【摘要】 目的观察hsCRP、apoB/apoA1、血脂表达与早发冠心病急性冠脉综合征的关系。方法采用随机平行对照方法纳入2014年2月至2018年2月于清远市人民医院收治的110例早发冠心病急性冠脉综合征患者为观察组,另选取因胸痛同期住院经冠状动脉造影证实冠脉病变为阴性的118例非冠心病患者为对照组。统计两组患者一般资料,抽取空腹肘静脉血,采用全自动生化分析仪检测血脂载脂蛋白A1(apoA1)、载脂蛋白B(apoB)、超敏C反应蛋白(hsCRP)及血糖(GLU)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、尿酸(UA)、血肌酐(Scr)水平。采用多因素Logistic回归分析法分析早发冠心病急性冠脉综合征的独立影响因素,分析hsCRP、apoB/apoA1、血脂表达与早发冠心病急性冠脉综合征的关系。结果两组年龄、体质指数(BMI)、UA及糖尿病病史所占比例比较差异无统计学意义(P>0.05);观察组男性、吸烟史、饮酒史、冠心病家族史、高血压病史所占比例显著高于对照组(P<0.05),且Scr、GLU水平显著高于对照组(P<0.05)。两组LDL-C、apoB水平比较差异无统计学意义(P>0.05);观察组血清hsCRP、TC、TG、non-HDL-C、apoB/apoA1水平显著高于对照组(P<0.05),apoA1、HDL-C水平显著低于对照组(P<0.05)。多因素Logistic回归分析结果显示,除男性、吸烟史、冠心病家族史外,hsCRP、TG、HDL-C、non-HDL-C、apoA1、apoB/apoA1均为早发冠心病急性冠脉综合征的独立影响因素(P<0.05)。结论 hsCRP、TG、non-HDL-C、apoB/apoA1在早发冠心病急性冠脉综合征患者外周血中水平明显升高,apoA1、HDL-C在其外周血中明显降低,上述因子可作为该病预测指标。更多还原

【Abstract】 Objective To investigate the relationship between hsCRP, apoB/apoA1, blood lipid expression and acute coronary syndrome(ACS) in premature coronary heart disease. Methods A total of 110 patients with acute coronary syndrome with premature coronary heart disease admitted to Qingyuan People’s Hospital from February 2014 to February 2018 were enrolled in the observation group. Another 118 patients with non-coronary heart disease who were hospitalized for chest pain at the same time but were confirmed to be coronary artery lesions negative by coronary angiography were selected as the control group. The general data of the two groups of patients were counted and the fasting elbow vein blood was taken. Apolipoprotein A1(apoA1), apolipoprotein B(apoB),high-sensitivity C-reactive protein(hsCRP) and blood glucose(GLU), total cholesterol(TC), triglyceride(TG) by automatic biochemical analyzer High-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), non-high-density lipoprotein cholesterol(non-HDL-C), uric acid(UA), and serum creatinine(Scr)levels were measured. Multivariate logistic regression analysis was used to analyze the independent influencing factors of acute coronary syndrome in patients with premature coronary heart disease. The relationship between hsCRP, apoB/apoA1, blood lipid expression and acute coronary syndrome of early onset coronary heart disease was analyzed. Results There was no significant difference in the proportion of age, body mass index(BMI), UA and diabetes history between the two groups(P>0.05). The proportion of males, smoking history, drinking history,family history of coronary heart disease and hypertension history in the observation group was significantly higher than that in the control group(P<0.05), and the levels of Scr and GLU were significantly higher than those in the control group(P<0.05). There was no significant difference in the levels of LDL-C and apoB between the two groups(P>0.05). The levels of serum hsCRP, TC, TG, non-HDL-C and apoB/apoA1 in the observation group were significantly higher than those in the control group(P<0.05), and the levels of apoA1 and HDL-C were significantly lower than those in the control group(P<0.05). Multivariate logistic regression analysis showed that in addition to male, smoking history, and family history of coronary heart disease, hsCRP, TG, HDL-C, non-HDL-C, apoA1, and apo B/apo A1 were all early coronary heart disease acute coronary syndromes. Independent influence factors(P<0.05).Conclusion hsCRP, TG, non-HDL-C, apoB/apoA1 were significantly elevated in peripheral blood of patients with early-onset coronary heart disease and acute coronary syndrome. ApoA1 and HDL-C were significantly decreased in peripheral blood and could be used as predictors.更多还原