血栓前状态及血小板聚集率与冠心病危险因素的相关性分析

Correlation between Prethrombotic State and Platelet Aggregation Rate and Risk Factors of Coronary Heart Disease

目的分析冠心病稳定型心绞痛血栓前状态的危险因素和临床特点,探讨血栓前状态及血小板聚集率与冠心病危险因素的相关性。方法选择行冠脉造影且冠状动脉狭窄程度≥50%的稳定型心绞痛病人115例,通过甲襞微循环和血小板聚集率筛查,纳入冠心病稳定型心绞痛血栓前状态病人50例和非血栓前状态病人65例。收集纳入病人的临床资料及血液检查情况,分析血栓前状态及血小板聚集率与冠心病危险因素的相关性。结果与冠心病非血栓前状态组比较,冠心病血栓前状态组的总胆固醇(TC)、三酰甘油(TG)、超敏C反应蛋白(hs-CRP)水平明显升高(P<0.05)。血栓前状态与冠心病危险因素的Logistic回归分析显示:TC(OR=0.031,P=0.016)、hs-CRP(OR=0.591,P=0.013)水平是血栓前状态的影响因素(P<0.05)。血小板聚集率和各临床参数的双变量分析发现,TC(r=0.270,P=0.003)、TG(r=0.262,P=0.005)、LDL-C(r=0.239,P=0.010)、hs-CRP(r=0.319,P=0.001)与血小板聚集率具有明显相关性,且hs-CRP与血小板聚集率只在冠心病血栓前状态组具有相关性(r=0.293,P=0.039),在冠心病非血栓前状态组无相关性。结论 TC、TG、hs-CRP对冠心病血栓前状态具有诊断价值,冠心病病人TC、TG、hs-CRP水平升高会使高血小板聚集率的风险增加。

Objective To investigate the risk factors and clinical features of prethrombotic state in patients with stable angina pectoris(SAP),and to explore the relationship between prethrombotic state and platelet aggregation rate and risk factors of coronary heart disease(CHD).Methods One hundred and fifteen patients with SAP with coronary artery stenosis of more than 50%by coronary angiography were analyzed.Screening by nail-fold microcirculation and platelet aggregation rate,fifty patients with prethrombotic state of SAP and 65 patients without prethrombotic state were included.The clinical data and blood test were collected.The relationship between prethrombotic state and platelet aggregation rate and risk factors of CHD were analyzed.Results Comparied with non prethrombotic state group,the levels of total cholesterol(TC),triglyceride(TG),and high sensitive C reactive protein(hs-CRP)were increased in prethrombotic state group(P<0.05).Logistic regression analysis of prethrombotic state and risk factors of CHD showed that the levels of TC(OR=0.031,P=0.016),and hs CRP(OR=0.591,P=0.013)were closely related to prethrombotic state.Bivariate analysis of platelet aggregation rate and clinical parameters showed that TC(r=0.270,P=0.003),TG(r=0.262,P=0.005),low density lipoprotein cholesterol(LDL-C)(r=0.239,P=0.010),and hs-CRP(r=0.319,P=0.001)had significant correlation with platelet aggregation rate.The hs-CRP and platelet aggregation rate was only correlated in the prethrombotic state of CHD(r=0.293,P=0.039),and was not related in the non-thrombotic state group.Conclusion TC,TG,and hs-CRP have diagnostic value in the identification of patients with prethrombotic state of coronary heart disease.Increased levels of TC,TG,and hs-CRP in coronary heart disease increase the risk of high platelet aggregation rate.TC,TG,and hs-CRP have diagnostic value for the identification of prethrombotic state in patients with CHD.The increased levels of TC,TG,and hs-CRP in patients with CHD will increase the risk of high platelet aggregation rate.