冠心病患者血浆纤维蛋白原与血管内皮功能及颈动脉斑块分级的相关性研究

Correlation of flow-mediated dilation,common carotid atheromatous plaque score with fibrinogen in coronary heart disease patients

目的探讨冠心病患者血管内皮功能及颈动脉斑块分级与血浆纤维蛋白原(FIB)的相关性。方法冠心病患者76例与正常对照组30例采用高分辨率血管超声法检测肱动脉血流介导的内皮依赖性血管舒张功能(FMD)、颈动脉内膜厚度(IMT)及斑块积分,检测血浆中纤维蛋白原,并对冠心病患者进行冠脉造影。结果冠心病患者颈动脉斑块积分0级28例,1级25例,2级18例,3级5例。冠心病患者FMD为(6.94±4.21)%,IMT(1.03±0.32)mm,FIB为(3.24±1.07)g/L,均高于对照组比较,差异有统计学意义。冠心病患者FIB与FMD存在负相关(r=-0.429,P<0.05),与颈动脉斑块分级存在正相关(r=0.363,P<0.05),与颈动脉IMT无相关性(r=0.09,P>0.05)。结论冠心病患者FIB水平升高,冠心病患者血浆FIB与颈FMD存在负相关,与颈动脉斑块分级存在正相关。FIB水平能反映内皮功能受损的程度及动脉粥样硬化的程度。临床上加强降纤治疗对延缓冠心病患者内皮功能受损及动脉粥样硬化发展可能有重要的作用。

Objective To investigate the correlation of flow-mediated dilation, common carotid atheromatous plaque score with fibrinogen in coronary heart disease patients. Methods 76 coronary heart disease patients and 30 normal control patients were recruited for this study. The intima-media thickness （ IMT）, arteriosclerotic plaques in carotid arteries and flow-mediated dilation （FMD） in the brachial artery were evaluated with B-mode ultrasonography in all subjects. And plasma fibrinogen （ FIB ） was examined in all subjects. Results The carotid IMT, atheromatous plaque score, plasma FIB levels and FMD of coronary heart disease group were significantly higher than those of the control group （ P 〈 0.05 ）. Plasma FIB levels was negtively correlated with FMD （ r = -0. 429, P 〈 0.05 ）. And plasma FIB levels was positively correlated with common carotid atheromatous plaque score（ r = 0. 363 ,P 〈 0.05 ）in coronary heart disease patients. There was no correlation between plasma FIB levels and cIMT in coronary heart disease patients （ r = 0.09, P 〉 0.05 ）. Conclusion There is higher plasma FIB level in coronary heart disease patients. Plasma FIB levels is negtively correlated with FMD, and plasma FIB levels is positively correlated with common carotid atheromatous plaque score in coronary heart disease patients. Plasma FIB levels maybe reflect the degree of atherosclerosis and FMD impair. Intensive treatment of decreasing plasma FIB may have a important role on retarding the development of atherosclerosis and FMD impair in coronary heart disease patients.