高水平纤维蛋白原与冠状动脉狭窄严重程度相关性探讨  

The relationship between hyperfibrinogenemia and severity of coronary heart disease

作　　者：刘梅颜[1] 胡大一[1] 闫丽[1] 刘文红[1] 刘如辉[1] 

机构地区：[1]北京大学人民医院心内科,100044

出　　处：《中华内科杂志》2004年第11期820-823,共4页Chinese Journal of Internal Medicine

摘　　要：目的　探讨高水平的纤维蛋白原 (FIB)与冠状动脉 (冠脉 )病变严重程度的相关性。方法　对 195例疑诊为冠心病的患者进行冠状动脉 (冠脉 )造影 ,图像分析后根据冠脉损害程度评分。所有患者检测FIB、总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白 (LDL C)、高密度脂蛋白 (HDL C)和D二聚体。在控制其他影响因素后 ,分析FIB与冠脉病变程度的定性和定量关系。结果偏相关分析在控制可能影响FIB水平的其他因素如性别、年龄、血脂、D二聚体、高血压、糖尿病后 ,显示FIB与冠脉的病变程度明显相关 ,相关系数为 0 2 89,P <0 0 1。多元逐步回归分析发现FIB和年龄是影响冠脉病变程度的 2个重要变量 (F值分别为 16 89,15 4 7,P <0 0 1;复相关系数为 0 2 9,0 38,P <0 0 1)。在排除了年龄、性别、血压、血脂、糖尿病和吸烟的影响之后 ,证明FIB水平与冠脉病变程度之间存在有意义的回归关系。将所有资料根据FIB水平的 2 5 %、5 0 %、75 %分界点分为 4组 ,发现冠脉病变程度随着FIB的提高而加重 ,其中男性、合并有糖尿病的患者更为明显。结论　高水平的FIB可以反映冠脉病变的严重程度 。Objective To study the relationship between serum advanced fibrinogen and the severity of coronary artery stenosis. Methods In a collection of 195 patients suspected of coronary artery disease (CAD), coronary artery stenosis was studied with coronary angiography. The severity of coronary artery disease was quantified with a modified Gensini score on the basis of angiogrphic imaging manipulation system. Fibrinogen, total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and D-dimer were determined in all the patients. After the influences of other risk factors were controlled, the relationship between fibrinogen and severity of CAD was analyzed.Results Partial correlation analysis showed that fibrinogen was positively correlated with the severity of CAD ( r =0.293, P <0.01). Multiple stepwise regression analysis indicated that fibrinogen and age were significant variables associated with the severity of coronary artery disease ( F value was 16.89,15.47, P <0.01; R was 0.29,0.38, P <0.01).All the patients were assigned to one of four groups according to fibrinogen level with 25, 50 and 75 percentile as cut-off points. We found that high fibrinogen level was associated with severe coronary artery disease, particularly in men and in diabetes mellitus patients.Conclusion Elevated fibrinogen level is related to the severity of CAD.

关 键 词：FIB 冠脉病变 严重程度 糖尿病 患者 纤维蛋白原 D二聚体 高水平 证明 结论 

分 类 号：R541.4[医药卫生—心血管疾病] R446[医药卫生—内科学]