Alpha-adrenoceptor blockade and class III antiarrhythmic activity combined: hemodynamic and electrophysiological effects of melperone in the dog

Melperone has been found to possess vasodilating and slight positive inotropic properties in addition to its class III antiarrhythmic action. To determine whether some of these effects might be related to an alpha-adrenoceptor blocking action of melperone, phenoxybenzamine (10 mg/kg) was given as a 2-h infusion to 12 pentobarbital-anesthetized dogs. In addition, six of the dogs were given atenolol 0.5 mg/kg i.v. After a 1-h stabilizing period, melperone (0.5, 2.5, and 12.5 mg/kg) was given i.v. in cumulative doses to both series of dogs. In the presence of alpha-blockade as well as combined alpha- and beta-blockade, atrial, atrioventricular (AV) nodal, and ventricular refractoriness increased and heart rate and AV nodal conduction time decreased, as previously reported after addition of melperone alone. A slight increase in left ventricular (dP/dt)max occurred after the addition of melperone (2.5 mg/kg) in the presence of alpha- and beta-blockade, but only after the highest dose of melperone were small decreases in blood pressure and total peripheral resistance induced. The present study indicates that melperone combines the properties of class III antiarrhythmic action, slight positive inotropy, and alpha-adrenoceptor mediated vasodilation.     

Slower Adaptation of VO2 to steady state of submaximal exercise with beta-blockade

The kinetics of oxygen uptake (VO2) were assessed in 17 normal subjects with beta-blockade and placebo. beta-blockade was achieved with either 50 mg oral metoprolol or 40 mg oral propranolol, each twice per day. Tests were conducted on the cycle ergometer at work rates approximating 80% of the work rate at ventilatory anaerobic threshold. Work rate was initiated as a square wave starting from prior rest. Data obtained 48 h, 1 week, and 4 weeks after starting drug or placebo were pooled to increase the number of points for regression analysis of kinetic parameters. While there were no differences in the plateau values for VO2 with and without beta-blockade, the rate of adaptation to steady state was significantly slower with beta-blockade than with placebo (P less than 0.05). This resulted in an increase of oxygen deficit by approximately 200 ml O2. Cardiac output measured by CO2 rebreathing was significantly reduced by beta-blockade (metoprolol by 4.1%, propranolol by 12.2%, both P less than 0.05). Blood lactate concentration was unaffected by beta-blockade. It was concluded that the influence of beta-blockade on the oxygen transport system was responsible for the significantly slower increase of VO2 to steady state in submaximal exercise.     

Need for beta-blockade in hypertension reduced with long-term minoxidil.

Sequential changes in plasma renin activity and urinary aldosterone and noradrenaline were assessed in eight patients with severe hypertension after minoxidil had been added to their treatment. Doses of 2.5--27.5 (mean 12.5) mg/day reduced the mean blood pressure from 166/113 +/-6/2 mm Hg to 124/88+/-4/2 mm Hg in one week. Plasma renin activity and urinary aldosterone and noradrenaline increased twofold to threefold initially but returned to baseline values within two to three weeks and remained unchanged during a mean follow-up of 5.1 months. Beta-blocking drugs were then withdrawn slowly in six patients without adverse effects, though blood pressure and heart rate increased in three patients, who required minimal doses of beta-blockers. Plasma renin activity and urinary aldosterone and noradrenaline did not change significantly after beta-blockade had been stopped. We conclude that the need for beta-blockade is greatly reduced with long-term minoxidil treatment and that it may be unnecessary in some patients.     

Effects of hypoxic and CO hypoxia on isolated hearts.

Isolated perfused dog hearts were made hypoxic by respiring the support dog with low oxygen (hypoxic hypoxia) or with carbon monoxide (CO hypoxia). Each heart was exposed to both types of hypoxia, separately. Effects on coronary flow (Qt), coronary vascular resistance, cardiac oxygen consumption (Vo2), and contractility (%deltadP/dt) were studied. Two series of experiments were done. Series I: At constant perfusion pressure. As oxygen content (Cao2) was lowered from 20 to 5 vol%, Qt doubled with hypoxic hypoxia and almost tripled with CO hypoxia (P less than 0.01). Vo2 and contractility increased with both types of hypoxia. Beta-adrenergic blockade eliminated the increase in VO2 and contractility but not the difference in Qt increase between hypoxic and CO hypoxia. Series II: At constant Qt (with beta-blockade), vascular resistance decreased more with CO than hypoxic hypoxia. Finally, alpha-blockade eliminated the difference in vascular resistance and thus with complete (alpha and beta) blockade, the two types of hypoxia have the same effect and are indistinguishable.     

