| Objective: Coronary artery calcification (CAC) is the symbol ofatherosclerotic lesions[1]. With coronary artery calcification score (CACS),we can classify the coronary artery calcification. With the improvement oftechnology, MDCT can provide high-quality images for the the coronaryartery calcification classification, which make coronary artery calcificationscore widely used in clinical practice. Coronary artery calcification related tothe coronary atherosclerosis scope, quantity, and the possibility of coronarystenosis, the more obvious of coronary atherosclerosis is, the more severe andextensive of the lesions as well as the higher incidence of coronary arterystenosis would be. Coronary heart disease is a disease caused with themultiple etiologies, which was affected by many factors. Previous researchesfounded that heredity, age, hypertension, dyslipidemia, diabetes, smoking,obesity and unhealthy lifestyles are regarded as the major risk factors ofcoronary heart disease. Dyslipidemia is the most important risk factor ofatherosclerosis and total cholesterol (TC), Low-density lipoprotein cholesterol(LDL-C) are the main causes of coronary heart disease. That reducing LDL-Cwith drug treatment can significantly reduce the risk of coronary heart disease,It is cleared clarfied in China Adult Dyslipidemia Prevention Guide that theprevention and treatment of abnormal blood lipids is very important incoronary heart disease, and the primary goal is to reduce the levels of LDL-C.But researches have found that even using statin to reduce LDL-C, there werestill more than50%of the patients with cardiovascular events, which may bedue to Very-Low-density lipoprotein (LDL) can not reflect all of atherogeniclipid particles. The atherogenic lipid particles include Very-Low-densitylipoprotein (VLDL), Lipoprotein(a)[LP (a)] and other ingredients. How canwe control dyslipidemia further and reduce cardiovascular morbidity remains a major issue of cardiovascular research. With more research of dyslipidemiain patients with coronary heart disease, it is founded that the incidence ofcoronary heart disease is closely with Apolipoprotein A(ApoA) andApolipoprotein B(ApoB) which may become a new target to predict coronaryheart disease and to effectively determine the efficacy of lipid-lowering durgs.In this study, we identified the degree of coronary artery calcification withartery calcification score by256MDCT measured, and analyzed therelationship between serum ApoA, ApoB levels and the degree of coronaryartery calcification.Methods:1Survey objects: Select95patients who have examed by256MDCT forchest tightness or chest pain at the Second Affiliated Hospital of HebeiMedical University from January2013to June2013,43males,52females,average age (60.42-9.35) years old.2Survey content:(1) Recorded the clinical data of age, gender,hypertension, diabetes, smoking history,(2) According to the coronarycalcification score with256MDCT measured, patients were divided into threegroups: low score group (coronary artery calcification score in0-99points)with29cases, moderate score group (coronary artery calcification score in100-399points) with34cases and high score group (coronary artery calciumscore≥400points) with32cases,(3) All patients underwent fasting lipidtesting, including: TC, TG, LDL-C, HDL-C, ApoA, ApoB, Lp (a),(4)Compared of the differences of lipid components in the three groups, andanalyzed the relationship between serum ApoA, ApoB levels and the degreeof coronary artery calcification.3Statistical analysis: The experimental date are statistically analyzedwith SPSS16.0statistical software. Measurement data with normaldistribution is represented of mean±standard deviation. T test was used tocompare the averages between two groups, Analysis of variance was used tocompare the averages between three groups. Enumeration data using χ2test,partial correlation analysis was used to analyze the relationship between serum ApoA, ApoB and coronary artery calcification score, p <0.05wasconsidered statistically significant.Results:1Comparison of the general clinical data of patientsThere were no statistically significant differences in gender among thethree groups（p>0.05), but age，hypertension, diabetes and smoking history inthree groups were statistically significant（p<0.05).2Comparison of lipid components among three groupsThe levels of TC, TG, LDL-C, HDL-C, ApoA, ApoB, Lp (a) werestatistically significant. Compared with the low score group, TC, TG, LDL-C,ApoB, Lp (a) in high score group and moderate score group were significantlyhigher than the low score group (p<0.05), HDL-C, ApoA in high points inhigh score group and moderate score group were significantly higher than thelow score group (p<0.05).Compared of high score group and moderate score group, there were nostatistically significant differences in TC, TG, LDL-C, HDL-C, Lp (a).butApoB, ApoA levels had statistically significant differences between the twogroups. ApoB in high score group was significantly higher than moderatescore group (p<0.05), ApoA in high score group was significantly lower thanmoderate score group (p<0.05).3The relationship of lipid components and coronary artery calcificationscoreAfter partial correlation analysis adjusted for sex, age, hypertension,diabetes, smoking factors, LDL-C, ApoB were positively correlated withcoronary artery calcification score（r=0.410,0.581P<0.05），HDL-C, ApoAwere negatively correlated with coronary artery calcification score（r=-0.457,-0.426P<0.05）, the correlation coefficient of ApoB was maximum(r=0.581,p <0.05).Conclusion:Serum levels of ApoB, ApoA, HDL-C, LDL-C was significantlyinterrelated with the severity of coronary artery calcification. LDL-C, ApoB were positively correlated with coronary artery calcification score, HDL-C,ApoA were negatively correlated with coronary artery calcificationscore.ApoB had the maximum level of correlation with coronary arterycalcification, indicating that ApoB levels can better reflect the severity ofcoronary artery calcification. |
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