纤维蛋白原与急性冠脉综合征患者冠状动脉病变严重程度的关系研究

背景急性冠脉综合征(ACS)患者纤维蛋白原升高与患者预后不良有关,但其对ACS患者冠状动脉病变严重程度的影响尚不清楚。目的探讨纤维蛋白原与ACS患者冠状动脉病变严重程度的关系。方法选取2019年1—5月首都医科大学附属北京天坛医院重症监护病房收治的ACS患者108例,根据SYNTAX评分分为轻度病变组(SYNTAX评分<23分,n=74)和中重度病变组(SYNTAX评分≥23分,n=34)。比较两组患者一般资料〔包括性别、年龄、体质指数(BMI)、高血压发生情况、糖尿病发生情况、脑血管疾病发生情况、冠心病病史、吸烟史〕、实验室检查指标〔包括脑钠肽(BNP)、总胆固醇、粒细胞/淋巴细胞比值、平均血小板体积、纤维蛋白原、同型半胱氨酸、估算的肾小球滤过率〕;纤维蛋白原与ACS患者SYNTAX评分的相关性分析采用Pearson相关分析;ACS患者冠状动脉病变严重程度的影响因素采用多因素Logistic回归分析。结果(1)两组患者男性比例、年龄、BNP、纤维蛋白原比较,差异有统计学意义(P<0.05);两组患者BMI、高血压发生率、糖尿病发生率、脑血管疾病发生率、有冠心病病史及吸烟史者所占比例、总胆固醇、粒细胞/淋巴细胞比值、平均血小板体积、同型半胱氨酸、估算的肾小球滤过率比较,差异无统计学意义(P>0.05)。(2)Pearson相关分析结果显示,纤维蛋白原与ACS患者SYNTAX评分与呈正相关(r=0.348,P<0.05)。(3)多因素Logistic回归分析结果显示,年龄〔OR=1.119,95%CI(1.021,1.226)〕、纤维蛋白原〔OR=3.458,95%CI(1.038,11.523)〕是ACS患者冠状动脉病变严重程度的影响因素(P<0.05)。结论纤维蛋白原与ACS患者冠状动脉病变程度呈正相关,是ACS患者冠状动脉病变严重程度的独立影响因素。

Relationship between Fibrinogen and Severity of Coronary Artery Lesion in Patients with Acute Coronary Syndrome

Background Fibrinogen significantly elevated and it is correlated with the poor prognosis in patients with acute coronary syndrome(ACS),however,its impact on severity of coronary lesion is unknown yet.Objective To investigate the relationship between fibrinogen and severity of coronary artery lesion in patients with ACS.Methods From January to May 2019,a total of 108 patients with ACS were selected in the Intensive Care Unit,Beijing Tiantan Hospital Affiliated to Capital Medical University,and they were divided into A group(SYNTAX score<23,n=74)and B group(SYNTAX score≥23,n=34)according to SYNTAX score.Comparison of general information(including gender,age,BMI,incidence of hypertension,diabetes mellitus and cerebrovascular disease,history of coronary artery disease and smoking)and laboratory examination results(including BNP,TC,granulocyte to lymphocyte ratio,mean platelet volume,fibrinogen,Hcy and eGFR)was compared between the two groups;Pearson correlation analysis was used to analyze the correlations between fibrinogen and SYNTAX score in patients with ACS,moreover multivariate Logistic regression analysis was used to analyze the influencing factors of severity of coronary artery lesion in patients with ACS.Results(1)There was statistically significant difference in male ratio,age,BNP and fibrinogen between the two groups,respectively(P<0.05),while there was no statistically significant difference in BMI,incidence of hypertension,diabetes mellitus or cerebrovascular disease,proportion of patients with history of coronary artery disease or smoking,TC,granulocyte to lymphocyte ratio,mean platelet volume or eGFR between the two groups(P>0.05).(2)Pearson correlation analysis results showed that,fibrinogen was positively correlated with SYNTAX score in patients with ACS(r=0.348,P<0.05).(3)Multivariate Logistic regression analysis results showed that,age〔OR=1.119,95%CI(1.021,1.226)〕and fibrinogen〔OR=3.458,95%CI(1.038,11.523)〕were influencing factors of severity of coronary artery lesion in patients with ACS(P<0.05).Conclusion Fibrinogen is positively correlated with the severity of coronary artery lesion in patients with ACS,an it is one of independent influencing factors of the severity of coronary artery lesion.