Long-term beta blockade: possible protection from myocardial infarction.

The clinical behaviour of 90 patients on beta-blocking drugs for established coronary heart disease who were admitted to a coronary care unit with prolonged ischaemic myocardial pain was compared with that of 90 similar patients not on this therapy. Transmural myocardial infarction was confirmed in 30 of the patients on beta-blockers and in 62 controls. A diagnosis of myocardial necrosis without infarction was made in 20 patients on beta-blockers and in 14 controls. Coronary insufficiency was diagnosed in 40 patients on beta-blockers and in 14 controls. The incidence of simus bradycardia, hypotension, syncope, and radiological pulmonary oedema was similar in the two groups. Established beta-blockade, therefore, has not been shown to prejudice the outcome of patients with coronary heart disease admitted to hospital with prolonged ischaemic myocardial pain. On the contrary, it may protect some patients from the development of a myocardial infarction.     

Autonomic Control of Insulin Secretion and the Treatment of Heart Failure

To investigate the role of the autonomic nervous system in controlling insulin secretion 13 normal subjects and 5 patients with heart failure underwent insulin secretion tests. Alpha-adrenergic stimulation and beta-receptor blockade significantly depressed the secretion of insulin in response to intravenous tolbutamide in normal subjects, while both alpha-blockade and beta-stimulation significantly increased the insulin secretion response in both normal subjects and patients in heart failure. Parasympathetic stimulation and blockade had no significant effect on the insulin secretion response. These findings suggest that drugs that block the alpha-adrenergic receptors or stimulate the beta-adrenergic receptors by their ability to counteract the insulin suppression resulting from increased sympathetic nervous activity may play a vital metabolic part in the deranged metabolism of the failing heart in addition to their direct haemodynamic benefits.     

Hemodynamic effects of procainamide and quinidine and the influence of beta-blockade before and after experimental myocardial infarction.

The use of antiarrhythmie drugs in combination has been limited because of possible side effects secondary to myocardial depression in the acute myocardial infarction patient. Therefore, we investigated in intact dogs (group I) the hemodynamic interaction of propranolol plus procainamide (subgroup A) or quinidine (subgroup B) and in dogs after experimental myocardial infarction produced by coronary artery ligation (group II). Infusion of procainamide (30 mg/kg over 5 min) in animals of group IA produced a significant (P less than 0.05) decrease of 30% in mean aortic pressure, a decrease of 40% in left ventricular dp/dt and 29% in cardiac output. When procainamide was reinfuse after propranolol (1 mg/kg), its hemodynamic effects were not significantly different from those observed before propranolol in both groups IA and IIA. Infusion of quinidine (10 mg/kg over 5 min) in animals of group IB (intact dogs) also produced significant decreases of 24% in mean aortic pressure and 38% in dp/dt while cardiac output was unchanged. However, these hemodynamic changes were seen only after beta-blockade and were significantly different from those obtained before propranolol, where heart rate increased by 14%, dp/dt by 30%, and cardiac output by 35%. These changes occurred despite a similar reduction in mean aortic pressure. This drug combination produced similar response in animals after coronary artery ligation (group IIB). In conclusion, we feel that the administration of propranolol does not prevent the depressive circulatory effects of procainamide. The combined use of quinidine and propranolol also has a negative circulatory effect although not as marked as the effects observed after procainamide with propranolol.     

Decreased first-pass metabolism of labetalol in chronic liver disease.

The effect of chronic liver disease on the rate of elimination and extent of "first-pass" metabolism of labetalol was studied. Pharmacokinetic measurements were made after both oral and intravenous administration to seven healthy subjects and to 10 patients with chronic liver disease. Plasma half life was similar in the two groups. Plasma concentrations were considerably higher in the patients than in the healthy subjects after oral administration but similar after intravenous injection. Thus the bioavailability of labetalol was increased in liver disease due to reduced first-pass metabolism. Bioavailability in the group of patients correlated negatively with serum albumin concentration. There were falls in supine heart rate and blood pressure which tended to be greater after oral administration in the patients with liver disease, suggesting an exaggerated response related to the increased bioavailability. Oral dosage requirements of labetalol and possibly other drugs susceptible to first-pass metabolism are reduced in the presence of liver disease.     

