:
出版日期:
2018-07-31

文章信息/Info

Title:
Correlation of apolipoprotein AI, apolipoprotein B and their ratio with the severity of cerebral white matter lesions
作者:
黄维华吕田明李焕敏杜淑华杨灿洪袁师其
关键词:
载脂蛋白AI载脂蛋白B/载脂蛋白AI脑白质病变危险因素保护因素
Keywords:
apolipoprotein AI apolipoprotein B white matter lesions risk factors protective factors
摘要:
目的探讨载脂蛋白AI(ApoAI)、载脂蛋白B(ApoB)及ApoB/ApoAI与脑白质病变严重程度的关系。方法回顾性收集 648例经头颅MRI证实脑白质病变患者,根据Fazekas量表分为轻度脑白质变性者(n=386)和中重度脑白质变性者(n=262),收 集总胆固醇、甘油三脂、高密度脂蛋白、低密度脂蛋白、ApoAI、ApoB、ApoB/ApoAI比值以及人口统计学资料,并通过单因素方 差分析、多因素logistic回归分析确定中重度脑白质变性的独立危险因素。结果轻度与中重度者两组间比较年龄、性别、高血 压、糖尿病、冠心病、既往卒中史、同型半胱氨酸、高密度脂蛋白、ApoAI 及ApoB/ApoAI 差异有统计学意义(P<0.05),但两组 ApoB水平差异无统计学意义(P=0.233)。多因素logistic回归分析显示ApoAI和ApoB/ApoAI作连续型变量资料时,调整混杂 因素后发现ApoB/ApoAI是中重度脑白质病变的独立危险因素(OR=11.456,95%CI:3.622~36.229,P<0.001),而ApoAI是中重 度脑白质变性的独立保护因素(OR=0.068,95%CI:0.018~0.262,P<0.001)。以ApoAI的上四分位数(p75)为截点分为低ApoAI (≥1.38 g/L)、高ApoAI(<0.138 g/L);以ApoB/ApoAI 的下四分位数(p25)为截点分为低ApoB/ApoAI(≤0.58 g/L)、高ApoB/ ApoAI(>0.58 g/L)。通过比较发现,高ApoAI、低ApoB/ApoAI组患者的中重度WML的发病率最低(P<0.001)。结论在脑白 质病变患者中,ApoB/ApoAI水平增高为中重度脑白质病变的独立危险因素,ApoAI水平增高为脑白质病变的独立保护因素。
Abstract:
Objective To investigate the correlation of apolipoprotein AI (ApoAI), ApoB , ApoB/ApoAI and the severity of brain white matter lesions (WML). Methods A total of 648 patients with WML confirmed by brain magnetic resonance imaging (MRI) were divided into mild WML group (n=386) and moderate to severe WML group (n=262) according to evaluations with the Fazekas scale. The demographic data, blood biochemical parameters and the levels of ApoAI, ApoB and ApoB/AI ratio were compared between the two groups to identify the risk factors of moderate to severe WML. Results Univariate analysis showed that age, gender, hypertension, diabetes, coronary heart disease, previous stroke, homocysteine, HDL-C, ApoAI, and ApoB/AI ratio all differed significantly between the two groups (P<0.05), but ApoB levels were similar between them (P>0.05). Multivariate logistic regression analysis revealed that with ApoAI and ApoB/AI ratio as the continuous variables, after adjustment for the compounding factors, ApoB/AI ratio was an independent risk factor (OR=11.456, 95%CI: 3.622-36.229, P< 0.001) and ApoAI was an independent protective factor for moderate to severe WML (OR=0.068, 95%CI: 0.018-0.262, P<0.001). With the upper quartiles of ApoAI level (1.38 g/L) and ApoB/AI ratio (0.58) as their respective cutoff values, patients with a high ApoAI level and a low ApoB/AI ratio were found to have the lowest incidence of moderate to severe WML (P<0.001). Conclusion An increased ApoB/AI ratio is an independent risk factor and an increased ApoAI level is an independent protective factor for moderate to severe WML.
更新日期/Last Update: 1900-01-01