纤维蛋白原对老年女性急性心肌梗死患者肾功能不全的预测作用

Role of fibrinogen in predicting renal insufficiency in elderly female acute myocardial infarction patients

目的探讨纤维蛋白原对老年女性急性心肌梗死(AMI)患者肾功能不全的预测作用。方法采用横断面选取2016年1月~2019年12月天津医科大学第二医院心脏科就诊的老年女性AMI患者345例,并以估算的肾小球滤过率(eGFR)≥60 ml/(min·1.73 m^(2))作为肾功能正常组(233例),eGFR<60 ml/(min·1.73 m^(2))作为肾功能不全组(112例)。采用Spearman相关性分析eGFR与高血压、年龄、TC、LDL-C、尿酸、尿素、肌酐、高敏C反应蛋白(hs-CRP)、N末端B型钠尿肽前体(NT-proBNP)、纤维蛋白原等生化指标的关系,二元logistic回归分析影响老年女性AMI患者肾功能不全的危险因素。结果与肾功能正常组比较,肾功能不全组年龄、饮酒、尿酸、尿素、肌酐、hs-CRP、NT-proBNP、纤维蛋白原水平明显升高,TC、HDL-C、LDL-C、白球比、白蛋白、红细胞计数、血小板计数明显降低(P<0.05,P<0.01)。Spearman相关性分析显示,eGFR与纤维蛋白原呈负相关(r=-0.168,P=0.002)。二元logistic回归分析显示,年龄、hs-CRP、纤维蛋白原是老年女性AMI患者肾功能不全的独立危险因素(OR=0.960,95%CI:0.926~0.996,P=0.032,OR=0.998,95%CI:0.994~1.000,P=0.046,OR=0.688,95%CI:0.476~0.992,P=0.045)。结论纤维蛋白原对老年女性AMI患者肾功能不全具有独立预测作用。

Objective To study the role of fibrinogen in predicting renal insufficiency in elderly female AMI patients.Methods Three hundred and forty-five elderly female AMI patients were divided into normal renal function group(n=233)and renal insufficiency group(n=112)according to their eGFR.The relationship of eGFR with hypertension,age,serum levels of TC,LDL-C,UA,BUN,SCr,hs-CRP,NT-proBNP and fibrinogen was analyzed by Spearman correlation analysis.The risk factors for renal insufficiency in elderly female AMI patients were analyzed by binary logistic regression analysis.Results The age was significantly older,the history of alcohol consumption was significantly longer,the serum levels of UA,BUN,SCr,hs-CRP,NT-proBNP,fibrinogen were significantly higher while the serum levels of TC,HDL-C,LDL-C,albumin,WBC,RBC and platelet count were significantly lower in renal insufficiency group than in normal renal function group(P<0.05,P<0.01).Spearman correlation analysis showed that fibrinogen was negatively with eGFR(r=-0.168,P=0.002).Binary logistic regression analysis displayed that age,hs-CRP,fibrinogen were the independent risk factors for renal insufficiency in elderly female AMI patients(OR=0.960,95%CI:0.926-0.996,P=0.032;OR=0.998,95%CI:0.994-1.000,P=0.046;OR=0.688,95%CI:0.476-0.992,P=0.045).Conclusion Fibrinogen is an independent predictor of renal insufficiency in elderly female AMI patients.