Acute volume loading, atrial natriuretic peptide release and cardiac function in healthy men. Effects of beta-blockade

Release of ANP is dependent on right atrial distension and pressure, which in turn are dependent on both venous return and left ventricular function. These two latter parameters are both modulated by beta-receptors. In the present study, the effects of selective beta-blockade vs non-selective beta-blockade on hypertonic volume expansion induced changes in ANP release and systemic hemodynamics were assessed in 8 healthy normotensive male volunteers. On placebo, infusion of hypertonic saline (1200 ml of 2.5% NaCl) caused an intravascular volume expansion of 10-11%, and small non-significant increases in cardiac performance (LVEDV, SV, or CI), but it provoked a 2-fold increase in plasma ANP. Beta-blockade by either atenolol or propranolol blunted the increase in cardiac volume load (reflected by LVEDV) as compared to placebo, but did not affect the ANP response to volume expansion. The increase in ANP correlated closely with the intravascular volume expansion on placebo and to a lesser extent on beta-blockade. In healthy men, therefore, intravascular volume expansion that caused only small changes in cardiac activity, resulted in clear increases in release of ANP. Inhibition of the increase in cardiac volume load by beta-blockade did not interfere with ANP increase, suggesting a role for extra-cardiac receptors in the release of ANP or a change in the pressure/volume relationship.     

Metabolic and hormonal response to physical exercise during beta 1-selective and non-selective beta-blockade

The effects of a beta 1-selective (metoprolol, 150 mg per day) and a non-selective beta-blocking agent (propranolol, 120 mg per day) on metabolic and hormonal responses to physical exercise (a 30 min bicycle ergometer test) were investigated against placebo in seven healthy male volunteers with a double blind cross-over design. The blood glucose level remained unchanged during placebo, it tended to increase during metoprolol, whereas it decreased during propranolol. Both metoprolol and propranolol counteracted the exercise-induced increase in plasma free fatty acids and caused a slight decrease in muscle glycogenolysis. The increase in blood lactate concentration during exercise was not influenced by beta-blockade. The secretion of glucagon and cortisol was not modified significantly by beta-blockade, whereas the growth hormone response to exercise was promoted equally by both beta-blocking agents. It has been assumed previously that, during treatment with beta-blocking agents, diminished hepatic gluconeogenesis, caused by the lack of lactate or free fatty acids, may result in a decline in blood glucose levels. The present results indicate that an inhibition of beta 2-mediated hepatic glycogenolysis by propranolol may also influence blood glucose homeostasis during exercise.     

Physical training under the influence of beta-blockade in rats. III. Effects on muscular metabolism

Rats were trained by daily running exercises for 7 weeks. In addition, one group of rats was trained under the influence of propranolol, while another group received daily injections of propranolol only. None of the treatments used had influence on the activities of myocardial enzymes: 3-hydroxyacyl-CoA - dehydrogenase (HADH), succinate dehydrogenase (SDH), malate dehydrogenase (MDH), and citrate synthase (CS) which were assayed for estimating oxidative capacity, or lactate dehydrogenase (LDH) which was used as a measure of anaerobic capacity. Training without propranolol resulted in elevated activities of the oxidative enzymes in M. extensor digitorum and in M. soleus. The corresponding changes in the rat group trained with propranolol always were much smaller, despite an equal amount of training. Only the trend for lowered activity of LDH was observable in skeletal muscle of the rat groups trained both with and without propranolol. Long-term beta-blockade alone did not induce enzymatic changes. It is concluded that a functioning sympathetic nervous system is necessary for the adaptive responses of muscular metabolism to training. Blockade of the sympathetic influence during exercise periods also hampers the training-induced responses.     

