摘要
目的观察载脂蛋白B/载脂蛋白A1比值（ApoB/A1比值）与稳定型心绞痛患者左主干斑块组织构成特征的相关性。方法选择2010年6月至2016年6月在河南省人民医院行经皮冠状动脉支架植入术（PCI）并口服他汀药物的稳定型心绞痛患者98例，在行冠脉造影时应用血管内超声的虚拟组织学成像技术（IVUS－VH）评估其左主干斑块组织构成情况，依据患者ApoB/A1比值的中位数（0.80）水平将之分为高ApoB/A1比值组（ApoB/A1比值〉0.80，n＝49），低ApoB/A1比值组（ApoB/A1比值≤0.80，n＝49），并测定患者总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL－C）、高密度脂蛋白胆固醇（HDL－C）、LDL－C/HDL－C比值、ApoB、ApoA1、ApoB/A1比值，应用IVUS——VH评价两组患者左主干斑块的组织构成特征，并进一步评价患者上述血脂、脂蛋白及其比值指标与IVUS－VH评价的左主干斑块组织构成指标的相关性。结果高ApoB/A1比值组冠脉左主干斑块的纤维脂质体积百分比显著高于低水平组（ 17.5%±1.2%比9.0%±1.0%, P＝0.03），纤维组织体积百分比显著低于低水平组（55.1%±2.1%比63.9%±1.8%, P〈0.01）,且多因素线性回归分析显示：ApoB/A1比值与左主干斑块纤维脂质组织体积百分比呈正相关（r＝0.445，β＝0.29，P＝0.010），与斑块纤维组织体积百分比呈负相关（r＝－0.567，β＝－0.32，P＝0.011），提示ApoB/A1比值水平与IVUS－VH评价的左主干斑块易损性相关。结论对于接受他汀治疗的稳定型心绞痛患者来说，ApoB/A1比值水平与IVUS－VH评价的左主干斑块的纤维脂质组织体积百分比呈正相关，与纤维组织体积百分比呈负相关，ApoB/A1比值对冠状动脉左主干斑块易损性具有一定的预测价值。
ObjectiveTo investigate the relationship between ApoB/A1 ratio and the characteristics of tissue components of their left main coronary artery（LMCA）plaque.MethodsA total of 98 patients with stable angina pectoris who received chronic statin treatment underwentpercutaneous coronary intervention in the People′s Hospital of Henan Province from June 2010 to June 2016 were included.We prospectively performed intravascular ultrasound virtualhistology （IVUS-VH） to their LMCA and evaluated the tissue characteristics, and the blood level of total cholesterol （TC） and low-density lipoprotein cholesterol（LDL-C）, high-density lipoprotein cholesterol（HDL-C）, triglyceride（TG）, LDL-C/HDL-C ratio, ApoB, ApoA1, ApoB/A1 ratio were measured, then the association of the tissue characteristics with the aboved lipids values were analyzed.
ResultsAccording to the median value of their ApoB/A1ratios （0.80）, they were divided into 2 groups [high ApoB/A1 ratio （〉0.80） （n=49） and low ApoB/A1 ratio （≤0.80） （n=49）]. The patients with a high ApoB/A1 ratio had alarger fibrolipid volume and a smaller fibrous volume compared to patients with a low ApoB/A1 ratio （ 17.5%±1.2% vs 9.0%±1.0%, P=0.03 and 55.1%±2.1% vs 63.9%±1.8%, P〈0.01）. Using multivariate linear regression analysis after adjustment for the above-mentioned confounding factors, the ApoB/A1 ratio had a significantly positive correlation with fibrolipid volume （r=0.445, β=0.29, P=0.010）and had a negative correlation with fibrous volume （r=-0.567, β=-0.32, P=0.011）, suggesting that the ApoB/A1 ratio was associated with the vulnerability of the LMCA plaque.ConclusionFor the patients with stable angina pectoris and chronic treatment of statins, a high ApoB/A1 ratio is associated with a high percentage of fibrolipid volume and a low percentage of fibrous volume in LMCA lesions, suggesting that the ApoB/A1 ratios could predict the vulnerability of the LMCA plaque.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2017年第27期2101-2106,共6页
National Medical Journal of China
基金
河南省科技厅重点攻关项目（132102310080）
关键词
ApoB/A1比值
血管内超声虚拟组织学成像
左冠状动脉主干
易损斑块
Apolipoprotein B/ApolipoproteinA ratio,Intravascular ultrasound virtualhistology,Left main coronary artery,Vulnerable plaque
