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目的评估载脂蛋白B(ApoB)/载脂蛋白A-I(Apo-aⅠ)比值是否比其他任一单个的血脂变量或脂质比值变量预测性较强,以探讨中国人群血脂水平与颈动脉斑块的关系。方法回顾性采集暨南大学第四附属医院神经内科及心血管内科2009年9月至2010年3月期间年龄≥40岁的833名住院患者的病情资料,包括性别、年龄、脂蛋白(a)、其它脂质-脂蛋白变量、超敏CRP、空腹血糖以及颈动脉B超检测资料。根据颈动脉有无斑块出现而将所有患者分为两组,即颈动脉斑块组及颈动脉无斑块组。两组之间的人口学资料采用描述性分析,二元Logistic回归用于筛选出颈动脉斑块出现的独立危险因子。结果斑块组的年龄、超敏CRP、甘油三酯、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)、高密度脂蛋白胆固醇(HDL-C)、ApoB、Apo-aⅠ、非高密度脂蛋白胆固醇、LDL-C/HDL-C比值、TC/HDL-C比值、Apo-B/Apo-aⅠ比值的中位数,要高于无斑块组,而HDL-C、Apo-aⅠ的中位数要低于无斑块组;斑块组的男性人数要明显多于无斑块组;两组之间空腹血糖水平没有差异(P>0.05)。二元Logistic回归显示男性(OR=1.745,95%CI:1.262～2.415)、年龄(岁)(OR=1.085,95%CI:1.068～1.101)、Apo-B/Apo-aⅠ比值(OR=9.860,95%CI:4.550～21.364)是颈动脉斑块出现的独立危险因子。结论男性、年龄、Apo-B/Apo-aⅠ比值是颈动脉出现斑块的独立危险因子。Apo-B/Apo-aⅠ预测颈动脉出现斑块要优于其他任一的脂质或脂质比值变量。
Objective To evaluate whether the ratio of ApoB to Apo-aI is more predictive than any other single lipid or lipid ratio variable in order to explore whether the level of serum lipids and carotid plaque Relationship. Methods The data of 833 inpatients aged ≥ 40 years from September 2009 to March 2010 in the department of neurology and cardiology of the Fourth Affiliated Hospital of Jinan University were retrospectively collected. The data included sex, age, lipoprotein (a) Other lipid-lipoprotein variables, hypersensitive CRP, fasting plasma glucose, and carotid artery B-ultrasound data. All patients were divided into two groups based on the presence or absence of carotid plaque, ie, carotid artery plaque group and carotid artery plaque group. Demographic data between the two groups were used for descriptive analysis. Binary Logistic regression was used to screen for independent risk factors for carotid plaques. Results The age of the plaque group, hypersensitivity CRP, triglyceride, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), high density lipoprotein cholesterol HDL-C), ApoB, Apo-aⅠ, non-HDL cholesterol, LDL-C / HDL-C ratio, TC / HDL-C ratio and Apo-B / Apo- No plaque group, while the median of HDL-C and Apo-aⅠwere lower than that of no plaque group; the number of male in plaque group was significantly more than that of non-plaque group; there was no difference in fasting blood glucose level between the two groups P> 0.05). Binary logistic regression analysis showed that the odds ratio (OR = 1.745, 95% CI: 1.262-2.415), age (year OR = 1.085, 95% CI: 1.068-1.101), Apo-B / Apo- , 95% CI: 4.550 ~ 21.364) were independent risk factors for carotid plaque. Conclusions Male, age, Apo-B / Apo-al ratio are independent risk factors of carotid artery plaque. Apo-B / Apo-a Ⅰ predicted plaque in the carotid artery is superior to any of the other lipid or lipid ratio variables.