高纤维蛋白原血症与冠状动脉病变严重程度的关系

The relationship between hyperfibrinogenemia and the severity of coronary lesions

目的探讨纤维蛋白原(FIB)与冠状动脉(以下简称冠脉)病变严重程度的关系。方法评估102例在该院行冠脉造影并明确诊断冠心病的患者的冠脉病变情况;测定血浆FIB水平,根据FIB值25%、50%、75%的分界点,将患者分为A(FIB 2.46～3.43 mg/L,n=26)、B(FIB 3.44～4.01 mg/L,n=25)、C(FIB4.04～4.77mg/L,n=25)、D(FIB 4.80～6.01mg/L,n=26)4组,比较各组患者冠脉病变情况。结果 4组患者在基线调查的所有因素中,年龄、男性患者比例、高血压、糖尿病、血肌酐值及空腹血糖比较,差异有统计学意义(P<0.05);4组患者冠脉病变评分比较差异有统计学意义(P<0.01),并随冠心病患者FIB水平升高,冠脉病变加重;多因素Logistic回归分析结果显示,FIB水平越高,冠脉病变越严重,中度与轻度病变比较,差异有统计学意义(OR=1.03,95%CI:1.01～1.04,P=0.000);重度与轻度病变比较,差异有统计学意义(OR=1.05,95%CI:1.02～1.07,P=0.000)。结论高FIB血症是冠脉病变严重程度的独立预测因子。

Objective To study the relationship between plasma fibrinogen(FIB)level and the severity of coronary lesions.Methods 102 cases of patients in this hospital were diagnosed with coronary heart disease by coronary angiography and coronary lesions were further evaluated.Plasma FIB level was measured.According to the boundary point 25%,50%,75% of the plasma FIB level,patients were separated into four groups,A:(FIB 2.46-3.43 mg/L,n=26);B:(FIB 3.44-4.01 mg/L,n=25);C:(FIB 4.04-4.77 mg/L,n=25);D:(FIB 4.80-6.01 mg/L,n=26).The coronary artery lesions in each group were compared.Results Among the four groups all the factors of baseline measurements,age,proportion of male patients,hypertension,diabetes,creatinine and fasting blood glucose were significantly different(P<0.05).The severity score of coronary lesions was significantly different in four groups(P<0.01).With the FIB level elevated,the coronary artery lesion is aggravated.Multifactorial logistic regression analysis showed that higher FIB level would increase the severity of coronary lesions(moderate vs.mild group,OR=1.03,95%CI:1.01-1.04,P=0.000);severe vs.mild group:(OR=1.05,95%CI:1.02-1.07,P=0.000).Conclusion Hyperfibrinogenemia is an independent predictor of the severity of coronary lesions.