| Background：Coronary atherosclerotic heart disease refers to coronary atherosclerosis,vascular stenosis or obstruction, or (and lead to myocardial ischemia andhypoxia or necrosis) due to coronary artery function changes (spasm) caused byheart disease, also known as ischemic heart disease. Coronary heart disease hasbeen the most common chronic disease which threat to human physical andmental health, reduce the quality of human life, with the unremitting efforts ofb a s i c researchers and clinical workers, more and more risk factors andpredictors have been found, and used to prevent the occurrence anddevelopment of the prediction of coronary heart disease step by step. Coronaryangiography techniques developed rapidly in China over the past dozen years,what provide more ntuitive and precise evidences and verification for variety ofcoronary heart disease risk factors, predictors.Detection of coagulation and blood lipids indicators used clinically hasalong history, clotting indicators are commonly used indicators for monitoringcoagulation status, hyperlipidemia is an independent risk factor for coronaryheart disease, the inextricable link exists between the two and coronary heartdisease. Activated partial thromboplastin time, fibrinogen are the bestcoagulation indicator of prothrombotic state, some studies speculated observedplasma APTT, FIB levels may indirectly reflect the state of the vascularendothelial injury or plaquein stability state, anticoagulant therapy mayeffectively inhibit the clotting process to reduce the occurrence of UAP andAMI caused by thrombosis.Dyslipidemia is an important risk factor for atherosclerosis, the relationship between serum lipid levels of triglycerides, total cholesterol andlow-density lipoprotein cholesterol and coronary heart disease and coronaryartery lesions has been familiar to our, and catched high degree of attention ofpeople.1970s, the United States put forward the idea that dyslipidemia areclosely related to cardiovascular disease, researches on the relationship betweenlipids and coronary heart disease from the total cholesterol to LDL cholesterol,triglycerides, high-density cholesterol to LDL cholesterol/HDL cholesterolratio, to the nearest apolipoprotein,and more and more in-depth understandingof the relationship between lipids and coronary heart disease were detected.Recently, a large number of domestic and international for apolipoprotein A1,apolipoprotein B prospective and retrospective study found that apoAl, apoB,apoAl/apoB are better predictors of cardiovascular events than aboveconventional lipids pectrum. ApolipoproteinA1/B ratio in the prediction and theassessment of the role has been widely confirmed, but apolipoprotein A1,apolipoprotein B are failed to attract enough attention in clinical work. Inpathological cases, HDL content can be changed, but the ApoAl/apoB ratio wasunaffected, so ApoAl/apoB ratio maybe instead of the HDL/LDL ratio as theindicator of atherosclerosis. Inaddition， basic researches confirmed theexistence of mutual ties between the coagulation factor and apolipoprotein.Relationship between clotting and lipids and severity of coronary, combineddetection of coagulation, lipids predict coronary heart disease incidence ofadverse events, are still hot in coronary heart disease researches.In this research, we are aimed to seek differences between different groupsof APTT, FIB, ApoA1/B ratio, to explore whether the joint detecting of APTT,FIB and ApoAl/B ratio can be as a better prediction method of coronary heartdisease.Objective: To investigate relations between the levels of APTT, FIB,ApoA1/B ratio, and coronary heart disease and coronary artery lesions; Assess whether combined detection of clotting factor, apolipoprotein A1/B levelfeasibility can be as a more effective predictor of coronary heart diseasemonitoring, prediction indicators.Methods: The projects elected160patients in department of Cardiology ofsecond hospital of Jilin University, from September2012to February2013.According to the clinical diagnostic criteria combined with some selectivecoronary angiography,These patients were divided into4groups: Controlgroup of40cases,40cases of stable angina pectoris (SAP) group,40cases ofunstable angina pectoris (UAP) group, acute myocardial infarction (AMI)group of41cases; Furthermore, according to selective coronary angiography insome patients of UAP group and AMI group,50patients were divided intoingle-vessel group of14cases, double vessel disease in16patients, threelesions of20cases. Each group were of non-statistically significant (p>0.05)ingender, age, smoking, hypertension, diabetes proportion and other. DetectAPTT, FIB, ApoA1, ApoB of patients in each group, and using the statisticalsoftware