纤维蛋白原与前白蛋白比值对心肌梗死抗血小板治疗患者血小板高反应性发生预测价值

Prediction of fibrinogen to prealbumin ratio on the occurrence of high platelet reactivity in myocardial infarction patients treated with antiplatelet therapy

目的 分析纤维蛋白原(FIB)与前白蛋白(PA)比值(FPR)在心肌梗死患者采用抗血小板治疗后发生血小板高反应性(HPR)预测作用。方法 采用前瞻性研究,选取2021-01-01-2022-12-31于平煤神马医疗集团总医院接受抗血小板治疗的122例心肌梗死患者作为研究对象,观察患者治疗24 h后HPR的发生情况。设计基线资料收集表,填写并记录患者的临床资料及实验室指标进行单因素分析,并监测患者治疗前FIB与PA水平,计算FPR,采用点二列相关性分析FPR与HPR发生关系,同时绘制受试者工作特征曲线(ROC曲线),分析FPR对患者经抗血小板治疗后HPR发生的预测作用。结果 122例心肌梗死患者抗血小板治疗后,HPR发生占比26.23%。发生组与未发生组糖尿病、CRP水平比较,差异有统计学意义,均P<0.05;2组其他资料比较,差异无统计学意义,均P>0.05。发生组FIB、FPR分别为(5.21±0.48) g/L、(2.83±0.26)%,高于未发生组的(4.88±0.37) g/L、(2.52±0.23)%,t值分别为3.995、6.326,均P<0.001;PA为(184.62±12.13) mg/L,低于未发生组的(194.07±11.21) mg/L,t=4.008,P<0.001。点二列相关性分析结果显示,FIB、FPR与患者治疗后HPR发生呈正相关,r值分别为0.353和0.503,均P<0.001;PA与患者治疗后HPR发生呈负相关,r=-0.344,P<0.001。ROC曲线分析结果显示,FIB、PA曲线下面积(AUC)分别为0.725和0.702,FPR的AUC为0.818。结论 FPR在心肌梗死患者抗血小板治疗后HPR发生情况中具有重要的预测作用,FPR越高提示患者HPR发生的可能性越高。

Objective To analyze the predictive effect of fibrinogen(FIB)to prealbumin(PA)ratio(FPR)on high platelet reactivity(HPR)in patients with myocardial infarction after antiplatelet therapy.Methods A prospective study was carried out,including 122 patients with myocardial infarction who received antiplatelet therapy in Pingmei Shenma Medical Group General Hospital from January 1,2021 to December 31,2022 as the study subjects,and the occurrence of high platelet reactivity was observed after 24 hours of treatment.The baseline data collection table was designed,and the clinical data and laboratory indexes of the patients were filled and recorded for single factor analysis.The FIB and PA levels of the patients before treatment were monitored,the FPR was calculated,and the relationship between FPR and HPR was analyzed by point two column correlation.The receiver operating characteristic(ROC)curve of subjects was drawn to explore the predictive effect of FPR on the occurrence of HPR after antiplatelet therapy.Results After antiplatelet therapy in 122 patients with myocardial infarction,the incidence of HPR accounted for 26.23%.There were statistical significant differences in diabetes and CRP levels between the two groups(P<0.05).There was no statistical significant difference between the two groups in other data(P>0.05).The FIB and FPR of the occurrence group[(5.21±0.48)g/L,(2.83±0.26)%]were higher than those of the non-occurrence group[(4.88±0.37)g/L,(2.52±0.23)%],and the PA was lower[(184.62±12.13)mg/L]than that of the non-occurrence group[(194.07±11.21)mg/L],the difference was statistically significant,the t-values were 3.995,6.326 and 4.008 respectively,all P<0.001.Through point binary correlation analysis,FIB and FPR were positively correlated with HPR after treatment,the r-values were 0.353 and 0.503,all P<0.001.PA was negatively correlated with HPR after treatment(r=-0.344,P<0.001).ROC curve analysis showed that the area under the curve(AUC)of FIB and PA was 0.725 and 0.702,respectively,and the AUC of FPR was O.818.ConclusionFPR plays an important role in predicting the occurrence of HPR after antiplatelet therapy in patients with myocardial infarction.The higher the FPR,the higher the possibility of HPR.