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目的分析中原地区人群血脂谱特征及ApoB/apoA-Ⅰ比值与颈动脉内膜中层厚度(cIMT)关系,为临床评价危险因素及药物疗效提供依据。方法 812例冠脉造影排除冠心病的人群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以性别分组的人群中,HDL-C、ApoA-Ⅰ、ApoB/apoA-Ⅰ、LDL/HDL、TC/HDL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(男性节点0.8,女性节点0.7)的人群,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),糖尿病发生率、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 cIMT是监测动脉粥样硬化进展和治疗效果的无创指标,与ApoB/apoA-Ⅰ比值显著相关。ApoB/apoA-Ⅰ比值结合cIMT是进行冠心病危险因素评估和治疗效果的更好指标。
Objective To analyze the relationship between serum lipid profiles and ApoB / apoA-Ⅰ ratio and carotid artery intima-media thickness (cIMT) in Central Plains to provide evidence for clinical evaluation of risk factors and drug efficacy. Methods Eight hundred and twelve coronary angiography patients with coronary heart disease were divided into two groups according to their blood lipid and apolipoprotein biochemical analysis. B-mode ultrasound was used to measure cIMT. The differences of blood lipid profile and cIMT between sex group and ApoB / apoA-Ⅰ ratio were statistically analyzed. Multiple regression analysis of relationship between cIMT and lipid profile. Results ①The sexes of HDL-C, ApoA-Ⅰ, ApoB / apoA-Ⅰ, LDL / HDL, TC / HDL and cIMT were significantly different between men and women (all P <0.05). (2) The age and the rate of statin treatment in the ApoB / apoA-Ⅰ ratio group (male node 0.8, female node 0.7) were higher in both men and women with lower ApoB / apoA-I ratio (all P <0.05 ), Incidence of diabetes mellitus, smoking, drinking, cIMT and other lipid profile indicators were higher in the ApoB / apoA-I ratio group 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 significantly different (all P <0.05). Conclusion cIMT is a non-invasive index for monitoring the progress of atherosclerosis and the therapeutic effect, which is significantly correlated with the ratio of ApoB / apoA-Ⅰ. ApoB / apoA-I ratio in combination with cIMT is a better indicator of the risk factors for coronary heart disease assessment and treatment.