首页|血清ApoA1、ApoB、Hcy水平与高血压合并冠心病的相关性

血清ApoA1、ApoB、Hcy水平与高血压合并冠心病的相关性

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目的 探讨血清载脂蛋白A1(apolipoprotein A1)、载脂蛋白B(apolipoprotein B)、同型半胱氨酸(homocysteine,Hcy)水平与高血压合并冠心病的相关性。方法 选取原发性高血压(essential hypertension,EH)患者、行冠状动脉(简称冠脉)CT或冠脉造影的高血压合并冠心病患者以及健康体检者共156例,分为4组:EH组(61例)、EH合并稳定型心绞痛(stable angina pectoris,SAP)组(EH+SAP组,29例)、EH合并急性冠脉综合征(acute coronary syndrome,ACS)组(EH+ACS组,32例)及健康体检者构成的对照组(34例)。检测各组入选者的血脂、Hcy水平,评估单支、双支、多支血管病变患者ApoA1、ApoB、Hcy水平的变化,并根据冠脉CT或冠脉造影检查结果计算高血压合并冠心病患者的Gensini评分。采用Logistic回归分析,探讨血清ApoA1、ApoB、Hcy水平与高血压合并冠心病的相关性。结果 4组入选者在年龄、性别及体重指数、吸烟史、饮酒史等方面,差异无统计学意义(均P>0。05)。EH+SAP组和EH+ACS组ApoB、Hcy水平均高于EH组及对照组(P<0。05),ApoA1水平则低于EH组及对照组(P<0。05)。二元多因素Logistic回归分析表明,ApoA1、ApoB、Hcy均为高血压合并冠心病的危险因素。Gensini评分越高及冠脉病变血管的支数越多,ApoA1水平越低,表明两者呈负相关关系;而Gensini评分越高及冠脉病变血管的支数越多,ApoB、Hcy水平越高,两者之间存在正相关关系,且差异均有统计学意义(均P<0。05)。结论 ApoA1、ApoB、Hcy可作为高血压合并冠心病的危险因素,并能在一定程度上预测冠脉血管病变的严重程度,其联合低密度脂蛋白、高密度脂蛋白等传统血脂指标,可共同为该病的预防及治疗提供参考。
Correlation of serum ApoA1, ApoB and Hcy levels with hypertension complicating coronary heart disease
Objective To investigate the correlation of serum apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) and homocysteine (Hcy) levels with hypertension complicating coronary heart disease (CHD) . Methods We selected 156 cases including patients with essential hypertension (EH), hypertensives with CHD who had undergone coronary CT or coronary angiography (CAG) , and healthy physical examinees. They were divided into four groups:EH group (n=61), EH accompanied with stable angina pectoris (SAP) group (EH+SAP group, n=29) , EH complicating acute coronary syndrome (ACS) group (EH+ACS group, n=32) , and healthy physical examinees (control group, n=34) . We detected blood lipids and Hcy levels of the enrolled subjects in each group, and evaluated the changes of ApoA1, ApoB and Hcy levels in patients with single, double and multi-vessel lesions. The Gensini scores of patients with hypertension complicating CHD were calculated according to coronary CT or CAG results. The correlation of serum ApoA1, ApoB and Hcy levels with hypertension complicating CHD was explored by Logistic regression analysis. Results There were no statistically significant differences in age, sex, BMI, smoking history and drinking history among the four groups (all P>0.05) . The levels of ApoB and Hcy in the EH+SAP group and the EH+ACS group were all higher than those in the EH group and the control group (P<0.05) , while the level of ApoA1 was the opposite. Binary multivariate Logistic regression analysis showed that ApoA1, ApoB and Hcy were all risk factors for hypertension complicating CHD. The higher the Gensini score and the number of diseased vessels were, the lower the level of ApoA1 was, indicating a negative correlation between them;the higher the Gensini score and the number of diseased vessels were, the higher the levels of ApoB and Hcy were, indicating a positive correlation between them, and the differences were all statistically significant (all P<0.05) . Conclusion ApoA1, ApoB and Hcy could be used as risk factors for hypertension complicating CHD, and could predict the severity of coronary artery disease to a certain extent. They could provide references for the prevention and treatment of the disease together with low-and high-density lipoprotein, and other traditional indexes of blood lipids.

essential hypertensionhypertension accompanied with coronary heart diseaseapolipoprotein A1apolipoprotein Bhomocysteine

任晓宇、周白丽

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810016 青海 西宁,青海大学研究生院

810007 青海 西宁,青海省人民医院心内科

原发性高血压 高血压合并冠心病 载脂蛋白A 载脂蛋白B 同型半胱氨酸

2024

实用心电学杂志
江苏大学

实用心电学杂志

影响因子:0.648
ISSN:2095-9354
年,卷(期):2024.33(4)