纤维蛋白原/高密度脂蛋白与急性心梗患者的预后相关性分析

Correlation Analysis of Fibrinogen/High-Density Lipoprotein Ratio with Prognosis in Acute Myocardial Infarction Patients

目的分析纤维蛋白原/高密度脂蛋白和急性心梗患者的预后相关性。方法选择2022年7月至2023年6月杞县中医院收治的93例急性心梗患者作为观察组,选择同期接受健康体检的90例志愿者作为对照组。对比两组的基本资料、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及纤维蛋白原(FIB)的表达水平差异。同时根据急性心梗患者的预后情况将患者分为预后良好组和预后不良组,对比两组患者心脏肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)、左心室舒张末期内径(LVEDD)和左心室收缩末期内径(LVEDS)以及左室射血分数(LVEF)差异。计算急性心梗患者FIB/HDL-C结果,并通过Pearson相关性分析法分析FIB/HDL-C与患者心功能指标的相关性,以Logistic回归分析法分析FIB/HDL-C与患者预后结局的相关性。结果观察组和对照组性别、年龄、BMI、文化程度、吸烟史对比差异无统计意义(P>0.05),观察组患者心梗家族史、饮酒史、合并慢性疾病比例均高于对照组,差异有统计学意义(P<0.05),同时观察组患者TC、TG、LDL-C、FIB、FIB/HDL-C均明显高于对照组,而HDL-C明显低于对照组患者,差异有统计学意义(P<0.05)。统计预后结局,急性心梗患者中预后不良患者有28例,预后不良组患者TG、HDL、LVEF明显低于预后良好患者;而FIB、FIB/HDL-C、LVEDD、LVEDS明显高于预后良好组患者,差异有统计学意义(P<0.05);相关性分析结果显示急性心梗患者FIB/HDL-C与LVEDD和LVEDS呈正相关,与LVEF呈负相关(P<0.05),并且FIB/HDL-C是急性心梗患者不良预后的危险因素(P<0.05)。结论FIB/HDL-C与急性心梗患者预后结局存在明显相关性,是急性心梗患者不良预后的危险因素,临床检测急性心梗患者入院时FIB/HDL-C水平能为其后续治疗提供参考方向。

Objective To analyze the correlation between fibrinogen/high-density lipoprotein ratio and prognosis in patients with acute myocardial infarction.Methods Ninety-three acute myocardial infarction patients admitted to Qixian Traditional Chinese Medicine Hospital from July 2022 to June 2023 were selected as the observation group,while 90 volunteers undergoing health check-ups during the same period were selected as the control group.Basic data,total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and fibrinogen(FIB)levels were compared between the two groups.Based on the prognosis of acute myocardial infarction patients,they were further divided into a good prognosis group and a poor prognosis group.Differences in cardiac troponin I(cTnI),creatine kinase-MB(CK-MB),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVEDS),and left ventricular ejection fraction(LVEF)were compared between the two groups.The FIB/HDL-C ratio was calculated for acute myocardial infarction patients,and the correlation between FIB/HDL-C and cardiac function indicators was analyzed using Pearson correlation analysis.Logistic regression analysis was used to analyze the correlation between FIB/HDL-C and patient prognosis.Results There were no statistically significant differences in gender,age,BMI,educational level,and smoking history between the observation and control groups(P>0.05).The observation group had higher proportions of family history of myocardial infarction,alcohol consumption,and chronic diseases compared to the control group,with statistically significant differences(P<0.05).TC,TG,LDL-C,FIB,and FIB/HDL-C levels were significantly higher,while HDL-C levels were significantly lower in the observation group compared to the control group(P<0.05).Among the acute myocardial infarction patients,28 had a poor prognosis.The poor prognosis group had significantly lower TG,HDL,and LVEF levels,and significantly higher FIB,FIB/HDL-C,LVEDD,and LVEDS levels compared to the good prognosis group(P<0.05).Correlation analysis showed that FIB/HDL-C was positively correlated with LVEDD and LVEDS,and negatively correlated with LVEF in acute myocardial infarction patients(P<0.05).FIB/HDL-C was identified as a risk factor for poor prognosis in acute myocardial infarction patients(P<0.05).Conclusion There is a significant correlation between FIB/HDL-C and prognosis in acute myocardial infarction patients,and FIB/HDL-C is a risk factor for poor prognosis.Clinical measurement of FIB/HDL-C levels at the time of hospital admission can provide guidance for subsequent treatment of acute myocardial infarction patients.