急性冠状动脉综合征患者GRACE评分与纤维蛋白原、D-二聚体的相关性研究被引量：10

Relationship between GRACE Risk Score and Fibrinogen,D-dimer in Patiens with Acute Coronary Syndrome

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摘要目的探讨急性冠状动脉综合征（ACS）患者的GRACE评分与其血浆纤维蛋白原、D-二聚体的相关性及临床意义。方法选择2014年10月～2016年1月经临床及冠脉造影明确的ACS患者319例为实验组，另取83例同期人院检查正常者为对照组。根据GRACE评分将实验组分为低危组（n=83）、中危组（n=117）、高危组（n：119），根据所有入选患者纤维蛋白原、D-二聚体水平，按四分位数分组分为≤25％组、26％-50％组、51％～75％组、〉75％组。比较不同危险分层ACS患者纤维蛋白原、D-二聚体的浓度差异及不同纤维蛋白原、D-二聚体水平组的GRACE评分高低，分析实验组纤维蛋白原、D-二聚体水平与GRACE评分的相关性及临床意义。结果与对照组相比，实验组纤维蛋白原、D-二聚体水平明显升高，差异有统计学意义（P〈0．05）；高危组的纤维蛋白原、D-二聚体水平明显高于中、低危组（P〈0．05）；与≤25％组相比，26％～50％组、51％～75％组、〉75％组GRACE评分显著升高（P〈0．05）；相关性分析显示，实验组纤维蛋白原、D-二聚体水平与GRACE评分呈正相关（r=0．514，r=0．520，P〈0．01）。ROC曲线分析显示，纤维蛋白原ROC曲线下面积为0．757（P〈0．05）；D-二聚体ROC曲线下面积为0．893（P〈0．05）。结论纤维蛋白原、D-二聚体对ACS患者早期危险分层具有独特预测价值，可作为ACS患者危险性预测因子。 Objective To study the relationship between GRACE risk score and Fibrinogen, D - dimer on patients with acute coronary syndrome （ACS） and its clinical significance. Methods We choosed 319 patients with ACS from October 2014 to January 2016 as experimental group. 83 healthy subjects were chosen as controls. Patients in experimental group were further divided into low risk group, moderate risk group and high risk group according to GRACE score,and into ≤25% group, 26% -50% group, 51% -75% group and 〉 75% group according to Fibrinogen, D -dimer concentration. The relationship between GRACE risk score and Fibrinogen, D -dimer, and its clinical significance were sdudied. Results Compared with the control group, Fibrinogen and D - dimer level in experimental group increased significantly （ P 〈 0.05 ）. Fibrinogen and D - dimer levels in high - risk group was obviously higher than in moderate and low risk groups （P 〈0.05）. Compared with ~〈25% group, 26% -50% group, 51% -75% group, GRACE score in 75% group was significantly higher （P 〈 0.05 ）. Correlation analysis showed that Fibrinogen and D - dimer level and GRACE scores in experimental group were positively correlated （r = 0. 514, r = 0. 520, P 〈 0.01 ）. ROC curve analysis showed that Fibrinogen area under the ROC curve was 0. 757 （P 〈 0.05） ; D - dimer area under the ROC curve was 0.893 （P 〈 0.05）. Conclusion Fibrinogen and D - dimer were cor- related with GRACE scores in patients with ACS, which can be used as a risk predictor for those patients.

作者张欢张延斌

机构地区徐州医学院

出处《医学研究杂志》 2016年第9期126-129,共4页 Journal of Medical Research

关键词纤维蛋白原 D-二聚体急性冠脉综合征 GRACE评分 Fibrinogen D - dimer Acute coronary syndrome GRACE score

分类号 R4 [医药卫生—临床医学]

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