血浆凝血因子水平与低年龄段急性心肌梗死的关系  

Relationship between levels of plasma coagulation factors and acute myocardial infarction in low age period

作　　者：梁记华[1] 高艳丽[1] 张蔚丽[2] 唐守义[1] 蔡坚[3] 吐尔逊·沙比尔[3] 

机构地区：[1]山东省菏泽市立医院心内二科,274031 [2]山东省烟台市烟台山医院心内一科,264001 [3]新疆医科大学第一附属医院神经内科,乌鲁木齐830000

出　　处：《重庆医学》2017年第24期3332-3335,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(81260180)

摘　　要：目的研究血浆凝血因子水平与低年龄段(<60岁)急性心肌梗死的关系及其诊断低年龄段急性心肌梗死的价值。方法选择在山东省菏泽市立医院心内科住院就诊的160例低年龄段急性心肌梗死患者作为观察组,160例同期住院就诊的低年龄段非急性心肌梗死患者作为对照组。采用酶联免疫双抗夹心法检测其血浆凝血酶原(FⅡ)、促凝血酶原激酶原(FⅦ)、血友病因子Ⅷ(FⅧ)、纤维蛋白原(Fg)和血管性血友病因子(vWF)的水平,通过单因素和多因素分析研究凝血因子与低年龄段急性心肌梗死的关系,并通过诊断试验评价与受试者工作特征曲线(ROC)分析其诊断低年龄段急性心肌梗死的价值。结果单因素分析显示,FⅡ、FⅦ、FⅧ和Fg的水平在观察组和对照组之间比较差异有统计学意义(P<0.05),vWF的水平比较差异无统计学意义(P>0.05)。多因素分析显示,FⅡ≥14.27μg/L和Fg≥22.99μg/L是低年龄段急性心肌梗死的独立危险因素;通过FⅡ的水平诊断低年龄段急性心肌梗死的价值较低,而通过Fg的水平诊断低年龄段急性心肌梗死的最佳截断值为22.99μg/L,其ROC曲线下面积为0.709,诊断价值中等,灵敏度(91.88%)和阴性预测值较高(86.02%),假阴性率较低(13.98%),正确率尚可(70.94%)。结论凝血因子FⅡ≥14.27μg/L和Fg≥22.99μg/L是低年龄段急性心肌梗死的独立危险因素,检测Fg的水平有可能对诊断低年龄段急性心肌梗死具有提示意义。Objective To explore the relationship between the levels of plasma coagulation factors（F）and acute myocardial infarction（AMI）in low age period（60years old）and their diagnostic value in diagnosing AMI in low age period.Methods One hundred and sixty inpatients with low age AMI in the cardiology department of the Heze Municipal Hospital were selected as the case group,and contemporaneous 160 cases of low age non-AMI served as the control group.FⅡ,FⅦ,FⅧ,fibrinogen（Fg）and von willebrand（vWF）were measured with enzyme-linked immunoabsorbent anti-sandwich assay.The relationship between coagulation factors and low age AMI was analyzed with univariate and multivariate analysis,and their value for diagnosing low age AMI was evaluated with diagnostic test and receiver operating characteristics（ROC）curve.Results The univariate analysis showed that FⅡ,FⅦ,FⅧ and Fg levels had significantly statistical difference between the case group and control group（P〈0.05）,and the vWF level had no statistically difference（P〈0.05）.The multivariate analysis indicated that the FⅡ level≥14.27μg/L and FⅦlevel≥22.99μg/L were the independent risk factors for low age AMI.The value of FⅡfor diagnosing low age AMI was lower,and the optimal cut off value of Fg for diagnosing low age AMI was 22.99μg/L,its area under ROC curve was 0.709 with a moderate diagnostic value,and the sensitivity（91.88%）and negative predictive value（86.02%）were higher,the false negative rate（13.98%）was lower,and the accuracy（70.94%）was moderate.Conclusion The FⅡlevel≥14.27μg/L and Fg level≥22.99μg/L are the independent risk factors for low age AMI,and detecting the Fg level could have hint significance in diagnosing low age AMI.

关 键 词：凝血因子 急性心肌梗死 单因素分析 多因素分析 诊断试验 受试者工作特征曲线 

分 类 号：R542.22[医药卫生—心血管疾病]