高水平的纤维蛋白原与LDL/HDL比值对冠脉风险的联合评估价值探讨  

The predictive value both high of serum Fibrinogen and LDL/HDL for acute coronary risk

作　　者：刘梅颜[1] 胡大一[1] 杨绍辉 刘如辉[1] 刘文红[1] 

机构地区：[1]北京大学人民医院心内科,北京100044 [2]北京冶金医院内科,北京100029

出　　处：《中级医刊》2004年第11期21-23,共3页

摘　　要：目的　探讨高纤维蛋白原血症和高脂血症在冠心病发病中的作用及其对急性冠脉事件的联合预测价值。方法　在控制吸烟和体重因素后 ,将经冠状动脉造影确诊有急性冠脉事件 (包括不稳定心绞痛和急性心肌梗死 )的 12 2名冠心病患者和 10 8例冠造阴性的患者做对比研究 ,分析纤维蛋白原 (Fibrinogen ,FIB)水平和LDL/HDL比值的差别 ,以及在不同水平时发生急性冠脉事件的风险。结果　CHD组患者的纤维蛋白原水平及LDL/HDL比值明显高于对照组 (3 87.5± 14 5 .6vs 3 3 7.9± 87.5 ,P <0 .0 5 ;2 .61± 3 .2vs1.84± 0 .65 ,P <0 .0 5 )。经多元逐步回归分析在排除了年龄、性别、血压、血糖等其他因素的影响之后 ,证明纤维蛋白原水平和高密度脂蛋白与急性冠脉事件的发生存在有意义的回归关系。高纤维蛋白原水平及高LDL/HDL比值发生急性冠脉事件的风险远远大于单一指标发生急性冠脉事件的风险。结论　联合应用纤维蛋白原和LDL/HDL比值对于全面评价急性冠脉事件风险有着重要意义。Objective To study the value of high serum Fibrinogen and LDL/HDL ratio together in predicting acute coronary risk. Methods After controlling the factors of smoking and BMI, Fibrinogen and LDL/HDL ratio and its relationship with CHD in 230 cases underwent coronary angiographies(122 patients with CHD and 108 people as normal control were analyzed). Results Fibrinogen and LDL/HDL ratio were significantly higher in patients with CHD than those of the normal control group(387.5±145.6 vs 337.9±87.5,P<0.05;2.61±3.2 vs 1.84±0.65,P<0.05) Multivariate regression analysis showed that Fibrinogen and LDL/HDL were significant variables associated with acute coronary events risk. When Fibrinogen and LDL/HDL ratio were both in high level, acute coronary events risk might increase highly, compared with single index. Conclusion Both high Fibrinogen and LDL/HDL ratio level might have possible relationship with the risk of coronary events, which jointly accelerated the development of arteriosclerosis. Both high Fibrinogen and LDL/HDL ratio were good predicting indexes for acute coronary risk.

关 键 词：冠脉事件 LDL 急性 比值 纤维蛋白原水平 HDL 联合 回归关系 差别 

分 类 号：R541.4[医药卫生—心血管疾病] R269.542[医药卫生—内科学]