探讨冠心病经皮冠状动脉介入治疗（percutaneous transluminal coronary, PCI）术后载脂蛋白B/载脂蛋白A1（ApoB/A1）比值及相关血脂指标的变化，及其对术后心脏事件的预测价值。

收集2013年5月至2014年8月在晋中市第一人民医院行PCI的老年患者117例，根据服用降脂药物的种类分为阿托伐他汀组（71例）、辛伐他汀组（46例）。观察比较两组患者术前及术后1、6、12个月的总胆固醇（TC）、LDL-C、HDL-C水平及ApoB/ApoA1、TC/HDL比值的变化情况，并分析其与12个月内发生心脏事件（再发心绞痛、心肌梗死、心源性猝死、再次血管重建术、死亡）的相关性。组间不同时点的比较以及趋势性和交互作用均采用重复测量方差分析，预后分析采用受试者工作特征曲线下面积（AUC）。

出院后1个月内不良事件发生率为4.3%（5/117），出院后1～6个月不良事件发生率为6.0%（7/117），出院后6～12个月不良事件发生率为12.0%（14/117）。两组患者LDL-C、HDL-C、TC水平及ApoB/ApoA1比值、TC/HDL-C比值的变化均为线性趋势（F=53.878、134、10.364、52.852、64.523，P<0.05或0.01），而且随访期间两组患者LDL-C、HDL-C、TC水平均处于正常范围。术后1个月，各项血脂指标对于判断PCI术后预后的意义不大，但ApoB/ApoA1比值较其他血脂指标对术后预后判断价值更大（AUC=0.43，最接近0.05）；术后6、12个月ApoB/ApoA1比值较其他血脂指标对术后预后判断价值也更大（AUC=0.709、0.010，均P<0.05）。

PCI术后ApoB /ApoA1比值与心脏事件的发生相关，相对于其他血脂指标预测价值更大，而且随着时间的延长其预测性越来越准确。

To investigate the changes of apolipoprotein B/apolipoprotein Al (ApoB/A1) ratio and related blood lipid indexes after PCI for coronary heart disease, and its predictive value for postoperative cardiac events.

117 elderly patients who underwent PCI in the department of cardiology of the First People's Hospital of Jinzhong from May 2013 to August 2014 were collected and divided into atorvastatin group (71 cases) and simvastatin group (46 cases) according to the types of lipid-lowering drugs they took. The changes of levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoproteincholesterol (HDL-C) and ApoB/ApoA1 and ratio of TC/HDL before and 1, 6 and 12 months after PCI in the two groups were observed and compared, and their correlations with the occurrence of cardiac events (recurrent angina pectoris, myocardial infarction, sudden cardiac death, etc., re-vascular reconstruction, death) within 12 months were analyzed. Repeated measurement ANOVA was used for comparison between groups and trend analysis, and area under the receive operating characteristic curve was used for prognosis analysis.

The incidence of adverse events was 4.3% (5/117) within 1 month after discharge, 6.0% (7/117) within 1 to 6 months after discharge, and 12.0% (14/117) within 6 to 12 months after discharge. The changes of levels of LDL-C, HDL-C, TC and ratios of ApoB/ApoA1 and TC/ HDL-C in the two groups were all linear (F=53.878, 134, 10.364, 52.852, 64.523, P < 0.05 or 0.01), and the levels of LDL-C, HDL-C, TC in the two groups were in the normal range during the follow-up. One month after the operation, various blood lipid indexes had little value in evaluating the prognosis after PCI, but the ApoB/ApoA1 ratio was more valuable than other blood lipid indexes in evaluating the prognosis after PCI (AUC=0.43, closest to 0.05). 6 and 12 months after the operation, the ApoB/ApoA1 ratio was also more valuable in evaluating postoperative prognosis than other blood lipid indexes (AUC=0.709, 0.010, all P < 0.05).

The ratio of ApoB /ApoA1 after PCI is related to the occurrence of cardiac events, which has greater predictive value compared with other blood lipid indexes, and its prediction becomes more and more accurate as time extends.