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载脂蛋白A-I作为血管造影评估冠状动脉疾病的标志物。

Apolipoprotein A-I as a marker of angiographically assessed coronary-artery disease.

作者信息

Maciejko J J, Holmes D R, Kottke B A, Zinsmeister A R, Dinh D M, Mao S J

出版信息

N Engl J Med. 1983 Aug 18;309(7):385-9. doi: 10.1056/NEJM198308183090701.

Abstract

This study was designed to determine whether the plasma level of apolipoprotein A-I is a better discriminator of angiographically documented coronary-artery disease than the level of high-density-lipoprotein (HDL) cholesterol in male subjects. The level of plasma apolipoprotein A-I in 83 patients with coronary-artery disease was 96.7 +/- 4.2 mg per deciliter (mean +/- S.E.M.), which was significantly lower (P less than 0.0001) than the level in 25 patients without coronary-artery disease (146.9 +/- 2.1 mg per deciliter). The levels of HDL cholesterol were also lower (P less than 0.0001) in patients with coronary-artery disease (31.9 +/- 1.5 mg per deciliter) than in those without it (45.9 +/- 2.3 mg per deciliter). A stepwise discriminant analysis, however, indicated the superiority of apolipoprotein A-I over HDL cholesterol in detecting coronary-artery disease. Furthermore, a linear discriminant analysis suggested that although HDL cholesterol by itself was a discriminator of coronary-artery disease, it did not provide a substantial increase in discriminatory value over that provided by apolipoprotein A-I; in contrast, apolipoprotein A-I levels added discriminatory value to the information obtained by measuring HDL cholesterol alone. We conclude that apolipoprotein A-I by itself is more useful than HDL cholesterol for identifying patients with coronary-artery disease.

摘要

本研究旨在确定在男性受试者中,载脂蛋白A-I的血浆水平是否比高密度脂蛋白(HDL)胆固醇水平更能鉴别经血管造影证实的冠状动脉疾病。83例冠状动脉疾病患者的血浆载脂蛋白A-I水平为每分升96.7±4.2毫克(均值±标准误),显著低于25例无冠状动脉疾病患者的水平(每分升146.9±2.1毫克)(P<0.0001)。冠状动脉疾病患者的HDL胆固醇水平(每分升31.9±1.5毫克)也低于无冠状动脉疾病患者(每分升45.9±2.3毫克)(P<0.0001)。然而,逐步判别分析表明,在检测冠状动脉疾病方面,载脂蛋白A-I优于HDL胆固醇。此外,线性判别分析表明,虽然HDL胆固醇本身是冠状动脉疾病的一个判别指标,但与载脂蛋白A-I相比,其判别价值并没有显著增加;相反,载脂蛋白A-I水平为仅通过测量HDL胆固醇所获得的信息增加了判别价值。我们得出结论,就识别冠状动脉疾病患者而言,载脂蛋白A-I本身比HDL胆固醇更有用。

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