纤维蛋白原与冠状动脉病变严重程度相关性临床研究

目的：探讨纤维蛋白原（FIB）水平与冠状动脉（冠脉）病变严重程度的相关性。方法：对239例疑诊为冠心病的患者进行冠脉造影。根据冠脉病变程度患者被分成冠脉狭窄组（主干或分支直径狭窄程度〉50％）和对照组（主干或分支直径狭窄程度≤50％）。再将冠脉狭窄组按狭窄累及范围分为单支组，双支组和多支（3支以上）组。所有患者检测FIB、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白-胆固醇（LDL-C）、高密度脂蛋白-胆固醇（HDL-C）、脂蛋白（Lp）a。在控制其他影响因素后，分析FIB与冠脉病变的定性和定量关系。结果：冠脉狭窄组患者的FIB水平明显高于对照组（P〈0．05）。在冠脉狭窄组中双支组与多支组的FIB水平显著高于单支组（P〈0．05）。双支组与多支组FIB水平无显著差异。偏相关分析在控制可能影响FIB水平的其他因素如性别、年龄、血脂、高血压、糖尿病后，显示FIB与冠脉的病变程度明显相关（r=0．693，P〈0．05）。且冠脉病变程度随着FIB的提高而加重（P〈0．05）,其中合并有糖尿病的患者更为明显。结论：FIB水平增高可以反映冠脉病变的严重程度．同时又是简单易行的临床蛤测指标。

Correlation between fibrinogen and severity of coronary lesions

Objective：To study the correlation between fibrinogen and severity of coronary lesions. Methods：In a total of 239 patients suspected as coronary artery disease （CAD）, coronary angiographies were performed,and they were divided into coronary stenosis group （stenosis〉50%, 177cases）and no coronary stenosis group （control group, stenosis ≤50%, 62 cases） by quantitative coronary angiography. The fibrinogen, total cholesterol （TC）, triglyceride （TG）, low-density lipoprotein cholesterol （LDL-C）, and high-density lipoprotein cholesterol （HDL-C） also determined in each patient. Partial regression analysis was conducted. Results： The result from partial regression analysis showed that there was a positive correlation between the fibrinogen and the severity of coronary lesions （r= 0. 489,P〈0. 05）. Especially, the level of fibrinogen was significantly higher in patients with diabetes than in patients with no diabetes （P〈0.05）. There was still a positive correlation between the fibrinogen and the severity of coronary lesions（r= 0. 693. P〈0.05） after adjusting other factors, such as age, blood pressure, smoking, blood fat, and diabetes. Conclusion：The serum level of fibrinogen may have a prognosis value on the severity of coronary lesion in patients with CAD.