纤维蛋白原及血脂成分与冠心病患者PCI术后非罪犯血管病变进展的相关性分析  

Correlation analysis of fibrinogen and blood lipid composition to the progression of NCCLs in CHD patients after PCI

作　　者：马茜钰 张金鹏 张兆元 彭石 王姣 张锦[3] Ma Qian-Yu;Zhang Jin-Peng;Zhang Zhao-Yuan;Peng Shi;Wang Jiao;Zhang Jin(The First Clinical Medical College of Lanzhou University,Lanzhou 730000,China;School of Public Health,Weifang Medical College,Weifang,Shandong 261000,China;Department of Cardiology,the First Hospital of Lanzhou University/Gansu Provincial Key Laboratory of Cardiovascular Disease,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,兰州730000 [2]潍坊医学院公共卫生学院,山东潍坊261000 [3]兰州大学第一医院心血管内科/甘肃省心血管疾病重点实验室,兰州730000

出　　处：《解放军医学杂志》2021年第8期771-776,共6页Medical Journal of Chinese People's Liberation Army

基　　金：甘肃省高等学校创新能力提升项目(2019B-005);兰州大学第一医院2018年度院内基金(ldyyyn2018_39)。

摘　　要：目的分析血浆纤维蛋白原(Fib)及血脂成分与冠心病患者经皮冠状动脉介入(PCI)术后非罪犯血管病变(NCCLs)进展的相关性。方法收集2017年1-12月在兰州大学第一医院心血管内科住院接受首次PCI治疗,并于2020年12月31日前复查冠状动脉造影(CAG)的210例患者(两次手术至少间隔6个月以上)的临床资料进行回顾性分析。根据NCCLs是否进展分为进展组(n=99)和非进展组(n=111),同时根据进展组患者NCCLs进展程度再分为三个亚组:轻度进展组(n=42)、中度进展组(n=35)、重度进展组(n=22)。比较进展组和非进展组患者,轻、中、重度进展组患者的基线临床资料,分析Fib及血脂成分与NCCLs进展的相关性,以及影响NCCLs进展的危险因素。结果进展组与非进展组在性别、吸烟史、饮酒史、高血压史、高脂血症史、心力衰竭、入院血压方面差异无统计学意义(P>0.05),进展组平均年龄大于非进展组,且糖尿病患者多于非进展组,差异有统计学意义(P<0.05)。进展组血浆Fib、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)水平高于非进展组,差异均有统计学意义(P<0.05);两组血浆三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)水平差异无统计学意义(P>0.05)。随着NCCLs病变程度增加,血浆Fib、TG、LDL-C、non-HDL-C在轻、中、重度进展组中逐渐升高,而血浆HDL-C逐渐降低,但在各亚组间差异无统计学意义(P>0.05)。Fib、TC、LDL-C、non-HDL-C、D-二聚体与NCCLs进展呈正相关,且Fib与TC、LDL-C、non-HDL-C也呈正相关。性别、年龄、糖尿病史可作为NCCLs进展的危险因素,其OR值分别为2.284、1.052、0.293。结论血浆Fib及血脂成分与NCCLs进展相关,且Fib与部分血脂成分也存在相关性,但Fib不是NCCLs的危险因素。Objective To analyze the correlation of plasma fibrinogen(Fib)and blood lipid composition to the progression of non-culprit coronary lesions(NCCLs)in CHD patients after percutaneous coronary intervention(PCI).Methods The clinical data were collected and retrospectively analyzed of 210 patients admitted from January 2017 to December 2017 in the Department of Cardiovascular Medicine of the First Hospital of Lanzhou University,received the first PCI treatment,and repeated the coronary angiography(CAG)before December 31,2020(the interval between two operations should be at least 6 months).According to whether the NCCLs progressed,210 patients were divided into progressive group(n=99)and non-progressive group(n=111),and then,according to the degree of NCCLs progression,patients in progressive group were further divided into three subgroups:mild(n=42),moderate(n=35)and severe(n=22)progressive subgroup.The baseline clinical data were compared between the patients in progressive group and in non-progressive group,and among the patients in mild,moderate and severe progression subgroups.The correlation of the plasma Fib and blood lipid composition to the progression of NCCLs,and the risk factors affecting the progression of NCCLs were analyzed.Results There were no statistical difference between progressive group and non-progressive group in gender,smoking history,drinking history,hypertension history,hyperlipidemia history,heart failure,and admission blood pressure(P>0.05),but the mean age was higher in progressive group than that in non-progressive group,and more patients with diabetes in progressive group than those in non-progressive group,and there existed statistically significant differences(P<0.05).The plasma levels of Fib,cholesterol(TC),low density lipoprotein cholesterol(LDL-C),and non-high density lipoprotein cholesterol(non-HDL-C)were higher in progressive group than those in non-progressive group with statistically significant differences(P<0.05).There existed no significant difference(P>0.05)between the two

关 键 词：纤维蛋白原 血脂 冠状动脉 非罪犯血管病变 进展 相关性 

分 类 号：R543.3[医药卫生—心血管疾病]