ST段抬高型心肌梗死患者纤维蛋白原和D-二聚体的变化  

Relationship between plasma fibrinogen and D-dimer in patients with ST-elevation myocardial infarction

作　　者：李勇[1] 郭路芬[1] 马临安[1] 李志忠[1] 吕树铮[2] 

机构地区：[1]首都医科大学附属北京安贞医院心肺血管抢救中心北京市心肺血管病研究所,100029 [2]首都医科大学附属北京安贞医院心内科,100029

出　　处：《中国综合临床》2009年第2期150-152,共3页Clinical Medicine of China

摘　　要：目的探讨ST段抬高型心肌梗死（STEMI）患者与冠状动脉造影阴性者纤维蛋白原和D-二聚体含量的差异。方法选取我院2005年1月至2007年12月诊断为STEMI并行直接经皮冠状动脉介入（PCU治疗的患者100例。同时选取冠状动脉造影阴性者100例为对照组。比较2组间纤维蛋白原和D-二聚体含量。结果2组性别、年龄、高血压史、糖尿病史和吸烟史差异无统计学意义（P均〉0．05）。STEMI组血浆纤维蛋白原含量为（2．38±0．91）g／L，对照组为（2．65±0．68）g／L，差异有统计学意义（t=-2．34，P〈0．05）。D-二聚体的平方根STEMI组为（13．23±5．08）μg/L，对照组为（9．40±5．03）μg/L，差异有统计学意义（t=5．36，P〈0．01）。血浆D-二聚体与纤维蛋白原含量比值的平方根STEMI组为（9．11±4．13），对照组为（5．92±3．35），差异有统计学意义（t=5．99，P〈0．01）。结论STEMI患者的纤维蛋白原低于冠状动脉造影阴性的对照组，D-二聚体高于对照组，提示在STEMI急性期存在急性血栓形成和继发纤溶。Objective To study the difference in fibrinogen and D-dimer between the patients with ST-elevation myocardial infarction（STEMI） and those with normal angiography of coronary artery. Methods 100 patients with STEMI who underwent PCI and 100 patients with normal coronary arteriograms as controls from Jan. 2005 to Dec. 2007 were studied. Plasma concentrations of fibrinogen and D-dimer were compared. Results There was no significant difference in gender, age, history of hypertension and diabetes and smoking between the two groups. Plasma concentration of fbrinogen （Fg） was higher in control group [ （ 2.65 ±0.68 ） g/L ] than STEMI group [ （ 2.38 ±0.91 ） g/L ] （ P 〈 0.05 ）. The square root of plasma concentration of D-dimer was higher in STEMI group [ （ 13.23 ±5.08 ） μg/L ] than control group[ （9.40 ±5.03 ） μg/L ] （ P 〈 0.01 ）. The square root of the rate between D-dimer and fibrinogen was higher in STEMI group （9.11 ±4.13）than control group（5.92 ±3.35） （P 〈0.01 ）. Conclusion The levels of fibrinogen in patients with STEMI are significantly lower than that of control group, and D-dimer is higher in the former group than in the latter group, suggesting that fresh thrombosis and secondary fibrinolysis exit in STEMI patients at the acute stage.

关 键 词：冠状动脉疾病 ST段抬高型心肌梗死 纤维蛋白原 D-二聚体 

分 类 号：R542.22[医药卫生—心血管疾病]