上海交通大学学报（医学版）2026，Vol.46Issue(3)：312-321,10.DOI:10.3969/j.issn.1674-8115.2026.03.005
基于血管内超声分析载脂蛋白B控制水平对冠状动脉斑块进展影响的队列研究
Impact of apolipoprotein B control on coronary atherosclerotic plaque progression:a cohort study using intravascular ultrasound
摘要
Abstract
Objective·To investigate the correlation between apolipoprotein B(ApoB)control level and coronary plaque progression in patients with stable coronary atherosclerotic heart disease(CHD).Methods·This study retrospectively enrolled 86 patients with stable CHD(146 lesions)who were treated in the Department of Cardiology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,from January 2020 to May 2023.At baseline,demographic characteristics,physical examination finding,medical history,and medication use were collected.At baseline and follow-up,cardiometabolic parameters(including blood lipids and blood glucose)were measured,and intravascular ultrasound(IVUS)was performed to evaluate the same untreated intermediate coronary lesions(stenosis rate 30%‒70%).Time-averaged values of cardiometabolic parameters during follow-up were calculated.Quantitative analysis was performed on IVUS images to measure total atheroma volume(TAV)and percent atheroma volume(PAV)at baseline and follow-up.Patients were divided into a plaque progression group and a non-progression group according to a cutoff value of PAV change≥5%.Spearman correlation analysis and multivariate Logistic regression were used to evaluate the association between time-averaged ApoB control level and coronary plaque progression.Results·During follow-up,the mean change in PAV was 3.6%(-2.7%,9.7%),and plaque progression was detected in 65 lesions(44.5%).A positive correlation was observed between time-averaged ApoB control level and mean change in TAV(r=0.22,P=0.008).Multivariate logistic regression analysis further demonstrated that,after adjustment,each 0.1 mmol/L increase in time-averaged ApoB control level was associated with a 0.885-fold increase in the risk of plaque progression(P=0.048).Conclusion·Higher ApoB levels remain an independent predictor of coronary plaque progression after adjustment for potential confounders.These findings suggest that comprehensive management of cardiometabolic parameters,including ApoB,should be strengthened in clinical practice to delay plaque progression and improve patient prognosis.关键词
冠状动脉粥样硬化性心脏病/斑块进展/载脂蛋白B/血管内超声Key words
coronary atherosclerotic heart disease(CHD)/plaque progression/apolipoprotein B(ApoB)/intravascular ultrasound(IVUS)分类
医药卫生引用本文复制引用
阿布力克木·阿木提,李悠然,杨晨蝶,Tay GuanPoh,冯硕,张瑞岩,王晓群..基于血管内超声分析载脂蛋白B控制水平对冠状动脉斑块进展影响的队列研究[J].上海交通大学学报（医学版）,2026,46(3):312-321,10.基金项目
国家重点研发计划(2022YFC2503502) （2022YFC2503502）
国家自然科学基金(82170423) （82170423）
上海交通大学医学院"双百人"项目(2024-0801) （2024-0801）
上海市卫生健康委员会医学新技术研究与转化种子计划(2024ZZ2042) （2024ZZ2042）
国家转化医学中心(上海)开放课题项目[NRCTM(SH)-2023-13]. National Key Research and Development Program of China(2022YFC2503502) （上海）
National Natural Science Foundation of China(82170423) （82170423）
"Two-hundred Talents"Program of Shanghai Jiao Tong University School of Medicine(2024-0801) （2024-0801）
Shanghai Municipal Health Commission Medical New Technology Research and Transformation Seed Program(2024ZZ2042) （2024ZZ2042）
Opening Project of National Research Center for Translational Medicine,Shanghai[NRCTM(SH)-2023-13]. （SH）
