纤维蛋白原与白蛋白浓度预测急性心肌梗死患者经皮冠状动脉介入治疗中无复流发生的价值  

Predictive values of concentrations of fibrinogen and albumin on no-reflow in patients with acute myocardial infarction during percutaneous coronary intervention

作　　者：桑小闯 郭长青 SHANG Xiao-chuang;GUO Chang-qing(The Sixth People′s Hospital of Anyang City,Anyang,Henan 455000,China)

机构地区：[1]安阳市第六人民医院,河南安阳455000

出　　处：《岭南心血管病杂志》2020年第4期395-399,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨纤维蛋白原、白蛋白浓度预测急性心肌梗死(acute myocardial infarction,AMI)患者急诊经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗中无复流发生的价值。方法选择2016年1月至2019年3月在河南省安阳市第六人民医院因AMI行PCI治疗的患者170例,按照PCI治疗后是否发生无复流分为无复流组(n=103)和正常血流组(n=67)。入院后24 h内测定患者纤维蛋白原、白蛋白、高敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)、肌酸激酶同工酶(creatine kinase isoenzyme MB,CKMB)浓度及左心室射血分数(left ventricular ejection fraction,LVEF),计算无复流及正常血流组纤维蛋白原阳性率和白蛋白阳性率并比较两组相关指标。比较不同纤维蛋白原浓度患者的临床情况。结果纤维蛋白原≤5.5 mg/L患者的总心血管事件发生率(20.79%vs.40.58%,P<0.05),血清hs-CRP[(7.28±0.84)mg/L vs.(11.43±2.18)mg/L,P<0.05]、CK-MB[(267.899±29.19)U/L vs.(377.24±41.25)U/L,P<0.05]浓度及充血性心力衰竭患者比例[16.83%vs.37.68%,P<0.05]均低于纤维蛋白原>5.5 mg/L患者,而LVEF高于纤维蛋白原>5.5 mg/L患者(0.57%±0.06%vs.0.42%±0.05%,P<0.05),差异均有统计学意义。正常血流组患者白蛋白浓度[(43.16±5.29)g/L vs.(38.19±473)g/L,P<0.05]、年龄[(72.19±8.83)岁vs.(60.19±7.35)岁,P<0.05]、男性患者比例(51.22%vs.83.72%,P<0.05)明显高于无复流组,差异均有统计学意义(P<0.05)。无复流组患者白蛋白阳性率(89.32%vs.13.43%,P<0.05)、纤维蛋白原阳性率(95.15%vs.16.42%,P<0.05)明显高于正常血流组,差异有统计学意义。结论入院24 h内纤维蛋白原、白蛋白浓度升高的AMI患者PCI治疗后发生无复流的可能性较大,纤维蛋白原、白蛋白浓度升高可作为AMI患者PCI治疗后发生无复流预测指标。Objectives To explore the predictive values of concentrations of fibrinogen and albumin on no-reflow in patients with acute myocardial infarction(AMI)during percutaneous coronary intervention(PCI).Methods Totally170 patients with AMI who underwent PCI in The Sixth People’s Hospital of Anyang City from January 2016 to March2019 were selected.They were divided into no-reflow group(n=103)and normal flow group(n=67)according to whether there was no reflow after PCI.Concentrations of fibrinogen,albumin,high-sensitivity C-reactive protein(hs-CRP),creatine kinase isoenzyme MB(CKMB)and left ventricular ejection fraction(LVEF)of the patients were measured within 24 h after admission.Positive rates of albumin and fibrinogen were recorded and relevant clinical data were compared between the two groups.Clinical data between patients with different concentration of fibrinogen were comparedResults The incidence of total cardiovascular event(20.79%vs.40.58%,P<0.05),concentrations of hs-CRP[(7.28±0.84)mg/L vs.(11.43±2.18)mg/L,P<0.05],CK-MB[(267.899±29.19)U/L vs.(377.24±41.25)U/L,P<0.05]and percentage of patients with congestive heart failure[16.83%vs.37.68%,P<0.05]were significantly lower in patients with fibrinogen≤5.5 mg/L than those in patients with fibrinogen>and 5.5 mg/L.Concentration of albumin[(43.16±5.29)g/L v.s.(38.19±473)g/L,P<0.05],age[(72.19±8.83)years vs.(60.19±7.35)years,P<0.05],percentage of male patients(51.22%vs.83.72%,P<0.05)in normal blood flow group was significantly higher than those in noreflow group.The positive rates of albumin(89.32%vs.13.43%,P<0.05)and fibrinogen(95.15%vs.16.42%,P<0.05)in no-reflow group were significantly higher than those in normal blood flow group.Conclusions Increasing concentrations of albumin and fibrinogen within 24 h after admission in patients with AMI will have more possibility to occur noreflow during PCI,which can be predictive factors on no-reflow in patients with AMI during PCI.The ratio of fibrinogen to albumin can be regarded as an independent risk factor for

关 键 词：心肌梗死 纤维蛋白原 白蛋白 无复流 预测 血管成形术 经腔 经皮冠状动脉 

分 类 号：R542.2[医药卫生—心血管疾病]