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目的:分析河南地区冠心病患者血脂谱特征及载脂蛋白B(ApoB)/载脂蛋白A-I(ApoA-I)比值与颈动脉内膜中层厚度(cIMT)关系。方法:冠脉造影确诊的正常对照组和冠心病患者,进行血脂及载脂蛋白生化分析,B型超声测量cIMT,统计学分析性别分组和ApoB/apoA-I比值分组血脂谱特征和cIMT的差异。多元回归分析cIMT和血脂谱的关系。结果:①以性别分组的冠心病患者中,高密度脂蛋白胆固醇(HDL-C)、ApoA-I、ApoB/apoA-I、低密度脂蛋白胆固醇(LDL-C)/HDL-C、总胆固醇(TC)/HDL-C和cIMT在男女两组有显著差异(均P<0.05)。②以ApoB/apoA-I比值分组(男性截断点0.8,女性截断点0.7)的冠心病患者,年龄和他汀治疗率在ApoB/apoA-I比值低的男女两组均高于比值高的组(均P<0.05),糖尿病、吸烟、饮酒、cIMT和其他血脂谱指标在ApoB/apoA-I比值高的男女两组均高于比值低的组(均P<0.05)。③多元回归分析显示,仅ApoA-I、ApoB和ApoB/apoA-I回归系数有统计学差异(均P<0.05)。结论:冠心病患者cIMT与ApoB/apoA-I比值显著相关。ApoB/apoA-I比值反映cIMT的敏感性比LDL-C更好。
Objective: To analyze the characteristics of blood lipid profile and the relationship between ApoB / ApoA-I ratio and carotid artery intima-media thickness (cIMT) in patients with coronary heart disease in Henan province. Methods: The normal control group and coronary heart disease patients diagnosed by coronary angiography were performed biochemical analysis of lipids and apolipoprotein, cIMT was measured by B-mode ultrasound, and the difference of the lipid profile and cIMT between the sex group and ApoB / apoA-I ratio was statistically analyzed . Multiple regression analysis of relationship between cIMT and lipid profile. Results: ①High density lipoprotein cholesterol (HDL-C), ApoA-I, ApoB / apoA-I, LDL-C / HDL-C, total cholesterol (TC) / HDL-C and cIMT in both groups were significantly different (P <0.05). ②According to the ApoB / apoA-I ratio (male cutoff point 0.8, female cutoff point 0.7), the age and the rate of statin treatment in both ApoB / apoA-I group were higher than those with higher ApoB / apoA- (P <0.05). The indexes of diabetes mellitus, smoking, alcohol consumption, cIMT and other lipid profiles in both ApoB / apoA-I ratios were higher in both groups than in the low ratio group (all P <0.05). ③ Multiple regression analysis showed that only the regression coefficients of ApoA-I, ApoB and ApoB / apoA-I were statistically different (all P <0.05). Conclusion: There is a significant correlation between cIMT and ApoB / apoA-I in patients with coronary heart disease. ApoB / apoA-I ratio reflects the sensitivity of cIMT better than LDL-C.