| Objective:To explore the application value of serum apolipoprotein B(apoB),apolipoprotein AI(apoAI)and apolipoprotein B/apolipoprotein AI ratio(apoB/apoAI ratio)in young CHD.Methods:From December 2014 to June 2017,140 young patients with suspected coronary heart disease(CHD)and their aged less than 45 years old were collected for chest pain(124 cases in males:92 cases of CHD patients,average age 41.24±3.65 and male non CHD patients 32 cases,average age 38.88±4.91;16 cases in female patients:13 cases of CHD patients,average age 41.69±2.43,non CHD patients 3cases,average age 44±1.00).The general information of cases included smoking history,drinking history,CHD family history,hypertension,type 2 diabetes(2DM).The following morning,venous blood was taken to determine the blood lipid level and other related indexes,and each patient was divided into 105 cases in group CHD after coronary angiography(CAG)and 35 cases in non CHD group.According to the CAG results,the cumulative number of lesions was divided into single branch lesion group 65 cases,double branch lesion group 19 cases,multiple(≥3 branch)disease group 21 cases and there were 2 cases of left main(LM),84 cases of left anterior descending branch(LAD),39 cases of left circumflex artery(LCX),and 31 cases of right coronary artery(RCX).Then according to the difference of Gensini score,the pathological changes were divided into 3 subgroups:mild lesion group(0<Gensini score<12)28 cases,moderate lesion group(12<Gensini integral<32)33and 44 cases of severe disease group(Gensini score equal to 32).Analysis of the relationship between relevant indicators and young CHD patients and young patients with non coronary heart disease and analyze the relationship between blood lipids and subgroups and severity of coronary artery lesions,and the characteristics of coronary artery lesions were analyzed in young CHD patients.SPSS22.0 software was used to make statistical analysis of the above data to clarify the relationship between the risk and coronary heart disease in this study,and to explore the correlation between apoB,apoAI,apo B/apoAI and coronary heart disease.Result:1.(1)Comparison of general non lipid indices between young CHD group and youth non CHD group:(1)The proportion of patients with hypertension,2DM,smoking,drinking,CHD family history and male were higher than those in the non CHD group,and these risk fingers in the CHD group were all dangerous.The average age of male patients in group CHD was significantly higher than that in the non CHD group,but the average age of the female CHD patients was lower than the average age of the female non CHD patients.And smoking,CHD family history and age were the risk indexes of CHD and there were statistically significant differences(P<0.05),but there was no statistical difference between hypertension,2DM,sex,drinking and CHD(P>0.05).(2)The blood lipid indexes of young CHD group and young non CHD group were compared:(1)The average level of LPa,apo B,apoB/apoAI ratio mean,LDL-C,TG and TC were higher than those in the non group.The average level of apoAI and HDL-C were lower than those of non CHD group.And compared with young non CHD group,the level of apoB and LDL-C was significantly higher than that of young non CHD group(P<0.05),apoAI and HDL-C were lower than those of young non CHD group(P<0.05).However,there was no significant difference in Lpa and apoB/apoAI between the two groups(P>0.05).2.Smoking,family history of coronary heart disease and age were associated with CHD in young CHD group,and the results were statistically significant(P<0.05).The correlation of family history of coronary heart disease was the best(OR=6.345,95%CI 1.252-32.149,P=0.026).But there was no significant difference in the correlation between sex,hypertension,2DM,alcohol consumption and CHD incidence(P>0.05).(2)It was found that apo B,apoAI,apo B/apoAI,LDL-C and HDL-C were related to the incidence of CHD in young people,and the results were statistically different(P<0.05)and the correlation of apoB level was the best(OR=9.876,95%CI 16.256-126.221,P=0.000).However,no correlation was found between LPa,TG and TC and the incidence of CHD in young adults(P>0.05)..3.There was a significant difference in the number of coronary artery lesions in the blood lipid index and the levels of apoB,LDL-C and TC(P<0.05),but there was no statistical difference between the LPa,apoAI,apoB/apoAI ratio,TC,TC and HDL-C(P>0.05).The results of the further comparison only found that the levels of apoB,LDL-C and TC were significantly different from those of the double branch and multi branch lesion group(P<0.05),but there was no significant difference in the levels of LPa,apoAI,apoB/apoAI,TC,TC and HDL-C(P>0.05)in the double branch and multi branch lesion group.And comparing the LPa,apoB,apoAI,apoAI/apoB ratio,LDL-C,HDL-C,TG,TC level,there was no statistical difference between the two subgroups(P>0.05).4.There was a significant difference between the degree of coronary artery disease and apoB,HDL-C in the blood lipid index(P<0.05),but there was no statistical difference between the levels of LPa,apoAI,LDL-C,apoAI/apoB,TG and TC(P>0.05).Further 22 comparison results showed that there were significant differences in the level of apoB and HDL-C in mild lesions and moderate lesions(P<0.05),but there was no significant difference in the levels of LPa,apoAI,apoAI/apoB,LDL-C,TG and TC(P>0.05)in mild lesions and moderate lesions.And the levels of LPa,apoB,apoAI,apoAI/apoB,LDL-C,HDL-C,TG and TC were not significantly different between the two subgroups(P>0.05)compared with the mild lesion group and the severe lesion group,the moderate lesion group and the severe lesion group.5.The level of apo B was positively correlated with the number of coronary artery lesions and the degree of coronary stenosis(r_s=0.025,P<0.05;r_s=0.012,P<0.05),and the level of LDL-C and TC was positively correlated with the number of coronary artery lesions(r_s=0.092,P<0.05;r_s=1.102,P<0.05),but not associated with the degree of coronary stenosis(P>0.05).And there was a significant negative correlation between the level of HDL-C and the degree of coronary stenosis(r_s=-0.086,P<0.034),but no correlation was found in the number of coronary artery lesions(P>0.05);there was no correlation between the levels of LPa,apoAI,apoAI/apoB,TG,TC and the degree of coronary artery disease and the degree of coronary stenosis(P>0.05).6.The incidence of left anterior descending branch(LAD)was the most common in the proportion of coronary artery disease in the young CHD group,and the incidence was up to 80%,and there was a statistical difference from the other coronary artery lesions(P<0.05),but there was no statistical difference between the other parts of the coronary artery(P>0.05).7.Coronary artery Gensini score in young patients with coronary heart disease was mainly in severe coronary lesions,accounting for 41.90%of total coronary artery disease.Conclusion:1.CHD family history,smoking and age are risk factors for CHD in young adults.2.Serum apoB,apoB/apoAI ratio,elevated LDL-C level and decreased apoAI and HDL-C levels were risk factors for the occurrence of CHD in young adults.3.The level of apo B was positively correlated with the number of coronary artery lesions and the degree of coronary stenosis.The level of LDL-C and TC was positively correlated with the number of coronary artery lesions,and the HDL-C level was negatively correlated with the degree of coronary artery stenosis.They can be used to assess the condition of coronary artery lesions. |
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