摘要
目的探讨血浆纤维蛋白原、血小板聚集对老年急性冠脉综合征发病的影响,为老年急性冠脉综合征的抗血小板聚集、降低血浆纤维蛋白原治疗提供参考依据.方法在北京地区老年居民20 411位中,以居委会为单位,整群随机抽样2 121人.其中男941人,女1 182人;最大年龄者89岁,最小者60岁,年龄(68.51±4.83)岁.以Rose问卷阳性,18导联心电图有缺血性改变为老年急性冠脉综合征的诊断标准.病例组32人,其中男23人,女9人,年龄(69.97±6.43)岁;以1:4完全随机抽取对照组128人,男92人,女36人,年龄(68.63±5.21)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3 min血小板聚集率.在两组中对老年急性冠脉综合征发病有影响的其他因素进行Logistic逐步回归分析.结果病例组血浆纤维蛋白原(453.41±105.25)mg/dl高于对照组(371.94±92.52)mg/dl,P=0.001;血小板最大聚集率(69.76±22.90)%及3 min血小板聚集率(54.76±22.84)%均高于对照组[(52.53±24.71%;43.50±26.76)%,P=0.013、P=0.021].Logistic回归结果也显示血浆纤维蛋白原(OR=0.994、95%CI为0.992～0.994)、血小板最大聚集率及3 min血小板聚集率(OR=0.520、95%CI为0.353～0.765;OR=0.578 95%CI为、0.403～0.829)为对老年急性冠脉综合征发病有显著影响意义的因素.结论老年急性冠脉综合征患者中血浆纤维蛋白原水平增高,血小板聚集功能增强.
Objective To study the relationship of plasma fthrinogen, platelet aggregation rate and acute coronarysy ndrome in the elderly. Methods Cross sectional survey on the acute coronary syndrome was implemented. Two thousands one hundred and twenty-four patients from 9 residential communities, aged 60 to 89 years, male 941, female 1 182, were randomly selected out from 20 411 elderly residents in Beijing. Thirty-two patients, including 23 male and 9 female, with age （69.97±6.43） years, were selected by the diagnosis of Rose and ECG examinations from the crosssectional study group. One hundred and twenty-three patients, including 92 male and 36 female, with age （68.63±5.21） years, were randomly selected by 1：4 ratio from the cross-sectional study group and served as control group. Plasma fibrinogen level and platelet aggregation rate were determined in the both groups. The factors associated with acute coronary syndrome were analysed using logistic regression analysis. Results Plasma fibrinogen level （453.41±105.25） mg/dl in the case group was higher than that in the control group （371.94±92.52 mg/dl） P = 0.001. Highest platelet aggregation rate and platelet aggregation rate at 3 minute [（69.76±22.90） %, （54.76±22.84） %, respectively] in the case group were higher than in the control group [（52.53±24.71）%, （43.50±26.76）%, P=0.013, P=0.021]. In the logistic regression analysis, factors such as plasma fibrinogen （ OR = 0.994, 95% CI 0.992-0.994）, Highest Platelet aggregation rate and Platelet aggregation rate at 3 minute （ OR = 0.520, 95 % CI 0. 353 - 0.765 ; OR = 0. 578, 95 % CI0.403 - 0. 829） were independent risk factors associated with acute coronary syndrome in this study. Conclusion Plasma fibrinogen level and platelet aggregation rate are higher in the alder patients with acute coronary syndrome. It could be worthwhile for physicians to inhibit platelet aggregation and reduce plasma fibrinogen level in the acute coronary syndrome patients.
出处
《中华急诊医学杂志》
CAS
CSCD
2005年第8期629-632,共4页
Chinese Journal of Emergency Medicine
基金
卫生部保健科研基金资助项目(2001-5-006)
