TPP、FM、CRP/HDL-C与LVEF关系及预测桥内血栓形成价值  

Relationship between TPP,FM,CRP/HDL-C and LVEF after coronary artery bypass grafting and its value in predicting intra-bridge thrombosis

作　　者：程军涛[1] 李芳[2] 高源 CHENG Juntao;LI Fang;GAO Yuan(Department of Thoracic Surgery,Anyang People‘s Hospital of Henan Province,Anyang,Henan,China,455000;Department of Ultrasound,Anyang Fifth People’s Hospital,Anyang,Henan,China,455000)

机构地区：[1]河南省安阳市人民医院胸心外科,河南安阳455000 [2]安阳市第五人民医院超声科,河南安阳455000

出　　处：《分子诊断与治疗杂志》2021年第3期445-448,452,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省高等学校重点科研项目(20A320033)。

摘　　要：目的探讨血栓前体蛋白(TPP)、纤维蛋白单体(FM)、C反应蛋白与高密度脂蛋白胆固醇比值(CRP/HDL-C)与冠脉搭桥术后左室射血分数(LVEF)关系及预测桥内血栓形成的价值。方法选取本院收治的468例冠脉搭桥术患者,根据术后1个月内是否有桥内血栓形成分为观察组(n=31,有桥内血栓)、对照组(n=437,无桥内血栓),比较两组一般资料、TPP、FM、CRP/HDL-C、LVEF,分析TPP、FM、CRP/HDL-C与LVEF的相关性及各指标预测桥内血栓形成的效能。结果术后1 d TPP、FM、CRP/HDLC与术后1 d LVEF呈负相关,术后7 d TPP、FM、CRP/HDL-C与术后7 d LVEF呈负相关(P<0.05);Logistic回归模型分析显示,糖尿病、HDL-C降低、术后1、7 d TPP、FM、CRP/HDL-C均与桥内血栓形成相关(P<0.05);术后7 d TPP、FM、CRP/HDL-C预测桥内血栓形成的AUC均大于0.8,呈现出一定的预测价值。结论 TPP、FM、CRP/HDL-C异常是冠脉搭桥术后桥内血栓形成的独立危险因素,且术后不同时间其水平变化与心功能关系密切,具有一定预测价值,对指导临床完善术后治疗方案具有重要意义。Objective To investigate the relationship between thrombus precursor protein(TPP),fibrin monomer(FM),C-reactive protein to high-density lipoprotein cholesterol ratio(CRP/HDL-C)and left ventricular ejection fraction(LVEF)after coronary artery bypass grafting and the value of predicting intrabridge thrombosis. Methods A total of 468 patients undergoing coronary artery bypass graft surgery in our hospital were selected. According to whether there was intra-bridge thrombosis within 1 month after operation,they were divided into observation group(n=31,with intra-bridge thrombosis)and control group(n=437,without intra-bridge thrombosis). The general data,TPP,FM,CRP/HDL-C,LVEF of the two groups were compared,and the correlation between TPP,FM,CRP/HDL-C and LVEF and the effectiveness of each index in predicting intra-bridge thrombosis were analyzed. Results The differences between the two groups of TPP,FM,CRP/HDL-C,and LVEF at different time points and interactions were statistically significant(P<0.05).TPP,FM,CRP/HDL-C at 1 day after operation were negatively correlated with LVEF at 1 day after operation,and TPP,FM,CRP/HDL-C at 7 days after operation were negatively correlated with LVEF at 7 days after operation(P<0.05). Logistic regression analysis showed that diabetes,the reduction of HDL-C,TPP,FM,and CRP/HDL-C at 1 and 7 days after operation were all related to intra-bridge thrombosis(P<0.05).The AUC of TPP,FM,CRP/HDL-C predicting intra-bridge thrombosis at 7 days after operation was greater than the corresponding index at 1 day after operation. The AUC of TPP,FM,and CRP/HDL-C predicting intra-bridge thrombosis were all greater than 0.8 at 7 days postoperatively,showing a certain predictive value.Conclusion TPP,FM,CRP/HDL-C abnormalities are independent risk factors for intra-graft thrombosis after coronary artery bypass graft surgery,and their level changes at different times after surgery are closely related to cardiac function. They have certain predictive value and are of great significance for guiding clinical i

关 键 词：血栓前体蛋白 纤维蛋白单体 C反应蛋白 高密度脂蛋白胆固醇 左室射血分数 

分 类 号：R654.2[医药卫生—外科学]