Levinson S S, Wagner S G
Department of Pathology, University of Louisville, Ky.
Arch Pathol Lab Med. 1992 Dec;116(12):1350-4.
Although research studies, using complex methods, have shown apolipoprotein B level to be a better marker for coronary artery disease than cholesterol level, it is unclear whether apolipoprotein B level can perform as well when measured by automated clinical laboratory kit methods. The purpose of this study was to determine whether apolipoprotein B level assayed by a kit method is a better marker for coronary artery disease than low-density lipoprotein and total cholesterol levels in patients presenting for angiography. The subjects were two groups of male patients, 44 to 70 years old: 139 with disease and 41 without. Apolipoprotein B level differentiated more than 20-fold better than total or low-density lipoprotein cholesterol levels between the medians of the two groups and showed better diagnostic sensitivity and better diagnostic specificity than total and low-density lipoprotein cholesterol levels. Triglyceride levels were highly significant but showed poorer diagnostic sensitivity than apolipoprotein B level. We conclude that apolipoprotein B level is a more effective marker for coronary artery disease than low-density lipoprotein or total cholesterol levels.
尽管采用复杂方法的研究表明，载脂蛋白B水平比胆固醇水平更能准确反映冠状动脉疾病，但尚不清楚采用自动临床检验试剂盒方法检测时，载脂蛋白B水平是否同样有效。本研究旨在确定，对于接受血管造影的患者，试剂盒检测法测定的载脂蛋白B水平是否比低密度脂蛋白和总胆固醇水平更能准确反映冠状动脉疾病。研究对象为两组44至70岁的男性患者：139例患有冠状动脉疾病，41例未患。两组患者中位数之间，载脂蛋白B水平的差异比总胆固醇或低密度脂蛋白胆固醇水平高20倍以上，且在诊断敏感性和特异性方面均优于总胆固醇和低密度脂蛋白胆固醇水平。甘油三酯水平具有高度显著性差异，但诊断敏感性低于载脂蛋白B水平。我们得出结论，对于冠状动脉疾病，载脂蛋白B水平比低密度脂蛋白或总胆固醇水平是更有效的指标。
