纤维蛋白原对2型糖尿病患者冠状动脉斑块狭窄率进展的影响  

Effect of fibrinogen on the progression of coronary plaque stenosis rate in patients with type 2 diabetes mellitus

作　　者：荐志洁[1] 乔香瑞 李海波 姚果林 郭华峰 刘辉 吴岳[2] 杨健[1] 成乐乐 JIAN Zhijie;QIAO Xiangrui;LI Haibo;YAO Guolin;GUO Huafeng;LIU Hui;WU Yue;YANG Jian;CHENG Lele(Department of Medical Imaging,the First Affiliated Hospital of Xi'an Jiaotong University,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710061,China;Department of Cardiovascular Medicine,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710061,China;Department of Medical Imaging,Xi'an Gao Xin Hospital,Xi'an,Shaanxi 710075,China;Department of Medical Imaging,Shaanxi Provincial Traditional Chinese Medicine Hospital,Xi'an,Shaanxi 710003,China;Biobank,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西省西安市710061 [2]西安交通大学第一附属医院心血管内科,陕西省西安市710061 [3]西安高新医院医学影像科,陕西省西安市710075 [4]陕西省中医医院医学影像科,陕西省西安市710003 [5]西安交通大学第一附属医院生物样本信息资源中心,陕西省西安市710061

出　　处：《中国动脉硬化杂志》2024年第5期410-414,共5页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金项目(82200500);陕西省重点研发计划项目(2023-YBSF-403);西安交通大学第一附属医院科研发展基金项目(2021ZYTS-01)。

摘　　要：[目的]探讨纤维蛋白原(FIB)与2型糖尿病(T2DM)患者冠状动脉斑块狭窄率进展的关系。[方法]纳入2015年1月—2020年12月在西安交通大学第一附属医院行两次及以上冠状动脉CT血管成像(CCTA)检查的T2DM住院患者,根据FIB中位数将受试者分为高FIB组和低FIB组。比较高、低FIB两组间冠状动脉斑块狭窄率进展及其他临床特征的差异,采用Spearman相关性分析和Logistic回归分析FIB水平与冠状动脉斑块狭窄率进展的关系。[结果]共纳入患者145例,高FIB组73例,低FIB组72例,两次CCTA中位随访时间为25(18,40)个月。高FIB组年龄、女性比例及斑块狭窄率进展高于低FIB组,差异均有统计学意义(P<0.05)。FIB水平与斑块狭窄率变化呈正相关(r^(2)=0.308,P<0.001)。多元Logistic回归分析显示,在校正年龄、性别及其他多种临床指标后,FIB水平为T2DM患者冠状动脉斑块狭窄率进展的危险因素(OR=5.25,95%CI:1.97~14.02,P<0.001)。[结论]基线高FIB水平是T2DM患者冠状动脉斑块狭窄率进展的独立危险因素,监测FIB水平有利于T2DM患者的心血管危险分层。Aim To investigate the relationship between fibrinogen(FIB)and the progression of coronary plaque stenosis rate in patients with type 2 diabetes mellitus(T2DM).Methods Hospitalized T2DM patients who underwent two or more coronary CT angiography(CCTA)examinations in the First Affiliated Hospital of Xi'an Jiaotong U-niversity from January 2015 to December 2020 were included.The subjects were divided into high FIB and low FIB groups according to the median of FIB.The differences in the progression of coronary plaque stenosis rate and other clinical characteristics were compared between the two groups,and the relationship between FIB level and the progression of coronary plaque stenosis rate was analyzed by Spearman's correlation analysis and Logistic regression.Results A total of 145 patients were included,73 in the high FIB group and 72 in the low FIB group at baseline,with a median follow-up time of 25(18,40)months between CCTA.The age,proportion of women,and the progression of coronary plaque stenosis rate were higher in the high FIB group than those in the low FIB group,and the differences were statistically signifi-cant(P<0.05).FIB level was positively correlated with the change in coronary plaque stenosis rate(r^(2)=0.308,P<0.001).Multivariate Logistic regression analysis showed that FIB level was a risk factor for the progression of coronary plaque stenosis rate in patients with T2DM(OR=5.25,95%CI:1.97~14.02,P<0.001),after adjusting for age,sex and other clinical risk factors.Conclusion High baseline FIB level is an independent risk factor for the progression of coronary plaque stenosis rate in patients with T2DM,and monitoring FIB level is beneficial to cardiovascular risk stratifica-tion in patients with T2DM.

关 键 词：纤维蛋白原 2型糖尿病 冠状动脉斑块狭窄率 

分 类 号：R5[医药卫生—内科学]