纤维蛋白原/白蛋白比值与冠状动脉微血管疾病的相关性分析  

Correlation analysis of fibrinogen/albumin ratio and coronary microvascular disease

作　　者：窦敏 单迎光[2] 许建威[3] 李风祥 秦小飞[2] Dou Min;Shan Yingguang;Xu Jianwei;Li Fengxiang;Qin Xiaofei(Graduate School of Zhengzhou University,Zhengzhou 450052,China;Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Ultrasound,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学研究生院,450052 [2]郑州大学第一附属医院心血管内科,450052 [3]郑州大学第一附属医院超声科,450052

出　　处：《中国心血管杂志》2023年第1期29-33,共5页Chinese Journal of Cardiovascular Medicine

基　　金：苏州工业园区心馨心血管健康基金会-中国心血管健康联盟冠脉微血管疾病创新基金(2018-CCA-CMVD-11);河南省科技发展计划(182102310303)。

摘　　要：目的探索纤维蛋白原/白蛋白比值(FAR)与冠状动脉微血管疾病(CMVD)的相关性,以及对其预测价值。方法回顾性研究。连续入选2020年9月至2021年9月于郑州大学第一附属医院心内科因心绞痛就诊,存在心肌缺血的客观证据,行选择性冠状动脉造影无明显心外膜冠状动脉狭窄的258例患者。检测冠状动脉血流储备(CFR),根据结果分为CFR<2.0组和CFR≥2.0组,比较两组的临床资料差异。相关性分析确定FAR与CFR的相关性;多因素logistic回归分析评估CMVD的独立预测因素;绘制受试者工作特征(ROC)曲线寻找预测CMVD发生的指标。结果与CFR≥2.0组相比,CFR<2.0组患者的空腹血糖、尿酸、C反应蛋白、凝血酶时间、纤维蛋白原和FAR显著升高,白蛋白和肌酸激酶显著降低(均为P<0.05)。相关性分析结果显示,FAR、C反应蛋白、纤维蛋白原与CFR呈显著负相关(r=-0.516、-0.325和-0.485,均为P<0.01)。多因素logistic回归分析结果显示,高尿酸、高FAR是CMVD的独立危险因素,高白蛋白是其保护因素(均为P<0.05)。ROC曲线分析显示,FAR、纤维蛋白原预测不合并阻塞性冠状动脉疾病的CMVD发生的曲线下面积分别为0.659(95%CI:0.597~0.716)、0.613(95%CI:0.553~0.615),阳性预测值分别为71.4%、66.3%,阴性预测值分别为61.9%、60.6%。结论FAR是不合并阻塞性冠状动脉疾病的CMVD的独立危险因素。Objective To explore the relationship between fibrinogen/albumin ratio(FAR)and coronary microvascular disease(CMVD),and its predictive value.Methods This research was a retrospective study.A total of 258 patients with symptoms of angina pectoris and objective evidence of myocardial ischemia in Department of Cardiology of the First Affiliated Hospital of Zhengzhou University were included from September 2020 to September 2021.CMVD was diagnosed by coronary flow reserve(CFR).According to the value of CFR,patients were divided into CFR<2.0 group and CFR≥2.0 group.Differences in clinical characteristics were compared between the two groups.Correlation analysis was used to determine the correlation between CFR and FAR,and multivariate logistic regression analysis was used to evaluate the independent predictors of CMVD.The receiver operating curve(ROC)was plotted to evaluate the predictive capacity of clinical factors.Results Compared with those in CFR≥2.0 group,fasting blood glucose,uric acid,C-reactive protein,thrombin time,fibrinogen and FAR were significantly increased in CFR<2.0 group,while albumin and creatine kinase were significantly decreased(all P<0.05).Correlation analysis showed that there were significantly negative correlations between FAR,C-reactive protein,fibrinogen and CFR(r=-0.516,-0.325 and-0.485,all P<0.01).From multivariate logistic regression analysis,high uric acid and high FAR were the independent risk factors for CMVD,and high albumin was a protective factor(all P<0.05).ROC curve analysis showed that area under the curve(AUC)of FAR was 0.659(95%CI:0.597-0.716)in prediction of CMVD without obstructive coronary artery disease,with positive predictive value of 71.4%and negative predictive value of 61.9%.AUC of fibrinogen was 0.613(95%CI:0.553-0.615)in prediction of CMVD without obstructive coronary artery disease,with positive predictive value of 66.3%and negative predictive value of 60.6%.Conclusions FAR is an independent risk factor for CMVD without obstructive coronary artery disease.

关 键 词：纤维蛋白原/白蛋白比值 冠状动脉微血管疾病 冠状动脉血流储备 

分 类 号：R541.4[医药卫生—心血管疾病]