南方医科大学学报

南方医科大学学报 ›› 2017, Vol. 37 ›› Issue (07): 938-.

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apoB与LDL-C评估冠心病风险的临床价值比较

陈思，赵金珍，胡晶，郭志刚   

  • 出版日期:2017-07-20 发布日期:2017-07-20

Clinical value of apolipoprotein B versus low-density lipoprotein cholesterol in assessing risks of coronary artery disease

  • Online:2017-07-20 Published:2017-07-20

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摘要： 目的探讨在载脂蛋白B（apoB）与低密度脂蛋白胆固醇（LDL-C）含量不一致情况下，比较apoB与LDL-C对冠心病风险评 估的重要价值。方法将接受冠脉造影检查的患者作为研究对象，共603例，根据apoB、LDL-C中位数水平分为低值组和高值 组，然后两两组合，共分为4组（低apoB/低LDL-C组，低apoB/高LDL-C组，高apoB/低LDL-C组，高apoB/高LDL-C组），根据冠 状动脉造影结果评估冠脉病变支数及冠状动脉狭窄程度，探讨apoB与LDL-C与冠心病及其病变严重程度之间的关系。结果 比较4组冠心病血管病变支、冠脉病变程度，差异明显存在统计学意义（P<0.05）。当LDL-C、apoB含量一致时，与低低组相比， 高高组的冠脉病变支数及冠脉病变程度有统计学差异（P<0.05）。当apoB与LDL-C含量不一致时，与低低组相比，高apoB低 LDL-C组冠脉病变支数明显增多（P=0.017），冠脉病变严重（P=0.034）；而低apoB高LDL-C组冠脉病变支数及严重程度差异不 明显（P>0.05）。采用Pearson 相关性分析，LDL-C、apoB、均为冠心病的危险因子。比较LDL-C和apoB 的ROC曲线下面积， LDL-C为0.579（P=0.014），而apoB为0.589（P=0.006）。结论在apoB与LDL-C不一致情况下，apoB与LDL-C均为冠心病的危 险因子，与冠心病病变程度密切相关，且apoB与LDL-C相比，在预测冠心病风险上同样具有重要的指导意义。

Abstract: Objective To compare the value of apolipoprotein B (apoB) and low-density lipoprotein cholesterol (LDL-C) in assessing the risk of coronary heart disease in patients with inconsistent apoB and LDL-C levels. Methods In a total of 603 patients undergoing coronary angiography, apoB and LDL-C levels were categorized into high and low levels relative to the median levels of apoB and LDL-C, based on which the patients were divided into 4 groups with low apoB/low LDL-C, low apoB/ high LDL-C, high apoB/ low LDL-C, or high apoB/high LDL-C. According to the results of coronary angiography, we evaluated the number of coronary artery branches with lesions and the severity of coronary artery stenosis in the 4 groups to assess the correlation of apoB and LDL-C with cardiovascular risks. Results We found significant differences in the number of coronary artery branches with lesions and the severity of coronary artery stenosis among the 4 groups (P<0.05). The number of coronary artery branches involved and the severity of stenosis differed significantly between patients with consistently high and low apoB/ LDL-C levels (P<0.005). Compared with those with low apoB/low LDL-C levels, the patients with high apoB/ low LDL-C levels showed a significantly greater number of coronary artery branches with lesions (P=0.017) and more severe stenosis (P=0.034), but such differences were not found in patients with low apoB/ high LDL-C levels. Pearson correlation analysis identified LDL-C and apoB as the risk factors for cardiovascular disease with areas under the ROC curve of 0.579 (P= 0.014) and 0.589 (P=0.006), respectively. Conclusions In patients with inconsistent levels of apoB and LDL-C, apoB and LDL-C levels are both risk factors of coronary heart disease in close relation with the disease severity. LDL-C and apoB are comparable for their important values in predicting the risk of coronary heart disease.