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目的:探讨载脂蛋白亚型与糖尿病合并冠脉病变严重程度相关性,为预防及治疗糖尿病伴发的动脉粥样硬化性疾病提供新的依据。方法:选取440名心内科患者,根据冠脉造影有无冠脉狭窄及是否合并糖尿病分为四组:冠脉内膜光滑组94人(A组);单纯冠脉狭窄组108人(B组);糖尿病合并冠脉狭窄组共184人(C组);糖尿病冠脉无狭窄组44人(D组),记录患者空腹血糖、餐后血糖、传统血脂脂谱、载脂蛋白A(apoA)、载脂蛋白B(apoB)及两者的比值(apoB/apoA);采用Gensini评分比较传统血脂、apoA、apoB及与Gensini积分值的相关性。结果:与正常对照组比较,糖尿病冠脉无狭窄组apoB、apoB/apoA、LDL和TG升高,apoA和HDL降低,B组和C组apoA与Gensini积分值存在负相关(P=0.0157<0.05);apoB;apoB/apoA与Gensini积分值存在正相关(P<0.0001);两组中,apoB与Gensini积分值相关系数最大(r=0.85795,0.85941),且apoB与Gensini积分值的相关性都强于LDL与积分值的相关性。结论:在糖尿病患者预测心血管风险上,apoB,apoA,apoB/apoA的测定可能优于传统的血脂指标。
Objective: To explore the relationship between the apolipoprotein subtype and the severity of coronary artery disease with diabetes mellitus, and provide a new basis for the prevention and treatment of atherosclerotic disease associated with diabetes mellitus. Methods: One hundred and forty-four patients with cardiology were divided into four groups according to coronary angiography: coronary artery stenosis group (94 patients), coronary artery stenosis group (B group) ), 184 patients with coronary artery stenosis (C group), 44 patients with coronary artery stenosis without coronary artery disease (Group D). The fasting blood glucose, postprandial blood glucose, blood lipid profile, apolipoprotein A (apoA) , ApoB (apoB / apoA) and the ratio of apoB / apoA. The Gensini score was used to compare the correlation between traditional blood lipids, apoA, apoB and Gensini scores. Results: Compared with the normal control group, the apoB, apoB / apoA, LDL and TG increased, the apoA and HDL decreased in the coronary artery without coronary artery stenosis group, and the negative correlation between apoA and Gensini integrals in the group B and C (P = 0.0157 <0.05 ); apoB; apoB / apoA positive correlation with Gensini integral value (P <0.0001); in both groups, the correlation coefficient between apoB and Gensini integral value was the highest (r = 0.85795,0.85941), and the correlation between apoB and Gensini integral Stronger than the correlation between LDL and integral values. CONCLUSIONS: The determination of apoB, apoA and apoB / apoA may be superior to the traditional lipid profile in predicting cardiovascular risk in patients with diabetes.