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黄卓山，钟钧琳，罗艳婷，彭隆，李苏华，刘金来Vol.39(2):-
摘要
探讨冠心病患者脂蛋白胆固醇、载脂蛋白各个指标尤其是LDL-C与HDL-C、apoA1与apoB的相关性，以及各个指标及比值与冠脉病变严重程度的相关性。选取-年在医院住院接受PCI术的冠心病患者例，入院后检测患者术前空腹血脂（包括TG、TC、LDL-C、HDL-C、apoA1、apoB），用Gensini评分表示冠脉病变严重程度。根据Gensini评分结果将患者分为A组（50分，例）与B组（≥50分，例）。线性相关分析结果显示，LDL-C与HDL-C（r=0.，P=0.）、apoA1与apoB（r=0.，P0.）、apoA1与HDL-C（r=0.，P0.）、apoB与LDL-C（r=0.，P0.）、apoA1与LDL-C（r=0.，P=0.）均存在正相关关系，apoB与HDL-C无相关性。LDL-C、HDL-C、TC均与Gensini评分无相关性，LDL-C/HDL-C比值与Gensini评分呈正相关（r=0.，P=0.01）。apoA1与Gensini评分呈负相关（r=-0.，P=0.），apoB及apoB/apoA1比值与Gensini评分无相关性。经多因素分析校正后，LDL-C/HDL-C与Gensini评分仍呈正相关（β=5.，P=0.）。在冠心病患者中，LDL-C与HDL-C、apoA1与apoB有一定相关性，但LDL-C与HDL-C的相关度较弱。LDL-C/HDL-C比值与冠脉病变严重程度存在较弱的正相关，是冠脉病变的危险因素，而apoA1则与其呈负相关，发挥保护作用
关键词：冠心病,脂蛋白胆固醇,载脂蛋白,Gensini评分
Abstract：
Toexplorethecorrelationsbetweendifferentindicesoflipoproteincholesterolandapolipopro?teinofcoronaryheartdisease（CHD）patients，especiallythatbetweenlowdensitylipoproteincholesterol（LDL-C）andhighdensitylipoproteincholesterol（HDL-C）andthatbetweenapolipoproteinA1（apoA1）andapolipoproteinB（apoB），aswellasthecorrelationsbetweentheseindices，indicesratiosandtheseverityofcoronaryarterylesion.coronaryheartdiseasepatientshospitalizedtoacceptpercutaneouscoronaryintervention（PCI）intheThirdAffiliatedHospitalofSunYat-senUniversityduring-wererecruitedinthestudy.Fastingserumlipidindicesincludingtriglycerides（TG），totalcholesterol（TC），LDL-C，HDL-C，apoA1andapoBwereexaminedbeforesurgery.Gensiniscorewascalculatedtoevaluatetheseverityofcoronaryarterylesion.patientswhoseGensiniscorewaslessthan50wereassignedtoGroupA，whilepatientswithGensiniscoregreaterthanorequal50weredistributedtoGroupB.PositivecorrelationswerefoundbetweenLDL-CandHDL-C（r=0.，P=0.），apoA1andapoB（r=0.，P0.），apoBandLDL-C（r=0.，P0.），apoA1andLDL-C（r=0.，P=0.）bylinearcorrelationanalysis.NosignificantcorrelationwasfoundbetweenapoBandHDL-C.NoneofLDL-C，HDL-C，TCwascorrelatedwithGensiniscore.However，LDL-C/HDL-CratiowaspositivelycorrelatedwithGensiniscore（r=0.，P=0.01）.TheresultsshowednosignificantcorrelationsbetweenapoB，apoB/apoA1ratioandGensiniscorebutnegativecorrelationbetweenapoA1andGensiniscore（r=-0.，P=0.）.ThepositivecorrelationbetweenHDL-C/LDL-CratioandGensiniscorewasstillvalidaftermulti-factorsadjustment（β=5.，P=0.）.Ofpatientswithcoronaryheartdisease，thereexistsomecorrelationsbetweenLDL-CandHDL-C，apoA1andapoB，whilethecorrelationbetweenLDL-CandHDL-Cisrelativelyweak.TheLDL-C/HDL-Cratio，weaklypositivelycorrelatedwiththeseverityofcoronaryarterylesion，isariskfactorofcoronaryarterylesion，whilethelevelofapoA1，negativelycorrelatedwiththeseverityofcoronaryarterylesion，couldplayaprotectiverole.
Keywords：coronaryheartdiseaselipoproteincholesterolapolipoproteingensiniscore
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