红细胞分布宽度、纤维蛋白原/白蛋白比值与基于冠状动脉血管造影的无创血流储备分数对冠状动脉功能性缺血的诊断价值  

Diagnostic value of red cell distribution width,fibrinogen/albumin ratio and CTA noninvasive flow reserve fraction in coronary artery functional ischemia

作　　者：党浩男 胡小瑜 DANG Haonan;HU Xiaoyu(Medical Laboratory Department,Shangluo Central Hospital,Shangluo 726000,China)

机构地区：[1]商洛市中心医院医学检验科,陕西商洛726000

出　　处：《陕西医学杂志》2025年第4期544-549,共6页Shaanxi Medical Journal

基　　金：陕西省自然科学基础研究计划项目(2021JM-684);陕西省卫生健康委员会科研基金资助项目(2022D052)。

摘　　要：目的:探究红细胞分布宽度(RDW)、纤维蛋白原/白蛋白比值(FAR)和基于冠状动脉CT血管造影(CTA)的无创血流储备分数水平诊断冠状动脉功能性缺血的价值。方法:选取高度怀疑冠状动脉功能性缺血患者作为本研究对象,患者均接受冠脉血流储备分数(FFR)评估,以FFR值≤0.8认为患者存在冠状动脉功能性缺血(金标准),根据评估结果,随机抽取49例FFR值高于0.8的患者纳入对照组,另随机抽取49例FFR值≤0.8的患者纳入研究组。检测患者外周血RDW、FAR水平,患者均接受CTA检查,并对两组间CT血流储备分数(CT-FFR)及RDW、FAR进行差异分析。收集两组患者的临床资料,分析影响患者发生冠状动脉功能性缺血的因素,并探究RDW、FAR和CT-FFR值对患者冠状动脉功能性缺血的诊断价值。结果:研究组患者的RDW、FAR水平高于对照组,CT-FFR值低于对照组(均P<0.05)。经单因素及多因素分析,RDW、FAR和CT-FFR值均为患者发生冠状动脉功能性缺血的影响因素。经过构建的受试者工作(ROC)曲线分析发现CT-FFR、RDW、FAR诊断患者发生冠状动脉功能性缺血存在较好的应用价值,其AUC值分别为0.977、0.731、0.823。结论:RDW和FAR水平在冠状动脉功能性缺血组中较高,而CT-FFR值较低,是有潜力用于诊断冠状动脉功能性缺血的无创标志物。这些指标在冠状动脉功能性缺血的早期诊断中可能具有一定的临床应用前景。Objective:To explore the value of erythrocyte distribution width(RDW),fibrinogen/albumin ratio(FAR)and noninvasive flow reserve fraction of coronary CT angiography(CTA)in diagnosing coronary functional ischemia.Methods:Select patients with highly suspected coronary artery functional ischemia as the subjects of this study.All patients were assessed by coronary flow reserve score(FFR).Patients with FFR lower than 0.8 were considered to have coronary functional ischemia(gold standard).49 patients with FFR value higher than 0.8 were randomly selected to be included in the control group,and 49 patients with FFR value≤0.8 were randomly selected to be included in the study group.All patients underwent CTA examination,and the difference of CT flow reserve fraction(CT-FFR),RDW and FAR between the two groups was analyzed.Clinical data of the two groups of patients were collected to explore the factors affecting the occurrence of patients with coronary functional ischemia,and to explore the diagnostic value of RDW,FAR and CT-FFR values in patients with coronary functional ischemia.Results:RDW and FAR levels of the study group were higher than those of the control group,and CT-FFR values were lower than those of the control group(all P<0.05).Through univariate and multivariate analysis,RDW,FAR and CT-FFR values were all influencing factors for the occurrence of coronary functional ischemia.After ROC curve analysis,it was found that CT-FFR,RDW and FAR had good application value in diagnosing patients with coronary functional ischemia,and their AUC values were 0.977,0.731 and 0.823,respectively.Conclusion:RDW and FAR levels were higher in the coronary functional ischemia group,while CT-FFR values were lower,which is a potential biomarker for the diagnosis of coronary functional ischemia.These indicators may have a certain clinical application prospect in the early diagnosis of functional ischemia of coronary artery.

关 键 词：红细胞分布宽度 纤维蛋白原/白蛋白比值 CTA无创血流储备分数水平 冠状动脉功能性缺血 冠脉血流储备分数 冠状动脉CT血管造影 诊断 

分 类 号：R543.3[医药卫生—心血管疾病]