老年周围动脉硬化闭塞病与血浆纤维蛋白原、血小板集聚率关系的研究

目的　探讨血浆纤维蛋白原、血小板聚集对老年周围动脉硬化闭塞病 (PAOD)的影响。方法　在北京市万寿路地区 2 0 4 11名老年居民中 ,以家委会为单位整群随机抽样 2 12 1人 ,男 94 1人 ,女 1180人 ,最大年龄 89岁 ,最小年龄 6 0岁 ,平均年龄 6 8.5 1岁± 4 .83岁。以踝动脉指数 <0 .9为PAOD诊断标准。以此诊断分成PAOD与非PAOD人群。在PAOD人群中抽取病例组 2 32例 ,其中男 73例、女 15 9例 ,平均年龄 70 .97岁± 6 .4 6岁 ;在非PAOD人群中按完全随机方式抽取对照组 4 6 4人 ,其中男 2 17人、女 2 4 7人 ,平均年龄 6 8.6 3岁± 5 .2 9岁。病例组与对照组均化验血浆纤维蛋白原浓度 ,血小板最大聚集率及 3min血小板聚集率。同时在两组中对PAOD患病有影响的因素进行多元logistic逐步回归分析。 结果　PAOD病例组血浆纤维蛋白原 (435 .4 5mg/dl±115 .2 5mg/dl)高于对照组 (36 0 .96mg/dl±93.5 2mg/dl) ,P =0 .0 0 1;3min血小板聚集率 (48.76 %± 2 3.90 % )高于对照组(43.5 0 %± 2 6 .76 % ) ,P =0 .0 12。logistic回归结果也显示血浆纤维蛋白原 (OR =0 .994 ,95 %CI :0 .992～ 0 .994 )及 3min血小板聚集率 (OR =0 .5 78,95 %CI:0 .4 0 3～ 0 .82 9)为对PAOD患病有显著影响意义的因素。结论　PAOD患者中

Study on the relationship of plasma f ibrinogen, platelet aggregation rate and peripheral arterial occlusive disease??

OBJECTIVE: To detect the relationship of plasma fibrinogen, platelet aggregation rate and peripheral arterial occlusive disease (PAOD) in the elderly. METHODS: Cross-sectional survey for PAOD was implemented. Two thousands one hundred twenty-one subjects aged 60 - 89 years, male 941, female 1180, means aged 68.51 +/- 4.83 years, were randomly selected out of 20 411 elderly residents within 94 residential communities on the Wanshoulu area, Beijing. Case group involved 232 subjects, including 73 males and 159 females, with mean age 70.97 +/- 6.46 years, were randomly selected from the PAOD group on the PAOD cross-sectional study. 464 subjects were involved in the control group, including 217 males and 247 females, with mean age of 68.63 +/- 5.29, were randomly selected beyond the PAOD group on the PAOD cross-sectional study. Plasma fibrinogen level and platelet aggregation rate were determined in both groups. T test between the two groups was performed. The factors contributing to PAOD in this study (including: age, gender, smoking, obesity, family history of hypertension, diabetes, coronary artery disease, stroke and triglycerides, cholesterol, high density lipoprotein, low density lipoprotein, plasma fibrinogen, platelet aggregation rate) were performed using logistic regression analysis by diagnostic criteria of PAOD in this study. Stepwise selection was also used in this multivariate regression analysis. RESULTS: Plasma fibrinogen level (435.45 mg/dl +/- 115.25 mg/dl), was higher in the PAOD group than in the control group (360.96 mg/dl +/- 93.52 mg/dl, P = 0.001). Platelet aggregation rate at 3 minute (48.76% +/- 23.90%) in the PAOD group was higher compared with the control group (43.50% +/- 26.76%) with P = 0.012. Logistic regression analysis showed that factors, as plasma fibrinogen (OR = 0.994, 95% CI: 0.992 - 0.994), platelet aggregation rate at 3 minute (OR = 0.578, 95% CI: 0.403 - 0.829) were independent risk factors contributing to PAOD in this study. CONCLUSION: Plasma fibrinogen level and platelet aggregation rate were higher in the older patients of PAOD. It is possible for clinical physicians to inhibit platelet aggregation and reduce plasma fibrinogen level in the PAOD patients.