纤维蛋白原与红细胞计数比值对经皮冠状动脉介入治疗合并糖尿病的冠心病患者死亡的预测价值

Value of the ratio of fibrinogen to red blood cell count in predicting death in patients with coronary heart disease complicated with diabetes after percutaneous coronary intervention

目的探讨基线纤维蛋白原与红细胞计数比值(FRR)对经皮冠状动脉介入治疗(PCI)合并糖尿病的冠心病(CHD)患者死亡的预测价值。方法本研究回顾性纳入1027例行PCI治疗的CHD合并糖尿病患者。其中,排除基线资料不全以及失访的患者,最终纳入990例。终点事件是全因死亡,平均随访时间为35.1±26.2个月。根据FRR中位数分为2组:低组(FRR<0.666;n=495)和高组(FRR≥0.666;n=495)。利用多元Cox比例风险模型,我们对FRR在追踪期间预测结果的价值进行了评估,并通过Kaplan-Meier方法执行了生存率分析。结果两组间性别、吸烟、饮酒、PT、DBIL、TP、TBIL、ALB和GLO等差异有统计学意义(P<0.05)。高FRR组的死亡率明显高于低FRR组(P=0.001)。多因素Cox比例风险模型,FRR是死亡事件的独立预测因子(校正后的HR为5.740[1.916-17.196],P=0.002)。受试者工作特征曲线(ROC)示,FRR、FIB和RBC的曲线下面积分别为0.658、0.616和0.377。通过结合多因素Cox比例风险模型和生存曲线分析,结果显示,两组间的生存差异显著(P<0.05)。结论FRR与死亡独立相关,并可作为PCI术后CHD合并糖尿病患者不良预后的独立预测因子。

Objective To investigate the value of baseline fibrinogen to red blood cell count ratio(FRR)in predicting death in patientsObjective To investigate the value of baseline fibrinogen to red blood cell count ratio(FRR)in predicting death in patients with coronary heart disease(CHD)complicated with diabetes after percutaneous coronary intervention(PCI).Method This study retrospectively included 1027 patients with CHD and diabetes who underwent PCI.Excluding patients with incomplete baseline information and lost follow-up,990 patients were included.The endpoint was all-cause mortality,with a mean follow-up of 35.1±26.2 months.Two groups were divided according to the median FRR:low group(FRR<0.666;N=495)and high group(FRR≥0.666;N=495).Using a multivariate Cox proportional risk model,we assessed the value of FRR predictions over the follow-up period and performed survival analyses using Kaplan-Meier methods.Results There were significant differences in gender,smoking,alcohol consumption,PT,DBIL,TP,TBIL,ALB and GLO between the two groups(P<0.05).The incidence of death was significantly higher in the high FRR group than in the low FRR group(P=0.001).In a multivariate Cox proportional hazard model,FRR was an independent predictor of mortality(adjusted HR 5.740[1.916-17.196],P=0.002).The receiver operating characteristic curve(ROC)showed that the areas under the curve of FRR,FIB and RBC were 0.658,0.616 and 0.377,respectively.Combined with multivariate Cox proportional risk model and survival curve analysis showed that the survival difference between two groups was statistically significant(log-rank,P<0.05).Conclusion FRR is independently associated with death and can be used as an independent predictor of poor prognosis in patients with CHD complicated with diabetes after PCI.