【摘要】 目的:探讨血清脂蛋白a[Lp(a)]、载脂蛋白B(ApoB)、小而密低密度脂蛋白胆固醇(sd LDL-C)与冠心病患者心血管事件结局的相关性。方法:纳入2021年1月—2024年1月本院诊治的198例冠心病患者，根据是否发生主要不良心血管事件(MACE)分为MACE组(45例)、非MACE组(153例)。对比两组临床资料、血清Lp(a)、ApoB及sd LDL-C水平，logistic回归分析影响MACE发生的危险因素。ROC曲线分析血清Lp(a)、ApoB、sd LDL-C及联合检测预测冠心病患者发生MACE的效能。结果:Logistic回归分析显示吸烟、饮酒、高水平Lp(a)、ApoB及sd LDL-C均为影响冠心病患者发生MACE的独立危险因素(OR=1.072、1.425、1.549、1.398、1.266,均P<0.05)。ROC曲线显示，Lp(a)(AUC=0.892,95%CI 0.840～0.931)、ApoB(AUC=0.811,95%CI 0.750～0.863)、sd LDL-C(AUC=0.937,95%CI 0.893～0.966)及联合检测(AUC=0.969,95%CI 0.934～0.988)预测冠心病患者发生MACE具有一定价值。结论:血清Lp(a)、ApoB、sd LDL-C水平均为影响冠心病患者发生MACE的独立危险因素，且上述指标能预测冠心病患者MACE的发生，联合预测价值更高。更多还原

【Abstract】 Objective: To investigate the correlation between serum lipoprotein a[Lp(a) ], apolipoprotein B(ApoB), small and dense low-density lipoprotein cholesterol(sd LDL-C) and major adverse cardiovascular events(MACE) in patients with coronary heart disease. Methods: A total of 198 patients with coronary heart disease were enrolled from January 2021 to January 2024 and divided into MACE group(45 cases) and non-MACE group(153 cases). The clinical data, serum Lp(a), ApoB and sd LDL-C levels of the two groups were compared, and the risk factors affecting the occurrence of MACE were analyzed by logistic regression. ROC curve was used to analyze the efficacy of serum Lp(a), ApoB, sd LDL-C and combined detection in predicting MACE in patients with coronary heart disease. Results: Logistic regression analysis showed that smoking, drinking, high level of Lp(a), ApoB and sd LDL-C were independent risk factors for MACE in coronary heart disease patients(OR=1.072, 1.425, 1.549, 1.398, 1.266, all P<0.05). ROC curve showed that Lp(a)(AUC=0.892, 95%CI=0.840-0.931), ApoB(AUC=0.811, 95%CI=0.750-0.863), sd LDL-C(AUC=0.937, 95%CI=0.893-0.966) and combined test(AUC=0.969, 95%CI=0.934-0.988) have certain value in predicting the occurrence of MACE in patients with coronary heart disease. Conclusion: Serum Lp(a), ApoB and sd LDL-C levels are all independent risk factors for the occurrence of MACE in patients with coronary heart disease, and the above indexes can predict the occurrence of MACE in patients with coronary heart disease, and the combined prediction value is higher.更多还原