SPSS13.0to analyze the data obtained.Results:1) the proportion of gender, age, smoking, high blood pressure,diabetes and other indicators was no statistically significant difference betweencontrol group, SAP group, UAP group and AMI group (p>0.05).2) APTTbetween the AMI group-SAP group, the AMI group-the control group, UAPgroup-SAP group, UAP-control group make revealed significant differences (p<0.05),in AMI group-UAP group, SAP group and control group ofcomparisons not statistically significant (p>0.05);The FIB were statisticallydifferent between the AMI group-SAP group, AMI group-control group, UAPgroup-SAP group, UAP-control group, SAP group-control group (p <0.05),the AMI group-UAP group of comparisons not statistically significant (p>0.05);apoA1/B ratio between the AMI group-SAP group, the AMI group-control group, UAP group-SAP group, UAP-control group revealed significant differences (p <0.05),comparison between AMI group and UAP group, SAPgroup and control group was not statistically significant (p>0.05).3)theproportion of gender, age, smoking, high blood pressure, diabetes and otherindicators was no statistically significant difference between single-vesselgroup, double-vessel group, three-vessel group (p>0.05).4)APTT inthree-vessel group was lower than single-vessel group, and the difference wasstatistically significant(p<0.05); APTT between double-vessel group andsingle-vessel group, the three-vessel group and double vessel group decreased,but the difference were of no statistically significance (p>0.05); FIB inthree-lesions group was higher than single-vessel group, and the difference wasstatistically significant(p<0.05); FIB between the three lesions group anddouble-vessel group, double-vessel group and single-vessel group tended toincrease, but the difference were of no statistically significance (p>0.05);apoA1/B ratio of the three lesions less than single vessel disease, double vesseldisease group, the difference was statistically significant; double vessel diseasegroup with single-vessel disease have decreased, but the difference was notstatistically significant(p>0.05).5）Correlation analysis between APTT, FIB,ApoA1/B ratio and Gensini score displayed that APTT was negativelycorrelated with Gensini score （r=0.114， p=0.017）, apoA1/B ratio wasnegatively correlated with Gensini score（r=0.110，p=0.021）, FIB with Gensiniscore increased an increasing trend, but no significant linear relationship.6）AllAPTT, FIB, ApoA1/B ratio from subjects were in linear analysis, and we foundthat APTT was negatively correlated with FIB (r=0.189, p=0.000),APTT waspositively correlated with apoA1/B ratio（r=0.228，p=0.000),FIB was negativelycorrelated with apoA1/B ratio（r=0.217，p=0.000）.Conclusion:1、APTT can be used as a predictor of coronary heart disease, can reflect the extent of coronary atherosclerosis lesions on some level; fibrinogen can bean independent risk factor for coronary heart disease, and assess the extent ofcoronary artery lesions on some level, but its assessment of coronary lesionsless than its forecast of acute coronary syndrome; apoA1/B ratio can be usedto predict the risk of coronary heart disease, and to assess the severity ofcoronary lesions.2、There was no significant linear relationship between fibrinogen andGensini score.The reason may due to:①May not be a parallel relationshipbetween the occurrence of acute coronary syndrome and coronary sclerosislesions involving the count and the degree of stenosis caused by,most of thetime,The fibrinogen is the clotting factor or inflammatory factor when thevascular endothelial, etc. is in the to suffer acute injury or in the stress state,soits role in the prediction of coronary heart disease acute adverse events ishigher than its role in the assessment of the severity of coronary lesions;②Body in a variety of circumstances, especially inflammation under stressproduce large amounts of fibrinogen, there was not a detailed screening whenfiltered sample, experimental results may cause errors;③Limited samplesincluded in this study, the sampling error or other bias may exist.3、This experiment found APTT was negatively related to fibrinogen,APTT was positively correlated with apoA1/B ratio, FIB was negativelycorrelated with apoA1/B ratio.But only through a cross-sectional study, it isdifficult to clear the specific relationships between the three，it need furtherbasis of experiments study to clear the common mechanism between clottingand lipids.Defects：1) Limited sample size;2) Fails to group according to age, sex,BMI, smoking, eating habits and whether taking anticoagulant, lipid loweringdrugs;3) is just a cross-sectional study, it is difficult to determine causality. |
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