急性冠脉综合征患者纤维蛋白原水平的变化及意义

Changes and significance of fibrinogen in patients with acute coronary syndrome

目的 观察急性冠脉综合征（ACS）患者纤维蛋白原（FG）的变化,分析其与冠状动脉病变的关系.方法 选取在我院住院的ACS患者231例,所有患者均进行冠状动脉造影,应用改良Gensini积分评估冠脉病变程度,按照Gcnsini积分分为低Gensini积分组和高Gensini积分组,比较两组患者主要临床资料,分析纤维蛋白原与冠状动脉病变的关系.结果 ①与低Gensini积分组相比,高Gensini积分组患者的FG明显升高,差异具有统计学意义[（3.11＆#177;0.76）g/L比（2.78＆#177;0.80）g/L,t=-3.183,P=0.002];②FG水平随着冠脉病变的支数增加和程度加重而升高（r=0.381,P＜0.01）;③冠状动脉病变程度多元Logistic回归分析示,FG与冠脉病变程度独立相关（OR=1.943,95％CI 1.129～3.343,P=0.017）;④ACS患者FG与与CRP呈正相关（r=0.363,P＜0.01）,与WBC也呈正相关（r=0.145,P＜0.05）.结论 FG与急性冠脉综合征患者冠脉病变程度独立相关.

Objective To observe the changes of fibrinogen in patients with acute coronary syndrome（ACS） and analyze the relationship between them.Methods 231 patients of ACS admitted in our hospital who undergone coronary angiography were anlyzed.The degree of coronary artery disease in all patients was evaluated with the modified Gensini scores,and according the Gensini score the patients were divided into low Gensini score group and high Gensini score group.The clinical data,levels of fibrinogen and the relationship between fibrinogen and coronary artery lesions were compared between two groups.Results （1）Compared with low Gensini score group,the FG was significantly higher in high Gensini score group [（3.11＆#177;0.76）g/L vs （2.78＆#177;0.80）g/L,t=-3.183,P=0.002].（2）The level of FG increased with the increase of the number and severity of coronary artery disease（r=0.381,P〈0.01）.（3）the multivariate logistic regression analysis showed that the level of FG was ab independent correlation factor with the degree of coronary artery lesion（OR=1.943,95%CI I.129-3.343,P=0.017） andcoronary artery disease ACS.（4）FG was positive correlated with CRP（r=0.363,P〈0.01） and the level of WBC（r=0.145,P〈0.05）.Conclusion FG is correlated with the severity of coronary artery lesions in patients with acute coronary syndrome.