Han Y, Yang C K, Gao C Y, Liu Y H, Cheng J T, Wang X P, Wang Z M, Cheng T F
Department of Cardiology, the People's Hospital of Henan Province, Zhengzhou 450003, China.
Zhonghua Yi Xue Za Zhi. 2017 Jul 18;97(27):2101-2106. doi: 10.3760/cma.j.issn.0376-2491.2017.27.005.
To investigate the relationship between ApoB/A1 ratio and the characteristics of tissue components of their left main coronary artery(LMCA)plaque. A total of 98 patients with stable angina pectoris who received chronic statin treatment underwentpercutaneous coronary intervention in the People's Hospital of Henan Province from June 2010 to June 2016 were included.We prospectively performed intravascular ultrasound virtualhistology (IVUS-VH) to their LMCA and evaluated the tissue characteristics, and the blood level of total cholesterol (TC) and low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), triglyceride(TG), LDL-C/HDL-C ratio, ApoB, ApoA1, ApoB/A1 ratio were measured, then the association of the tissue characteristics with the aboved lipids values were analyzed. According to the median value of their ApoB/A1ratios (0.80), they were divided into 2 groups [high ApoB/A1 ratio (>0.80) (=49) and low ApoB/A1 ratio (≤0.80) (=49)]. The patients with a high ApoB/A1 ratio had alarger fibrolipid volume and a smaller fibrous volume compared to patients with a low ApoB/A1 ratio ( 17.5%±1.2% vs 9.0%±1.0%, =0.03 and 55.1%±2.1% vs 63.9%±1.8%, <0.01). Using multivariate linear regression analysis after adjustment for the above-mentioned confounding factors, the ApoB/A1 ratio had a significantly positive correlation with fibrolipid volume (=0.445, =0.29, =0.010)and had a negative correlation with fibrous volume (=-0.567, =-0.32, =0.011), suggesting that the ApoB/A1 ratio was associated with the vulnerability of the LMCA plaque. For the patients with stable angina pectoris and chronic treatment of statins, a high ApoB/A1 ratio is associated with a high percentage of fibrolipid volume and a low percentage of fibrous volume in LMCA lesions, suggesting that the ApoB/A1 ratios could predict the vulnerability of the LMCA plaque.
为探讨载脂蛋白B（ApoB）/载脂蛋白A1（A1）比值与左主干冠状动脉（LMCA）斑块组织成分特征之间的关系。纳入2010年6月至2016年6月在河南省人民医院接受慢性他汀类药物治疗并接受经皮冠状动脉介入治疗的98例稳定型心绞痛患者。我们前瞻性地对他们的LMCA进行血管内超声虚拟组织学（IVUS-VH）检查并评估组织特征，同时检测总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯（TG）、LDL-C/HDL-C比值、ApoB、ApoA1、ApoB/A1比值的血药浓度，然后分析组织特征与上述血脂值之间的关联。根据他们ApoB/A1比值的中位数（0.80），将他们分为2组[高ApoB/A1比值组（>0.80，n=49）和低ApoB/A1比值组（≤0.80，n=49）]。与低ApoB/A1比值组患者相比，高ApoB/A1比值组患者的纤维脂质体积更大，纤维体积更小（17.5%±1.2% vs 9.0%±1.0%，P=0.03；55.1%±2.1% vs 63.9%±1.8%，P<0.01）。在对上述混杂因素进行校正后，采用多元线性回归分析，ApoB/A1比值与纤维脂质体积呈显著正相关（β=0.445，r=0.29，P=0.010），与纤维体积呈负相关（β=-0.567，r=-0.32，P=0.011），提示ApoB/A1比值与LMCA斑块的易损性相关。对于稳定型心绞痛且接受慢性他汀类药物治疗的患者，高ApoB/A1比值与LMCA病变中高比例的纤维脂质体积和低比例的纤维体积相关，提示ApoB/A1比值可预测LMCA斑块的易损性。
