血浆纤维蛋白原和血尿酸水平与早发冠心病的相关性  

Correlation among plasma fibrinogen,serum uric acid level and premature coronary heart disease

作　　者：沙璐琳 刘和俊[1] 

机构地区：[1]安徽医科大学第一附属医院心血管内科,安徽合肥230022

出　　处：《心血管康复医学杂志》2017年第2期154-158,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨血浆纤维蛋白原(Fg)和血尿酸(SUA)水平与早发冠心病(PCHD)病变严重程度及主要心血管事件(MACE)的相关性。方法:选择经冠脉造影(CAG)检查确诊为PCHD的患者195例,其中稳定型心绞痛(SAP)72例,不稳定型心绞痛(UAP)67例,急性心肌梗死(AMI)56例。另选正常对照组75例,比较4组患者Fg、血清尿酸(SUA)水平,分析其与冠脉病变严重程度、随访6个月期间MACE发生情况的关系。再采用ROC曲线评估血浆Fg和SUA水平对PCHD的临床预测价值。结果:与正常对照组和SAP组比较,UAP组和AMI组血浆Fg[(2.80±0.26)g/L、(2.85±0.32)g/L比(3.44±0.32)g/L、(4.25±0.35)g/L]、SUA[(306.56±15.55)μmol/L、(308.81±16.77)μmol/L比(349.48±15.59)μmol/L、(368.86±20.72)μmol/L]水平均明显升高(P<0.05或<0.01),且AMI组的血浆Fg,SUA水平明显高于UAP组(P均<0.05);Spearman相关分析显示血浆Fg、SUA水平与Gensini评分呈显著正相关(r=0.750、0.743,P均<0.01);随访期间发生MACE的PCHD患者血浆Fg和SUA水平显著高于未发生MACE组(P<0.05或<0.01)。同时ROC曲线示血浆Fg和SUA对PCHD的诊断有一定的预测价值[曲线下面积(AUC)=0.867、0.736]。结论:检测血浆纤维蛋白原、尿酸水平可为诊断早发冠心病及判断病变严重程度提供一定依据。Objective： To explore the correlation among plasma fibrinogen （Fg）, serum uric acid （SUA） level, severity of premature coronary heart disease （PCHD） and major adverse cardiovascular events （MACE）. Methods： A total of 195 PCHD patients diagnosed by coronary angiography （CAG） were selected, including 72 cases with stable angina pectoris （SAP）, 67 cases with unstable angina pectoris （UAP） and 56 cases with acute myocardial infarction （AMI）. Another 75 healthy subjects were enrolled as normal control group. Plasma Fg and serum urea acid （SUA） levels were compared among four groups, and their relationship with coronary disease severity and incidence of MACE during six-month follow-up were analyzed. Then ROC curve was used to assess predictive value of plasma Fg and SUA levels for PCHD. Resuits： Compared with normal control group and SAP group, there were significant rise in levels of plasma Fg [（2.80 ± 0.26） g/L, （2.85 ± 0.32） g/L vs. （3.44 ± 0.32） g/L, （4. 25 ± 0.35） g/L] and SUA [ （306.56± 15.55） μmol/L, （308.81 ± 16. 77） μmol/L vs. （349.48± 15.59） μmol/L, （368.86± 20.72）μmol/L] in UAP group and AMI group （P〈0.05 or d0.01）, and those of AMI group were significantly higher than those of UAP group （P〈0.05 both） ; Spearman correlation analysis indicated that plasma Fg and SUA levels were significant positively correlated with Gensini score （r = 0. 750, 0. 743, P〈0.01 both） ; levels of plasma Fg and SUA in those suffering from MACE during follow-up were significantly higher than those of patients without MACE, P〈0.05 or 〈0.01. Meanwhile, ROC curve suggested that plasma Fg and SUA possessed certain diagnostic value for PCHD [area under the curve （AUC） = 0. 867, 0. 736]. Conclusion： Plasma fibrinogen and serum uric acid detection can provide certain evidence for diagnosing PCHD and determining disease severity.

关 键 词：冠心病 纤维蛋白原 尿酸 

分 类 号：R541.409[医药卫生—心血管疾病]