纤维蛋白原与白蛋白比值对慢性肾脏病患者冠状动脉病变严重程度的预测价值  

Predictive value of the fibrinogen-to-albumin ratio for coronary severity in patients with chronic kidney disease

作　　者：赵梦琪 张杨 张松利 彭建军 Zhao Mengqi;Zhang Yang;Zhang Songli;Peng Jianjun(Department of Cardiology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China.)

机构地区：[1]首都医科大学附属北京世纪坛医院心内科,北京100038

出　　处：《中国循证心血管医学杂志》2025年第2期199-204,共6页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：北京世纪坛医院青年基金(2021-q20)。

摘　　要：目的探讨对于合并慢性肾脏病的患者纤维蛋白原与白蛋白比值(fibrinogen-to-albumin ratio,FAR)与冠状动脉病变程度的关系。方法回顾性分析2021年1月至2023年1月于首都医科大学附属北京世纪坛医院心血管内科住院的280例合并慢性肾脏病且首次行冠状动脉造影检查患者的临床资料。依据FAR三分位数将患者分为:低FAR组、中FAR组和高FAR组三组,采用Gensini评分系统评估冠状动脉病变的严重性及复杂程度,分析总结FAR与冠状动脉病变程度的相关性。结果FAR与Gensini评分呈正相关(r=0.291,P<0.001)。FAR升高是高Gensini评分的独立危险因素(OR=1.161,95%CI:1.070~1.259,P<0.001)。高FAR组冠心病患病比例、重度冠状动脉病变(三支病变和/或左主干病变)、慢性完全闭塞病变比例更高(P<0.05),且接受血运重建治疗患者比例更高(P<0.05)。ROC曲线分析显示:FAR预测高Gensini评分(>60分)的曲线下面积(AUC)为0.704(95%CI:0.641~0.767),(P<0.001),最佳截断值为8.56%,其对应敏感度为73.1%,特异度为61.5%。结论对于慢性肾脏病患者,FAR可作为无创性指标预测冠状动脉病变严重程度,具有临床应用价值。Objective To investigate the relationship between the fibrinogen-to-albumin ratio(FAR)and the extent of coronary artery disease in patients with chronic kidney disease(CKD).Methods Retrospective analysis was performed on the clinical data of 280 CKD patients who were admitted to the Department of Cardiology,Beijing Shijitan Hospital,Capital Medical University,between January 2021 and January 2023,and underwent their first coronary angiography.According to the tertiles of FAR,patients were divided into three groups:low FAR group,middle FAR group,and high FAR group.The severity and complexity of coronary lesions were assessed using the Gensini scoring system,and the correlation between FAR and the extent of coronary artery disease was analyzed.Results FAR was positively correlated with the Gensini score(r=0.291,P<0.001).Elevated FAR was an independent risk factor for a high Gensini score(OR=1.161,95%CI:1.070~1.259,P<0.001).Patients in the high FAR group had higher rates of coronary artery disease,severe coronary artery lesions(three-vessel disease and/or left main disease),chronic total occlusions(P<0.05),and were more likely to undergo revascularization(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for FAR in predicting a high Gensini score(>60)was 0.704(95%CI:0.641~0.767,P<0.001),with an optimal cutoff value of 8.56%,corresponding to a sensitivity of 73.1%and a specificity of 61.5%.Conclusion In patients with chronic kidney disease,FAR can be used as a noninvasive indicator for predicting the severity of coronary artery disease,and it has clinical value.

关 键 词：冠状动脉粥样硬化性心脏病 慢性肾脏病 GENSINI评分 纤维蛋白原与白蛋白比值 

分 类 号：R541.4[医药卫生—心血管疾病]