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有或无既往心肌梗死的中年男性的血清载脂蛋白AI、B及脂蛋白

Serum apolipoproteins AI and B and lipoproteins in middle aged men with and without previous myocardial infarction.

作者信息

Durrington P N, Hunt L, Ishola M, Kane J, Stephens W P

出版信息

Br Heart J. 1986 Sep;56(3):206-12. doi: 10.1136/hrt.56.3.206.

Abstract

The serum high density lipoprotein (HDL) subfractions, HDL2, and HDL3, and serum apolipoprotein AI and B (apo AI and B) were evaluated as potential indicators of the risk of ischaemic heart disease in men aged less than 60 years who had previously had a myocardial infarction and in controls with a similar socioeconomic background who had no history of myocardial ischaemia. Discriminant analysis confirmed that the combination of serum cholesterol, triglycerides, and total HDL cholesterol distinguished poorly between patients and controls. The best single discriminating variable was apo B. Stepwise discriminant analysis showed that this discrimination could be improved to a small extent by combining apo B with apo AI and parental history, but nothing was gained by measurement of serum cholesterol triglycerides, very low density lipoprotein cholesterol, low density lipoprotein cholesterol, HDL cholesterol, HDL2 or HDL3 cholesterol. Significantly more patients than controls with type IV hyperlipoproteinaemia had raised concentrations of serum apolipoprotein B, but the frequency of raised apolipoprotein B concentrations was no greater in patients with type IV hyperlipoproteinaemia than in those with normal serum lipids. The value of apo B as an indicator of cardiovascular risk should be assessed in prospective studies.

摘要

对年龄小于60岁、既往有心肌梗死的男性以及社会经济背景相似但无心肌缺血病史的对照组,评估血清高密度脂蛋白(HDL)亚组分HDL2和HDL3以及血清载脂蛋白AI和B(apo AI和B)作为缺血性心脏病风险的潜在指标。判别分析证实,血清胆固醇、甘油三酯和总HDL胆固醇的组合在患者和对照组之间区分效果不佳。最佳的单一判别变量是apo B。逐步判别分析表明,将apo B与apo AI及家族史相结合可在一定程度上改善这种区分,但测定血清胆固醇、甘油三酯、极低密度脂蛋白胆固醇、低密度脂蛋白胆固醇、HDL胆固醇、HDL2或HDL3胆固醇并无助益。IV型高脂蛋白血症患者中血清载脂蛋白B浓度升高的人数显著多于对照组,但IV型高脂蛋白血症患者中载脂蛋白B浓度升高的频率并不高于血脂正常者。应在前瞻性研究中评估apo B作为心血管风险指标的价值。

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