冠状动脉CTA结合动态心电图夜间ST段趋势图诊断冠状动脉硬化性心脏病的价值研究

摘要 目的：探讨冠状动脉CTA结合动态心电图夜间ST段趋势图对冠状动脉硬化性心脏病（冠心病）的诊断价值。方法：回顾性分析2022年1月-2023年2月在我院疑似冠心病的患者104例,所有患者均行冠状动脉造影、冠状动脉CTA、动态心电图及临床相关实验室检查。以冠状动脉造影结果作为诊断冠心病的金标准,分析比较冠状动脉CTA、动态心电图夜间ST段趋势图及两者联合诊断冠心病的诊断效能和一致性。结果：104例疑似冠心病的患者确诊93例（89.42%）。冠状动脉CTA诊断冠心病的敏感性为90.32%,特异性为72.73%,阳性预测值为96.55%,阴性预测值为47.06%,准确率为88.46%,与冠状动脉造影的Kappa值为0.813,一致性好。动态心电图夜间ST段趋势图诊断冠心病的敏感性为84.95%,特异性为63.64%,阳性预测值为95.18%,阴性预测值为33.33%,准确率为82.69%,与冠状动脉造影的Kappa值为0.724,一致性较好。有夜间ST段动态改变的冠心病检出率（84.95%,79/93）明显高于无夜间ST段动态改变的冠心病检出率（15.05%,14/93）,差异有统计学意义（P＜0.001）。冠状动脉CTA结合动态心电图夜间ST段趋势图诊断冠心病的敏感性为96.77%,特异性为90.91%,阳性预测值为98.90%,阴性预测值为76.92%,准确率为96.15%,与冠状动脉造影的Kappa值为0.923,一致性好。结论：冠状动脉CTA结合动态心电图夜间ST段趋势图诊断冠心病的临床价值优于冠状动脉CTA或动态心电图夜间ST段趋势图单独检查。     

Reassessment of failed beta-blocker treatment in angina pectoris by peak-exercise heart rate measurements.

Twenty-one patients with angina pectoris were treated with adrenergic beta-receptor antagonists. Previously the resting heart rate had been used as a guide to treatment, a reduction in the rate to 55-60 beats/min without symptomatic improvement indicating failure of medical treatment. These patients were re-evaluated before coronary arteriography using the peak-exercise heart rate as an index of adrenergic beta-receptor antagonism. The dose of beta-blocking drugs was increased to produce a peak-exercise heart rate of less than 100 beats/min or a consistent rate of 100-125 beats/min which would not lessen in spite of progressive dose increments. The resting heart rate was ignored. On these criteria 15 patients previously considered to have responded inadequately to beta-blockade responded satisfactorily and were therefore removed from the waiting list for coronary arteriography. They all remained well up to two years later. Six patients failed to respond and had coronary arteriography with a view to surgical treatment. Reliance on the resting heart rate as the index of optimum adrenergic beta-receptor antagonism is likely to lead to premature or unnecessary referral for surgery; the failure of beta-blockade in the treatment of angina pectoris can be determined simply and accurately by using peak-exercise heart rate.     

冠状动脉CTA联合血清HCY、Cys-C、ApoB/ApoA1比值对2型糖尿病患者合并冠状动脉病变的诊断价值

摘要 目的：探究冠状动脉CT血管造影（CTA）联合血清同型半胱氨酸（HCY）、胱抑素C（Cys-C）、载脂蛋白B/载脂蛋白A1（ApoB/ApoA1）比值对2型糖尿病（T2DM）患者合并冠状动脉病变的诊断价值。方法：回顾性选取2018年8月到2021年8月间我院收治的358例T2DM患者,均行常规生化指标、CTA检查、冠状动脉造影（CAG）检查,根据CAG检查结果为金标准将T2DM患者分为未合并冠脉病变组（190例）和合并冠脉病变组（168例）,比较两组血清HCY、Cys-C、ApoB/ApoA1比值,分析CTA与CAG诊断冠脉狭窄结果的一致性,应用受试者工作特征（ROC）曲线评估冠状动脉CTA联合血清HCY、Cys-C、ApoB/ApoA1比值对T2DM合并冠状动脉病变的诊断价值。结果：与未合并冠脉病变组比较,合并冠脉病变组血清HCY、Cys-C、ApoB、ApoB/ApoA1比值水平明显更高（P＜0.05）,ApoA1明显更低（P＜0.05）。以CAG为金标准,CTA诊断冠脉狭窄程度与CAG一致性较高（Kappa值0.748）。ROC曲线评估冠状动脉CTA诊断T2DM合并冠脉病变的AUC、灵敏度、特异度、准确度依次为0.802、74.40%、83.71%、79.11%。三项血清指标联合AUC、准确度显著优于单一指标（P＜0.05）。冠状动脉CTA联合血清HCY、Cys-C、ApoB/ApoA1比值诊断T2DM合并冠脉病变的价值显著优于各项指标单一诊断或三项血清指标联合诊断（P＜0.05）。结论：冠状动脉CTA联合血清HCY、Cys-C、ApoB/ApoA1比值诊断T2DM患者合并冠状动脉病变的价值较高,相较各项指标单一应用而言更具优势。     

