老年糖尿病合并冠心病患者纤维蛋白原、D-二聚体、淀粉样A蛋白水平变化

Changes of levels of fibrinogen fibers,D-dimer,amyloid A protein in elderly diabetic patients with coronary heart disease

目的探讨老年糖尿病合并冠心病(DM-CHD)患者纤维蛋白原(fibrinogen,Fib)、D-二聚体(D-dimer)、淀粉样A蛋白(serum amyloid A,SAA)水平变化及检测意义。方法选择2012年6月至2014年12月医院收治的老年糖尿病(diabetes mellitus,DM)及DM-CHD患者共85例,其中单纯DM 41例,DM-CHD 44例,另选取同期40例健康体检者为对照组,ELISA法测定SAA水平,全自动凝血分析仪测定D-二聚体水平,免疫比浊法测定Fib水平,比较3组SAA、D-二聚体、Fib水平,多因素Logistic回归分析DM-CHD发生的危险因素。结果 Fib、SAA及D-二聚体水平DM-CHD组和DM组与对照组比较差异有统计学意义(F=3.647、18.937、12.582,P均<0.01);SAA、D-二聚体水平DM-CHD组与DM组比较差异均有统计学意义(t=13.175、5.001,P均<0.01),Fib水平DM-CHD组与DM组比较差异无统计学意义(t=0.806,P=0.42),Logistic回归分析发现Fib、SAA、D-二聚体是DMCHD发生的独立危险因素(P<0.05)。结论老年DM-CHD患者Fib、D-二聚体、SAA蛋白水平升高,Fib、D-二聚体与SAA蛋白为DM-CHD发生的危险因素。

Objective To explore the significance of fibrinogen （Fib） , D-dimer, serum amyloid A （SAA） levels in elderly diabetic patients with coronary heart disease （DM-CHD）. Methods A total of eighty-five elderly patients with diabetes mellitus （DM） or DM-CHD from June 2012 to December 2014 in our hospital were selected, including forty-one patients with DM and forty-four patients with DM-CHD. Forty healthy people were chosen as the control group. The levels of SAA, D-dimer and Fib were detected and compared among the three groups. Risk factors of DM-CHD were analyzed by multivariate Logistic regression analysis. Resets The levels of Fib, SAA and D-dimer between DM-CHD group, DM group and eontrol group were statistically different （ F= 3. 647, 18. 937, 12. 582, all P〈0. 01 ）. There were significant difference in the levels of SAA, D-dimer between DM-CHD group and DM group （t= 13. 175,5. 001, P〈0. 01 ）. Logistic regression analysis showed that Fib, SAA, D-dimer were independent risk factors of DM-CHD （P〈0. 05）. Conclusions The levels of fibrinogen, D-dimer, SAA increase in elderly patients with DM-CHD. Fib, D-dimer and SAA are risk factorsfor DM-CHD.