纤维蛋白原与冠状动脉病变严重程度相关性临床研究

Correlation between fibrinogen and severity of coronary lesions

目的:探讨纤维蛋白原(FIB)水平与冠状动脉(冠脉)病变严重程度的相关性。方法:对239例疑诊为冠心病的患者进行冠脉造影,根据冠脉病变程度患者被分成冠脉狭窄组(主干或分支直径狭窄程度>50%)和对照组(主干或分支直径狭窄程度≤50%)。再将冠脉狭窄组按狭窄累及范围分为单支组,双支组和多支(3支以上)组。所有患者检测FIB、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)、脂蛋白(Lp)a。在控制其他影响因素后,分析FIB与冠脉病变的定性和定量关系。结果:冠脉狭窄组患者的FIB水平明显高于对照组(P<0.05)。在冠脉狭窄组中双支组与多支组的FIB水平显著高于单支组(P<0.05)。双支组与多支组FIB水平无显著差异。偏相关分析在控制可能影响FIB水平的其他因素如性别、年龄、血脂、高血压、糖尿病后,显示FIB与冠脉的病变程度明显相关(r=0.693,P<0.05)。且冠脉病变程度随着FIB的提高而加重(P<0.05),其中合并有糖尿病的患者更为明显。结论:FIB水平增高可以反映冠脉病变的严重程度,同时又是简单易行的临床监测指标。

Objective：To study the correlation between fibrinogen and severity of coronary lesions. Methods：In a total of 239 patients suspected as coronary artery disease （CAD）, coronary angiographies were performed,and they were divided into coronary stenosis group （stenosis〉50%, 177cases）and no coronary stenosis group （control group, stenosis ≤50%, 62 cases） by quantitative coronary angiography. The fibrinogen, total cholesterol （TC）, triglyceride （TG）, low-density lipoprotein cholesterol （LDL-C）, and high-density lipoprotein cholesterol （HDL-C） also determined in each patient. Partial regression analysis was conducted. Results： The result from partial regression analysis showed that there was a positive correlation between the fibrinogen and the severity of coronary lesions （r= 0. 489,P〈0. 05）. Especially, the level of fibrinogen was significantly higher in patients with diabetes than in patients with no diabetes （P〈0.05）. There was still a positive correlation between the fibrinogen and the severity of coronary lesions（r= 0. 693. P〈0.05） after adjusting other factors, such as age, blood pressure, smoking, blood fat, and diabetes. Conclusion：The serum level of fibrinogen may have a prognosis value on the severity of coronary lesion in patients with CAD.