老年主动脉瓣钙化与冠心病合并心律失常的相关性探讨

目的:探讨老年患者主动脉瓣钙化与冠心病合并心律失常的相关性。方法:纳入解放军总医院疑诊为冠心病的老年住院患者276例,行冠状动脉造影,同期行超声心动图和24 h动态心电图检查,详细记录患者病史。根据超声结果,将患者分成主动脉瓣钙化(AVC)组和非主动脉瓣钙化(NAVC)组,比较两组冠心病合并心律失常的检出率,评价老年患者主动脉瓣钙化对冠心病合并心律失常的预测价值。结果:AVC组和NAVC组的年龄、吸烟史、高血压史、糖尿病史存在显著性差异(P0.05);AVC组冠心病的确诊率为93.7%,而NAVC组为80.6%,两组差异有统计学意义(P=0.002);AVC组冠心病合并心律失常检出率也显著性高于NAVC组(59.2%vs 35.1%,P=0.043)。结论:主动脉瓣钙化与冠心病合并心律失常密切相关,有望作为冠心病合并心律失常的高危患者有效的筛查指标。     

Veno-arterial extracorporeal membrane oxygenation in addition to primary PCI in patients presenting with ST-elevation myocardial infarction

Introduction

Primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI) can cause great haemodynamic instability. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can provide haemodynamic support in patients with STEMI but data on outcome and complications are scarce.

Methods

An in-hospital registry was conducted enrolling all patients receiving VA-ECMO. Patients were analysed for medical history, mortality, neurological outcome, complications and coronary artery disease.

Results

Between 2011 and 2016, 12 patients underwent pPCI for STEMI and received VA-ECMO for haemodynamic support. The majority of the patients were male (10/12) with a median age of 63 (47–75) years and 4 of the 12 patients had a history of coronary artery disease. A cardiac arrest was witnessed in 11 patients. The left coronary artery was compromised in 8 patients and 4 had right coronary artery disease. All patients were in Killip class IV. Survival to discharge was 67% (8/12), 1?year survival was 42% (5/12), 2 patients have not yet reached the 1?year survival point but are still alive and 1 patient died within a year after discharge. All-cause mortality was 42% (5/12) of which mortality on ECMO was 33% (4/12). Patient-related complications occurred in 6 of the 12 patients: 1 patient suffered major neurological impairment, 2 patients suffered haemorrhage at the cannula site, 2 patients had limb ischaemia and 1 patient had a haemorrhage elsewhere. There were no VA-ECMO hardware malfunctions.

Conclusion

VA-ECMO in pPCI for STEMI has a high survival rate and neurological outcome is good, even when the patient is admitted with a cardiac arrest.

     

Physical training under the influence of beta-blockade in rats. II. Effects on vascular reactivity.

Rats were treated by daily swimming or running exercises for 7 weeks. One group of rats was also trained under the influence of propranolol, while another group received daily propranolol injections only. The rat groups trained without beta blockade maintained a higher tail skin temperature when exposed to 5 degrees C after the 7-week training period. This phenomenon was not observable in the animals having received their training under the influence of beta-blockade. Both rat groups trained without beta-blockade showed increased vasodilatatory response to isoprenaline, as judged from a higher elevation of the tail skin temperature in response to the drug. This response was absent in the animal group having performed its training periods under the influence of propranolol. After the injection of phenylephrine the trained rats had a higher tail skin temperature than did the controls or propranolol-treated rats. The present results suggest an elevated sensitivity of beta 2-adrenoceptors and/or decreased sensitivity of alpha-adrenoceptors in trained rats. It is suggested that for the development of these changes repeated activation of the sympathetic nervous system by exercise periods is needed. That is why they are preventable if the training is performed under the influence of beta-blockade.     

