Correlation Between Changes Of Apolipoprotein B/apolipoprotein A1,cystatin C,serum Bilirubin Levels And Severity Of Coronary Artery Disease In Patients With Coronary Heart Disease

Objective:To explore the correlation between the changes of apolipoprotein B(ApoB)/apolipoprotein A1(ApoA1)and cystatin C(Cys C)and serum bilirubin levels in patients with coronary heart disease and the severity of coronary artery disease.Methods:Selected 208 patients with coronary artery disease who were diagnosed and treated in our hospital from January 2018 to March 2019 as the observation group,and divided them into mild coronary artery disease group,moderate coronary artery disease group,and severe coronary artery disease group according to Gensini score In the three groups,another 123 non-coronary heart disease patients diagnosed by coronary angiography in our hospital during the same period were selected as the control group.Analyze the basic data,biochemical indicators and changes in the levels of apolipoprotein B/apolipoprotein A1,cystatin C,and serum bilirubin in the two groups of patients,and establish a multivariate logistic regression to screen independent risk factors for coronary heart disease.Operating characteristic(ROC)curve analysis of ApoB/ApoA1 ratio,Cys C,serum bilirubin for the diagnosis of coronary heart disease.Results:1.The ApoB/ApoA1 ratio and Cys C of patients in the mild,moderate,and severe coronary artery disease groups were higher than those of the control group,and with the increase of Gensini score,the ApoB/ApoA1 ratio and Cys C level of patients also increased(P<0.05);The serum total bilirubin(TBIL),direct bilirubin(DBIL),and indirect bilirubin(IBIL)levels of patients in the mild,moderate,and severe coronary artery disease groups are lower than those in the control group,and with the increase of Gensini score,The levels of TBIL,DBIL and IBIL of patients also decreased(P<0.05).2.The results of spearman correlation analysis showed that ApoB/ApoA1 ratio,Cys C level and Gensini score were positively correlated(r = 0.267,P<0.05;r = 0.374,P<0.05),and TBIL,DBIL,IBIL and Gensini score were negatively correlated(r =-0.340,P<0.05;r =-0.223,P<0.05;r =-0.337,P<0.05).3.Logistic regression analysis shows that the ratio of ApoB/ApoA1(OR=1.441,95%CI 1.192～1.743,P<0.001)and Cys C(OR=1.531,95%CI 1.305～1.795,P<0.001)can be used as influence Independent risk factors for coronary heart disease,and DBIL(OR=0.706,95% CI 0.516～0.966,P=0.029)and IBIL(OR=0.885,95%CI 0.814～0.962,P=0.004)can affect coronary heart disease Independent protection risk factors that occur.4.The ROC curve shows that the area under the curve of ApoAl,ApoB,ApoB/ApoAl ratio,Cys C,DBIL,and IBIL predicting recurrent cardiovascular events in coronary heart disease are 0.684,0.604,0.700,0.734,0.732 and 0.721.Conclusion:Both ApoB/ApoA1 ratio and Cys C are independent risk factors affecting coronary heart disease,and are positively correlated with Gensini score,while DBIL and IBIL are protective risk factors affecting coronary heart disease,and are negatively correlated with Gensini score,and both have good forecast performance.