血浆纤维蛋白原和D-二聚体与冠心病的关系及其临床意义

目的研究血浆纤维蛋白原(FG)和D-二聚体(DD)与冠心病(CHD)的关系及其临床意义。方法分别测定18例急性心肌梗死(AMI),23例不稳定型心绞痛(UA),34例稳定型心绞痛(SA)和对照组58例的FG和DD含量,并根据冠脉造影结果将冠心病组分为单支病变组25例,两支病变组21例,三支病变组29例进行PG和DD比较。结果AMI、UA组DD、FG含量明显高于SA和对照组(P<0.01);AMI组DD明显高于UA组(P<0.05);SA组与对照组DD、FG比较差异无显著性(P>0.05);AMI组和UA组的FG比较差异无显著性(P>0.05)。冠脉两、三支病变组FG和DD含量高于对照组和一支病变组,差异显著(P<0.01),三支病变组高于两支病变组(P<0.05),对照组和一支病变组差异无显著性(P>0.05)。结论血浆纤维蛋白原和D-二聚体的升高是冠心病事件的表现和依据,并可能与冠脉病变的严重程度相关。

The changes and Their clinical Significance of plasma Fibrinogen and D-dimer in Patients with Coronary Heart Disease

Objective To explore the changes and their clinical significance of plasma fibrinogen(FG) and D-dimer(DD) in patients with coronary heart disease(CHD).Methods FG and DD were measured in 18 patients with acute myocardial infarction(AMI group),23 patients with unstable angina(UA group),34 patients with stable angina(SA group) and 58 control cases,respectively.According to the results of coronary angiography,75 patients with CHD were divided into single-vessel group(25 cases),double-vessel group(21 cases) and triple-vessel group(29 cases).Results The levels of FG and DD in patients of AMI and UA groups were significantly higher than those in patients of SA and control groups(P<0.01).The plasma DD concentration in patients of AMI group was markedly higher than in patients of UA group(P<0.05).There was no significant difference in DD and FG levels in patients between SA and control groups(P>0.05).The plasma FG level had no significant difference between AMI and UA groups(P>0.05).The concentration of FG and DD in patients with double-and triple-vessel lesions was significant higher than that in single-vessel lesion and control group(P<0.01).Compared with the double-vessel group,the FG level in triple-vessel group was higher(P<0.05).No significant difference was found in DD and FG levels in patients between single-vessel and control group(P<0.05).Conclusions Elevated plasma FG and DD levels are the evidence of CHD and the higher values may imply more severity of CHD.