血浆D二聚体/纤维蛋白原比值与冠心病合并糖尿病患者冠脉重度狭窄的相关性研究  

Correlation between plasma D dimer/fibrinogen ratio and severe coronary artery stenosis in patients with coronary heart disease and diabetes mellitus

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作  者:刘娟[1,2] 邓毅凡 朱米雪 张钊源 余吉玲 曹干 何胜虎 张晶[1] Liu Juan;Deng Yifan;Zhu Mixue;Zhang Zhaoyuan;Yu Jiling;Cao Gan;He Shenghu;Zhang Jing(Department of Cardiology,Northern Jiangsu People's Hospital of Jiangsu Province,Yangzhou 225000,China;Department of Geriatrics,Hengyang Central Hospital,Hengyang 421000,China;Yangzhou Clinical Medical College,Dalian Medical University,Yangzhou 225000,China;Yangzhou Clinical College,Xuzhou Medical University,Yangzhou 225000,China)

机构地区:[1]江苏省苏北人民医院心血管内科,扬州225000 [2]衡阳市中心医院老年医学科,衡阳421000 [3]大连医科大学扬州临床医学院心血管内科,扬州225000 [4]徐州医科大学扬州临床学院心血管内科,扬州225000

出  处:《血栓与止血学》2024年第5期233-239,共7页Chinese Journal of Thrombosis and Hemostasis

基  金:2023年江苏省研究生科研与实践创新计划资助项目(SJCX23⁃2024)。

摘  要:目的探讨血浆D二聚体/纤维蛋白原比值(D⁃dimer/fibrinogen ratio,DFR)与冠心病合并糖尿病患者冠脉重度狭窄的相关性。方法选择2022年01月―2023年06月在江苏省苏北人民医院心血管内科行冠状动脉造影的患者581例,分为阴性组(99例)、单纯冠心病(scoronary heart disease,CHD)组(318例)、冠心病合并糖尿病(coronary heart disease combined with diabetes mellitus,DCHD)组(164例),比较三组患者DFR,再将DCHD组中Gensini评分>19的患者列为重度冠脉狭窄组,探讨DCHD患者重度冠脉狭窄的危险因素及DFR对于DCHD患者重度冠脉狭窄的预测价值。结果三组患者中,性别、年龄、吸烟史、高血压史、甘油三酯、血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、D二聚体、纤维蛋白原、DFR有统计学差异(P<0.05);进一步两两比较发现,D二聚体、纤维蛋白原、DFR总体趋势表现为DCHD组>单纯CHD组>阴性组,有统计学差异(P<0.05)。多因素Logisitic回归分析结果显示,年龄、高血压史、吸烟史、DFR≥90×10^(⁃6)是DCHD患者冠脉重度狭窄的独立危险因素;高密度脂蛋白胆固醇≥1.42 mmol/L为DCHD患者重度冠脉狭窄的独立保护因素(P<0.05)。绘制DFR预测DCHD患者发生重度冠脉狭窄的ROC曲线下面积为0.719[95%CI:0.649~0.789]。结论DCHD患者的DFR高于单纯冠心病及阴性组患者,且DFR≥90×10^(⁃6)可能为DCHD患者重度冠脉狭窄的独立危险因素,对DCHD患者发生重度冠脉狭窄具有一定的临床预测价值。Objective To investigate the correlation between plasma D dimer/fibrinogen ratio and severe coronary artery stenosis in patients with coronary heart disease and diabetes mellitus.Methods A total of 581 patients who underwent coronary angiography in the cardiovascular Department of Jiangsu Subei People's Hospital from January 2022 to June 2023 were selected and divided into negative group(99 cases),simple coronary heart disease(CHD)group(318 cases),and coronary heart disease combined with diabetes mellitus(DCHD)group(164 cases).The difference of D⁃dimer/fibrinogen ratio(DFR)among the three groups was compared,and patients with Gensini score>19 in the DCHD group were classified as the severe coronary stenosis group.To investigate the risk factors of severe coronary stenosis in DCHD patients and the predictive value of DFR for severe coronary stenosis in DCHD patients.Results There were significant differences in gender,age,smoking history,hypertension history,triglyceride(TG),serum total cholesterol(TC),high⁃density lipoprotein cholesterol(HDL⁃C),low⁃density lipoprotein cholesterol(LDL⁃C),D⁃dimer(D⁃D),fibrinogen(FIB)and DFR among the three groups(P<0.05).Further pound⁃wise comparison showed that the overall trend of D⁃D,FIB and DFR was DCHD group>CHD group>negative group,with statistical difference(P<0.05).Multivariate Logisitic regression analysis showed that age,history of hypertension,smoking history and DFR≥90×10^(⁃6)were independent risk factors for severe coronary artery stenosis in DCHD patients.HDL⁃C≥1.42 mmol/L was an independent protective factor for severe coronary stenosis in DCHD patients(P<0.05).The area under ROC curve(AUC)plotted by DFR to predict severe coronary stenosis in DCHD patients was 0.719(95%CI:0.649⁃0.789).Conclusion DFR in patients with DCHD was higher than that in patients with simple coronary heart disease and negative group,and DFR≥90×10^(⁃6)may be an independent risk factor for severe coronary artery stenosis in patients with DCHD,which has clinical

关 键 词:D二聚体/纤维蛋白原比值 重度冠脉狭窄 冠心病 糖尿病 

分 类 号:R541.4[医药卫生—心血管疾病]

 

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