急性冠状动脉综合征患者FDP及D-二聚体与短期预后的相关性  

Correlation Between Fibrinogen Degradation Product,D-Dimer and Short Term Prognosis in Patients with Acute Coronary Syndrome

作　　者：安冬梅[1] 宗刚军[1] 曹丽[1] 刘洁[1] 

机构地区：[1]中国人民解放军第101医院心血管内科,江苏省无锡市214044

出　　处：《中国动脉硬化杂志》2016年第8期829-832,共4页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金项目(81371657)

摘　　要：目的分析急性冠状动脉综合征(ACS)患者血浆纤维蛋白原降解产物(FDP)、D-二聚体与短期预后的相关性。方法选取154例ACS患者,随访3个月,依据随访期间主要不良心血管事件(MACE)发生情况分为两组:MACE组(75例)和非MACE组(79例)。检测并比较两组FDP、D-二聚体、凝血酶原时间(PT)、国际标准化比率(INR)水平及血小板计数(PLT)。多因素Logistic回归分析影响ACS患者MACE发生的危险因素。ROC曲线评估FDP、D-二聚体对ACS患者MACE发生的最佳预测值。结果与非MACE组相比,MACE组血浆FDP、D-二聚体水平增高(P<0.05),但两组PLT、PT及INR水平均无差异(P>0.05)。血浆FDP、D-二聚体是ACS患者发生MACE的危险因素(P<0.05)。血浆FDP和D-二聚体预测ACS患者发生MACE的ROC曲线下面积(AUC)分别为0.682和0.796(P=0.028,P=0.014)。以FDP≥2.54μg/L和D-二聚体≥0.61 mg/L为切点,AUC为0.857,对判断MACE发生的灵敏度为67.9%,特异度为76.5%,准确度为69.1%。结论 ACS患者血浆FDP及D-二聚体水平与发生MACE具有较强的相关性。Aim To analyze the correlation between plasma fibrinogen degradation product（ FDP）,D-dimer and short term prognosis in patients with acute coronary syndrome（ ACS）. Methods 154 patients with ACS were selected and followed up for 3 months. According to major adverse cardiovascular event（ MACE） in the follow-up period,the patients were divided into two groups： MACE group（ 75 cases） and non-MACE group（ 79 cases）. The levels of FDP,D-dimer,prothrombin time（ PT）,international normalized ratio（ INR） and platelet count（ PLT） were detected and compared between the two groups. The risk factors of influencing MACE occurrence in patients with ACS were confirmed by multivariate Logistic regression analysis. The best predictive values of FDP and D-dimer for MACE occurrence in patients with ACS were evaluated by receiver operating characteristic（ ROC） curve. Results Compared with nonMACE group,plasma levels of FDP and D-dimer were increased in MACE group（ P0.05）,but there were no differences in the levels of PLT,PT and INR between the two groups（ P0.05）. Plasma FDP and D-dimer were the risk factors of MACE occurrence in patients with ACS（ P0.05）. The area under ROC curve（ AUC） of FDP and D-dimer predicting MACE occurrence in patients with ACS were 0.682 and 0.796,respectively（ P = 0.028,P = 0.014）. Taking FDP ≥2.54μg /L and D-dimer ≥0. 61 mg /L as the cutoff point,AUC was 0. 857,the sensitivity was 67. 9%,the specificity was76.5%,and the accuracy was 69.1% for determining MACE occurrence. Conclusion The plasma levels of FDP and D-dimer in ACS patients are strongly correlated with the occurrence of MACE.

关 键 词：急性冠状动脉综合征 纤维蛋白原降解产物 D-二聚体 主要不良心血管事件 

分 类 号：R54[医药卫生—心血管疾病]