血清MCP-1、RANTES及CysC联合检测对急性冠状动脉综合征的诊断价值

目的:探讨联合检测血清单核细胞趋化蛋白-1(MCP-1)、活化T细胞趋化因子(RANTES)及半胱氨酸蛋白酶抑制剂C(Cys C)对急性冠状动脉综合征(ACS)患者的早期诊断和预后评估价值。方法:选择200例于2012年10月到2013年10月在本院就诊的冠心病患者200例,其中ACS患者120例(为ACS组),另稳定型心绞痛(SAP)患者80例(SAP组),另选择同期40例健康人为对照组。115例患者有冠状动脉粥样硬化,其中40例钙化斑块组、42例纤维斑块组及33例软斑块组,进行CT检查;用双抗体夹心酶联免疫(ELISA)法检测患者血清MCP-1、RANTES、Cys C及高敏C反应蛋白(Hs-CRP)水平,并用logistic回归方程评价联合检测MCP-1、RANTES及Cys C预测ACS的效果。结果:与SAP组、对照组相比,ACS组患者MCP-1、RANTES、Cys-C、Hs-CRP、LDL-C及空腹血糖(FBG)浓度均明显升高(P0.05);HDL-C浓度明显降低(P0.05);与纤维斑块组、钙化斑块组相比,软斑块组MCP-1、RANTES及Cys-C浓度均明显升高(P0.05);与钙化斑块组相比,纤维斑块组MCP-1、RANTES及Cys-C浓度均明显升高(P0.05);联合检测血清MCP-1、RANTES、Cys-C预测ACS患者,阳性准确率为89.2%,阴性准确率为92.5%,综合准确率为90.8%,明显高于单纯Hs-CRP的检测方法(P0.05)。结论:血清MCP-1、RANTES及Cys C联合检测对急性冠状动脉综合征的诊断效果优于单纯检测Hs-CRP。该联合检测方法具有一定的临床应用价值。     

"Third drug" trial: comparative study of antihypertensive agents added to treatment when blood pressure remains uncontrolled by a beta blocker plus thiazide diuretic.

Hydralazine, labetalol, methyldopa, minoxidil, prazosin, and placebo were compared when added by random allocation to atenolol 100 mg and bendrofluazide 5 mg daily in a series of 238 hypertensive patients inadequately controlled by the beta blocker-diuretic combination. Atenolol was withdrawn in those allocated to labetalol, and minoxidil was given only to men. The order of acceptability was: placebo, hydralazine, prazosin, methyldopa, minoxidil, labetalol. Minoxidil was more effective than the other active drugs, which had similar potency to one another. All the active agents were more effective than placebo. Hydralazine was the most generally suitable third drug, with prazosin a close second. Minoxidil was especially effective in patients with less severe hypertension but the same regimen caused fluid retention in those with more severe disease. Labetalol should probably be introduced at a low dose (150 mg daily) even when replacing full doses of a previously administered beta blocker.     

载脂蛋白亚型与糖尿病合并冠心病的相关性研究

目的:探讨载脂蛋白亚型与糖尿病合并冠脉病变严重程度相关性,为预防及治疗糖尿病伴发的动脉粥样硬化性疾病提供新的依据。方法:选取440名心内科患者,根据冠脉造影有无冠脉狭窄及是否合并糖尿病分为四组:冠脉内膜光滑组94人(A组);单纯冠脉狭窄组108人(B组);糖尿病合并冠脉狭窄组共184人(C组);糖尿病冠脉无狭窄组44人(D组),记录患者空腹血糖、餐后血糖、传统血脂脂谱、载脂蛋白A(apoA)、载脂蛋白B(apoB)及两者的比值(apoB/apoA);采用Gensini评分比较传统血脂、apoA、apoB及与Gensini积分值的相关性。结果:与正常对照组比较,糖尿病冠脉无狭窄组apoB、apoB/apoA、LDL和TG升高,apoA和HDL降低,B组和C组apoA与Gensini积分值存在负相关(P=0.01570.05);apoB;apoB/apoA与Gensini积分值存在正相关(P0.0001);两组中,apoB与Gensini积分值相关系数最大(r=0.85795,0.85941),且apoB与Gensini积分值的相关性都强于LDL与积分值的相关性。结论:在糖尿病患者预测心血管风险上,apoB,apoA,apoB/apoA的测定可能优于传统的血脂指标。