老年冠心病人纤维蛋白原水平与冠脉狭窄严重程度的相关性  

Correlation between fibrinogen level and severity of coronary stenosis in aged coronary heart disease people

作　　者：岳冬梅 包敏敏 周海霞[2] 卢英民 罗晓菡 黄达民 YUE Dong-mei;BAO Min-min;ZHOU Hai-xia;LU Ying-min;LUO Xiao-han;HUANG Da-min(Department of Cardiology,Affiliated Xinhua Hospital(Chongming Branch)of Medical College,Shanghai Jiaotong University,Shanghai,202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院心内科,上海市202150 [2]吉林大学中日联谊医院

出　　处：《心血管康复医学杂志》2018年第2期139-142,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：上海市崇明县科委基金课题(CKY2014-04);上海交通大学医学院附属新华医院崇明分院课题(Q201303)~~

摘　　要：目的:探讨老年冠心病人纤维蛋白原与冠脉狭窄程度的相关性。方法:选择冠状动脉造影明确诊断为冠心病且年龄>65岁的患者112例(冠心病组),并选择同期住院非冠心病病人108例为非冠心病组,冠心病组按照冠脉造影结果分为单支病变(30例)及多支病变组(82例)。检测入选患者血清纤维蛋白原(Fg)、D二聚体(D-D)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)、脑钠肽(BNP)等水平。并分析血清Fg水平与冠心病患者Gensini评分的相关性。结果:与非冠心病组比较,冠心病组血清Fg、D-D、甘油三酯(TG)、载脂蛋白B(ApoB)、脂蛋白a、CRP、BNP、Hcy水平明显升高(P均=0.001);且在冠心病组中,与单支病变组比较,多支病变组血清Fg、D-D、ApoB、尿酸、脂蛋白a、CRP、BNP、Hcy水平明显升高;血清高密度脂蛋白-胆固醇、ApoA1、载脂蛋白A1/载脂蛋白B(ApoA1/ApoB)水平明显降低(P<0.05或<0.01);血清Fg水平与冠脉狭窄程度(Gensini评分)呈显著正相关(r=0.303,P=0.001)。Fg是冠心病的独立危险因素(OR=2.74,95%CI:1.95~3.97,P=0.001)。结论:老年冠心病患者纤维蛋白原水平与冠脉狭窄程度呈显著正相关,其促发动脉粥样硬化的机制可能与脂代谢紊乱、高同型半胱氨酸血症、炎症反应等危险因素有关。Objective:To explore correlation between fibrinogen(Fg)level and coronary stenotic degree in aged coronary heart disease(CHD)people and its possible pathogenesis.Methods:A total of 112 patients,who were>65 years and diagnosed as CHD by coronary angiography(CAG),were selected as CHD group.Another 108 non-CHD patients hospitalized during the same period were enrolled as non-CHD group.According to CAG results,CHD group was divided into single vessel coronary disease group(n=30,single vessel group)and multi vessel coronary disease group(n=82,multi vessel group).Serum levels of Fg,D-dimer(D-D),C reactive protein(CRP),homocysteine(Hcy)and brain natriuretic peptide(BNP)were measured and compared between two groups.The correlation between serum Fg level and Gensini score was analyzed in CHD patients.Results:Compared with non-CHD group,there were significant rise in serum levels of Fg,D-D,triglyceride(TG),apolipoprotein B(ApoB),lipoprotein a,CRP,BNP and Hcy in CHD group,P=0.001 all;in CHD group,compared with single vessel group,there were significant rise in serum levels of Fg,D-D,ApoB,uric acid,lipoprotein a,CRP,BNP,Hcy,and significant reductions in serum levels of high density lipoprotein cholesterol,ApoA1 and ApoA1/ApoB in multi vessel group,P<0.05 or<0.01.Serum Fg level was significant positively correlated with coronary stenotic degree(Gensini score),r=0.303,P=0.001.Fg was independent risk factor of CHD(OR=2.74,95%CI:1.95~3.97,P=0.001).Conclusion:Serum Fg level is significant positively correlated with coronary stenotic degree in aged CHD patients.Its mechanism of triggering atherosclerosis may be related to risk factors such as dyslipidemia,hyperhomocysteinemia and inflammations etc.

关 键 词：冠心病 纤维蛋白原 老年人 

分 类 号：R541.409[医药卫生—心血管疾病]