血清纤维蛋白原水平与老年急性心肌梗死患者肾功能不全的相关性

Relationship between fibrinogen and renal insufficiency in elderly patients with acute myocardial infarction

目的:探讨血清纤维蛋白原(FIB)水平与老年急性心肌梗死(AMI)患者肾功能不全的关系。方法:选取2017年1月—2019年12月确诊的老年AMI患者456例。根据估算的肾小球滤过率(eGFR)分为肾功能正常组(373例)和肾功能不全组(83例)。记录患者的一般临床资料和血生化指标,采用Spearman相关分析血清纤维蛋白原FIB水平与eGFR的相关性,采用二元Logistic回归分析血清FIB水平是否为影响老年AMI患者肾功能不全的独立影响因素。结果:肾功能不全组糖尿病、ST段抬高型、KillipⅠ、Ⅱ、Ⅲ、Ⅳ级、心力衰竭、心律失常患者所占的比例及年龄、住院天数、尿素、尿酸、肌酐、高敏C反应蛋白、FIB、空腹血糖、白细胞、脑钠肽较肾功能不全组明显增加(χ^(2)=10.452、10.070、27.455、4.334、5.724、18.190、35.719、17.264,t=-8.386、-3.051、-7.602、-8.771、-7.789、-3.316、-4.031、-1.743、-2.442、-6.065,均P<0.05),白蛋白、白球比、低密度脂蛋白-胆固醇、总胆固醇、血红蛋白、红细胞明显降低(t=4.082、4.169、2.726、2.707、4.541、5.021,均P<0.05)。Spearman相关分析表明,FIB(r=0.247)与肾功能不全呈正相关(P<0.05)。二元Logistic回归分析表明血清FIB水平(OR=1.986,95%CI:1.071~3.680)是老年AMI患者肾功能不全的独立影响因素(P<0.05)。结论:血清FIB水平与老年AMI患者肾功能不全呈正相关,是老年AMI患者肾功能不全的独立影响因素。

Objective:To observe the relationship between fibrinogen(FIB)and renal insufficiency in elderly patients with acute myocardial infarction(AMI).Methods:A total of 456 elderly patients with AMI from January 2017 to December 2019 were selected.Patients were divided into normal renal function group(373 cases)and renal insufficiency group(83 cases)by estimated glomerular filtration rate(eGFR).Patients′general clinical data and blood biochemical indicators were recorded,Spearman correlation analysis was used to analyze the correlation between FIB level and eGFR,and binary Logistic regression was used to analyze whether FIB was an independent factor affecting renal insufficiency in elderly patients with AMI.Results:In the renal insufficiency group,the proportion of patients with diabetes,ST-elevation type,KillipⅠ,Ⅱ,Ⅲ,Ⅳgrade,heart failure,and arrhythmia,age,number of days in hospital,urea,uric acid,creatinine,high-sensitivity C-reactive protein,fibrinogen,fasting blood glucose,white blood cells,brain natriuretic peptide were significantly increased compared with the renal insufficiency group(χ^(2)=10.452,10.070,27.455,4.334,5.724,18.190,35.719,17.264,t=-8.386,-3.051,-7.602,-8.771,-7.789,-3.316,-4.031,-1.743,-2.442,-6.065,all P<0.05),and Albumin,white sphere ratio,low-density lipoprotein,total cholesterol,hemoglobin,red blood cells were significantly decreased(t=4.082,4.169,2.726,2.707,4.541,5.021,all P<0.05).Spearman correlation analysis showed that FIB(r=0.247)was positively correlated with renal insufficiency(P<0.05).Binary Logistic regression analysis showed that FIB(OR=1.986,95%CI:1.071-3.680)was an independent influencing factor of renal insufficiency in elderly patients with AMI(P<0.05).Conclusion:Serum FIB is positively correlated with renal insufficiency in elderly patients with AMI.Serum FIB is an independent influencing factor of renal insufficiency in elderly patients with AMI.