纤维蛋白原及同型半胱氨酸与冠状动脉易损斑块的相关性  

The Correlation of Fibrinogen and Homocysteine with Vulnerable Coronary Atherosclerotic Plaques

作　　者：李春光 黄宇玲 刘杰 朱柏霖 孙淑娴[1] 亢小丽[1] 马威[1] 刘帆 纪征[1] Li Chunguang;Huang Yuling;Liu Jie;Zhu Bolin;Sun Shuxian;Kang Xiaoli;Ma Wei;Liu Fan;Ji Zheng(Department of Cardiology,Tangshan Gongren Hospital,Tangshan,Hebei,063000,China;Department of Cardiology,Affiliated Hospital of North China University of Science and Technology,Tangshan,Hebei,063000,China)

机构地区：[1]唐山工人医院心内科,河北唐山063000 [2]华北理工大学附属医院心内科,河北唐山063000

出　　处：《当代医学》2018年第34期6-9,共4页Contemporary Medicine

摘　　要：目的探讨纤维蛋白原(FIB)及同型半胱氨酸(HCY)与冠状动脉易损斑块的相关性。方法按入选标准及排除标准选取2016年1月至2017年12月在唐山工人医院心内一科住院并且行血管内超声—虚拟组织学技术(IVUS-VH)及纤维蛋白原、同型半胱氨酸资料完整者共163例。根据冠状动脉病变部位斑块的IVUS-VH特征分为两组:稳定型斑块组(33例)及易损斑块组(130例)。比较两组患者的一般资料及FIB、HCY水平并进行相关统计学分析。结果 (1)易损斑块组与稳定斑块组比较,两组间的FIB、HCY水平比较差异具有统计学意义(P<0.05),易损斑块组的FIB、HCY水平呈上升趋势。(2)FIB、HCY对易损斑块的发生均有预测诊断价值,FIB、HCY预测易损斑块的最佳临界值分别为3.83 g/L、11.80 umol/L,敏感性分别为68.46%、79.23%,特异性分别为84.85%、72.73%。(3)FIB≥3.83 g/L相较于FIB<3.83 g/L,HCY≥11.80 umol/L相较于HCY<11.80 umol/L,均增加了发生易损斑块的风险(OR=10.13,8.00,95%CI:3.88～26.44,3.45～18.56)。结论纤维蛋白原、同型半胱氨酸水平与易损斑块的发生有关,对易损斑块有预测诊断价值。Objective To explore the correlation offibrinogen and homoc-ysteine with vulnerable coronary atherosclerotic plaques. Methods According to the inclusion criteria and exclusion criteria, there were 163 cases were selected from January 2016 to December 2017.These people had done the examination of intravascular ultrasound- virtual histology, at the same time fibrinogen and homocysteine data were integrated. According to intra-vascular ultrasound, the plaque stability was divided into stable patch group （n=33） and vulnerable plaque group （n 130）. Comparing the general date and the levels of FIB, HCY of patients in the two groups. Results ①Compared with the stable patch group, there was a statistical difference between the FIB and HCY levels between the two groups （P 〈 0.05）, and the FIB and HCY level were increasing in the vulnerable plaque group. ②The FIB and HCY levels had predictive diagnostic value for vulnerable plaques. The best threshold for FIB, HCY to predict the of vulnerable plaques were 3.83 g/L, 11.80 umol/L（the sensitivity is 68.46%, 79.23%, respectively; the specificity is 84.85%, 72.73%）. ③Compared with FIB〈 3.83g/L, FIB）3.83g/Lincreasedtheriskofoccurrenceofvulnerableplaques, OR（95%CI） 10.13（3.88-26.44）. Compaxed with HCY〈 11.80 umol/L, HCYll.80 umol/L increased the risk of occurrence of vulnerable plaques, OR（95%C0 8.00（3.45-18.56）. Conclusion The FIB and HCY levels were related to the occurrence of vulnerable plaques, in addition the FIB and HCY levels had predictive diagnostic value for vulnerable plaques.

关 键 词：纤维蛋白原 同型半胱氨酸 易损斑块 血管内超声—虚拟组织学技术 

分 类 号：R541.4[医药卫生—心血管疾病]