不同类型冠状动脉粥样硬化性心脏病患者血浆D-二聚体和纤维蛋白原水平变化

Levels of plasma D-dimer and fibrinogen in patients with different types of coronary heart disease

目的探讨不同类型冠状动脉粥样硬化性心脏病(CHD)患者血浆D-二聚体(DD)及纤维蛋白原(FBG)水平的变化。方法选择稳定型心绞痛(SA)患者36例(SA组)、不稳定型心绞痛(UA)患者38例(UA组)、急性心肌梗死(AMI)患者40例(AMI组)作为研究对象,并选取体检健康人40例作为正常对照组(NC组)。另根据患者冠状动脉造影结果将CHD患者分为单支病变组48例、双支病变组34例和3支病变组32例,分别测定并比较各组患者血浆DD及FBG水平。结果 AMI组患者血浆DD水平显著高于UA组、SA组和NC组(P<0.05);AMI组患者血浆FBG水平显著高于SA组和NC组(P<0.05),但AMI组与UA组患者血浆FBG水平比较差异无统计学意义(P>0.05);UA组患者血浆DD、FBG水平显著高于SA组和NC组(P<0.05),SA组与NC组患者血浆DD、FBG水平比较差异无统计学意义(P>0.05)。冠状动脉单支病变组、双支病变组和3支病变组患者血浆DD、FBG水平显著高于NC组(P<0.05);冠状动脉3支病变组患者血浆DD、FBG水平显著高于双支病变组和单支病变组(P<0.05),冠状动脉双支病变组患者血浆DD、FBG水平显著高于单支病变组(P<0.05)。结论血浆DD和FBG水平随着CHD的严重程度加重而升高,并与冠状动脉的狭窄程度有关;血浆DD和FBG可能在CHD的发生和发展中起重要作用。

Objective To investigate the changes of plasma D-dimer（DD） and fibrinogen（FBG） levels in patients with different types of coronary heart disease（CHD）.Methods Thirty-six patients with stable angina（SA group）,thirty-eight patients with unstable angina（UA group） and forty patients with acute myocardial infarction（AMI group） were chose as investigative objects;and forty healthy people were chose as normal control group（NC group）.According to the result of coronary arteriongraphy,the patients with CHD were divided into single vessel disease group（n=48）,double vessel disease group（n=34） and three vessel disease group（n=32）.The levels of plasma DD and FBG were detected and compared in the groups.Results The level of plasma DD in AMI group was significantly higher than that in UA,SA and NC group（P0.05）.The levels of plasma DD and FBG in UA group were significantly higher than those in SA and NC group（P0.05）.The levels of plasma DD and FBG in single vessel disease group,double vessel disease group and three vessel disease group were significantly higher than those in NC group（P〈0.05）.The levels of plasma DD and FBG in three vessel disease group were significantly higher than those in single vessel disease group and double vessel disease group（P〈0.05）.The levels of plasma DD and FBG in double vessel disease group were significantly higher than those in single vessel disease group（P〈0.05）.Conclusion The levels of plasma DD and FBG increase with the degree of CHD and coronary stenosis.Plasma DD and FBG may play an important role in the occurrence and development of CHD.