上海交通大学学报（医学版）

上海交通大学学报（医学版）

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急性冠脉综合征患者血清载脂蛋白A5水平及相关因素分析

华沙，赵建荣，邱筱炜   

  1. 上海交通大学 医学院附属瑞金医院卢湾分院心血管科， 上海 200020
  • 出版日期:2016-04-28 发布日期:2016-05-26
  • 通讯作者: 赵建荣, 电子信箱: drzjr@126.com。
  • 作者简介:华沙（1985—）， 女， 主治医师， 硕士; 电子信箱: 699146@qq.com。

Analysis of serum apolipoprotein A5 level and related factors for patients with acute coronary syndrome

HUA Sha, ZHAO Jian-rong, QIU Xiao-wei   

  1. Department of Cardiology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020
  • Online:2016-04-28 Published:2016-05-26

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摘要：

目的 对急性冠脉综合征（ACS）患者血清载脂蛋白A5（ApoA5）水平及相关因素进行分析。方法 选取2014年7月—2015年6月在瑞金医院卢湾分院心内科就诊患者188例作为研究对象。按国际指南ACS诊断标准分为ACS组96例和非ACS组（对照组）92例，ELISA法检测血清ApoA5水平，同时测定血脂谱、血常规、肾功能、血糖、心肌肌钙蛋白I （cTn I）及N末端脑钠肽前体（NT-proBNP）水平，根据ACS组患者的冠脉造影结果计算Gensini评分，围绕ApoA5展开相关性分析。结果 ACS组血清ApoA5水平显著低于对照组（P=0.022）。总体样本中，ApoA5与三酰甘油、游离脂肪酸、cTn I呈等级负相关，与高密度脂蛋白和ApoA1呈等级正相关。分组分析显示：在ACS组，ApoA5与cTn I和冠脉Gensini评分呈高度负相关(P=0.006 9, P=0.014)；对照组ApoA5与cTn I无关联（P=0.079）。结论 与非ACS患者比较，ACS患者血清ApoA5水平降低，且与心肌损伤和冠状动脉病变程度显著相关。

关键词: 冠状动脉粥样硬化性心脏病, 载脂蛋白A5, 急性冠脉综合征, 心肌肌钙蛋白I

Abstract:

Objective To analyze the serum apolipoprotein A5 (ApoA5) level and related factors for patients with acute coronary syndrome (ACS). Methods A total of 188 patients who visited the Department of Cardiology of Ruijin Hospital Luwan Branch from July, 2014 to June, 2015 were enrolled and assigned to the ACS group (n=96) and the non-ACS group (control group, n=92) according to the international guideline for ACS diagnosis criteria. Serum ApoA5 level was measured by ELISA and lipid profile, hemogram, creatinine, uric acid, blood glucose, cardiac troponin I (cTn I), and NT-proBNP were also detected. Gensini scores were calculated according to the results of coronary angiography for patients in the ACS group. Correlation analysis was performed based on ApoA5. Results The ApoA5 level in the ACS group was significantly lower than that in the control group (P=0.022). For all samples, ApoA5 was negatively correlated to TG, FFA, and cTn I and positively correlated to HDL and ApoA1. Subgroup analyses showed that ApoA5 was highly and negatively correlated to cTn I and coronary artery Gensini score in the ACS group (P=0.006 9, P=0.014), whereas ApoA5 was not correlated to cTn I in the control group (P=0.079). Conclusion The serum ApoA5 level in ACS patients is significantly lower than that in the patients without ACS and ApoA5 is significantly correlated to myocardial injury and the degree of coronary artery disease.

Key words: coronary atherosclerotic heart disease, apolipoprotein A5, acute coronary syndrome, cardiac troponin I