| Objective: Coronary heart disease(CHD)is a heart disease caused by coronary atherosclerosis causing stenosis or occlusion of lumen,ischemia,hypoxia or necrosis.Dyslipidemia has an important influence on the occurrence and development of coronary heart disease,and the essence of dyslipidemia is the abnormality of lipoprotein and apolipoprotein.Transgenic and knockout mice experiments show that apolipoprotein A5(ApoA5)and apolipoprotein C3(ApoC3)affect plasma triglyceride(TG)concentration and promte the occurrence and development of coronary heart disease in an independent but opposite way.This paper mainly studied the relationship between apolipoprotein A5,apolipoprotein C3 and apolipoprotein A5/apolipoprotein C3 and blood lipid level,the occurrence of coronary heart disease and the number of pathological changes of coronary arteries,so as to prevent the occurrence and progress of coronary heart disease by adjusting the apolipoprotein level.Methods: This study included 131 patients who underwent coronary angiogram in the Southern District Cardiology in our hospital due to chest discomfort from November 2018 to May 2019.According to the diagnostic criteria of coronary heart disease,they were divided into 69 patients in coronary heart disease group and 62 patients in non-coronary heart disease group.The age,sex,body mass index and smoking status of patients with coronary heart disease and non-coronary heart disease were counted,and the Total cholesterol(TC),TG,high density lipoprotein(HDL)and low density lipoprotein(LDL)levels of the two groups were measured.Meanwhile,the serum levels of ApoA5 and ApoC3 were determined by enzyme-linked immunosorbent assay(Elisa)respectively,and the ApoA5/ApoC3 ratio was calculated.Statistics were made on whether there were any statistical differences between the two groups of basic data.According to TG level,coronary heart disease group was separated into high TG value group and normal TG value group,t-he levels of ApoA5,ApoC3 and ApoA5/ApoC3 in non-coronary heart disease group,coronary heart disease group with high TG value and coronary heart disease group with normal TG value were compared.The relationship between serum ApoA5,ApoC3,ApoA5/ApoC3 and coronary heart disease,lesion number of coronary arteries and various indexes were studied.Results: 1 Comparison of clinical basic data between coronary heart disease group and non-coronary heart disease group:There were no significant differences in age,body mass index,smoking or not,TC,HDL and LDL levels between coronary heart disease group and non-coronary heart disease group(P>0.05),but there were significant differences in sex and TG level between the two groups(P<0.01).2 Comparison of apolipoprotein A5,apolipoprotein C3 and apolipoprotein A5/apolipoprotein C3 ratio levels between coronary heart disease group and non-coronary heart disease group:The levels of ApoA5/ApoC3 and ApoA5 in coronary heart disease group with TG high value and coronary heart disease group with TG normal value were lower than those in non-coronary heart disease group,and the level of ApoC3 in coronary heart disease group with TG high value was significantly higher than that in non-coronary heart disease group(P<0.01).The levels of ApoA5/ApoC3 and ApoA5 in coronary heart disease group with high TG were lower than those in normal TG group,and the level of ApoC3 in coronary heart disease group with high TG was significantly higher than that in coronary heart disease group with normal TG(P<0.01).3 Comparison of Apolipoprotein A5,Apolipoprotein C3 and Apolipoprotein A5/Apolipoprotein C3 ratio levels among different coronary heart disease lesion numbers:In coronary heart disease group,the levels of ApoA5/ApoC3 and ApoA5 in serum of patients with single-vessel disease group were generally higher than those of patients with double-vessel disease and three-vessel disease group,and the levels of ApoC3 in serum of patients with single-vessel disease group was generally lower than those of patients with double-vessel disease and three-vessel disease group,but the difference were not statistically significant(p>0.05).4 Logistic Regression Analysis:Logistic Regression Analysis showe-d that TG was an independent risk factor for the reduction of ApoA5 and ApoA5/ApoC3 levels(OR=0.043,95%CI(0.023,0.134),Wald 19.650,SE 0.588,P<0.01;OR=0.039,95%CI(0.009,0.157),Wald 20.641,SE 0.716,P<0.01),TG is an independent protective factor f or ApoC3 level rise(OR=9.084,95%CI(3.054,27.022),Wald 15.736,SE 0.556,P<0.01).5 Correlation analysis:Serum levels of ApoA5 and ApoA5/ApoC3 were negatively correlated with TG,while the level of ApoC3 was positively correlated with TG.ApoA5/ApoC3 ratio,ApoA5 and TC,LDL concentration levels had negative correlation trends,ApoC3 and TC,LDL concentration levels had positive correlation trends,but the difference was not statistically significant.Serum ApoA5/ApoC3 ratio,ApoA5 and HDL concentration levels had positive correlation trends,ApoC3 and HDL concentration levels had negative correlation trends,but the difference was not statistically significant.Conclusion: 1 Serum ApoA5,ApoA5/ApoC3 levels were negatively correlated with the occurrence of coronary heart disease.Serum ApoC3 concentration was positively correlated with the occurrence of coronary heart disease.Serum ApoA5 and ApoC3 were respectively protective factor and risk factor for coronary heart disease.ApoA5/ApoC3 ratio reflected the degree of coronary artery lesion to a certain extent and could be used as a basis for estimating the degree of coronary artery lesion.2 TG level was an independent risk factor for the decrease of serum ApoA5,ApoA5/ApoC3 levels,which was negatively correlated with serum ApoA5,ApoA5/ApoC3 levels.TG level was a protective factor for the increase of ApoC3 concentration,which was positively correlated with ApoC3 concentration level.3 This paper studied the relationship between ApoA5,ApoC3,ApoA5/ApoC3 and TG levels and coronary heart disease,providing theoretical basis for the selection of methods in the process of prevention and development of coronary heart disease. |
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