陈旧性心肌梗死患者血浆纤维蛋白原和抗凝血酶-Ⅲ与颈动脉内膜-中层厚度的相关性研究  

Correlation of Plasma Fibrinogen and Antithrombin-Ⅲ with Carotid Artery Intima-media Thickness in Elderly Patients with Old Myocardial Infarction

作　　者：杜荣品[1] 吕妍琨[1] 张至[1] 薛华[1] 陈淑霞[1] 陈华[1] 刘惠良[1] 

机构地区：[1]河北省人民医院心脏中心,河北省石家庄市050051

出　　处：《中国全科医学》2010年第29期3280-3282,共3页Chinese General Practice

摘　　要：目的探讨老年陈旧性心肌梗死患者血浆纤维蛋白原(FBN)、抗凝血酶-Ⅲ(AT-Ⅲ)与颈动脉内膜-中层厚度(IMT)的关系。方法共入选56例老年陈旧性心肌梗死患者,采用B型超声诊断仪检查颈动脉IMT,同时检测FBN和AT-Ⅲ水平。以颈动脉IMT作因变量,FBN、AT-Ⅲ和纤溶酶原激活物抑制剂-1(PAI-1)等13个变量作为自变量,采用逐步筛选法进行多元线性回归分析。结果 (1)FBN等7个变量进入方程:IMT=-0.5431+0.0438FBN+0.0831PAI-1+0.0024收缩压(SBp)+0.0023年龄(Age)+0.1725低密度脂蛋白胆固醇(LDL)-0.1256高密度脂蛋白胆固醇(HDL)+0.3733载脂蛋白B(Apo-B)。结果显示:FBN与颈动脉IMT正相关,是IMT增厚的独立危险因素;AT-Ⅲ未进入回归方程,显示其与颈动脉IMT增厚无相关。(2)FBN水平与IMT呈正相关(IMT=0.1758+0.2104FBN,r=0.7709,P<0.0001);AT-Ⅲ与颈动脉IMT增厚无相关(IMT=0.8538+0.0006AT-Ⅲ,r=0.1095,P=0.4215)。结论老年陈旧性心肌梗死患者病情稳定时,FBN是颈动脉IMT增厚的危险因素;AT-Ⅲ与颈动脉IMT增厚无相关。Objective To investigate the relationship of plasma fibrinogen（FBN） and antithrombin-Ⅲ（AT-Ⅲ） to carotid artery intima-media thickness（IMT） in elderly patients with old myocardial infarction.Methods The IMT was detected by B-type ultrasonic diagnostic apparatus and levels of FBN and AT-Ⅲ detected simultaneously in 56 elderly patients with old myocardial infarction.Taking IMT as dependent variable and 13 variables（including FBN,AT-Ⅲ PAI-1,etc.）as independent variables,a multiple linear regression analysis was performed by stepwise selection.Results Seven variables such as FBN etc.were allowed to enter into the regression model：IMT=-0.5431＋ 0.0438FBN＋ 0.0831PAI-1＋ 0.0024SBp＋ 0.0023Age＋ 0.1725LDL-0.1256HDL＋0.3733Apo-B.The results showed that FBN,positively correlated with carotid artery IMT,was the independent risk factor of IMT thickening,and that AT-Ⅲ was not allowed into the regression model,suggesting that it was not correlated with IMT thickening.FBN level was positively correlated with IMT（IMT=0.1758＋0.2104FBN,r=0.7709,P〈0.0001）,and AT-Ⅲ was not correlated with IMT thickening（IMT=0.8538＋0.0006AT-Ⅲ,r=0.1095,P=0.4215）.Conclusion In elderly patients with old myocardial infarction,FBN is a risk factor of carotid IMT thickening and AT-Ⅲ is not correlated with IMT thickening when condition is in a stable stage.

关 键 词：心肌梗死 老年人 颈动脉内膜-中层厚度 纤维蛋白原 抗凝血酶Ⅲ 

分 类 号：R542.22[医药卫生—心血管疾病]