摘要
目的探讨纤维蛋白原(Fg)浓度与冠状动脉病变严重程度及超敏C反应蛋白(hsCRP)的相关性,以及对Fg水平的影响因素。方法对82例疑诊为冠心病的患者进行冠状动脉造影,图像分析后以病变支数、病变Gensini总积分表示冠状动脉病变程度。分别用磁珠法、化学发光法测定血Fg、hsCRP浓度。分析Fg水平与冠状动脉病变支数、Gensini积分、hsCRP相关性。以Fg浓度为因变量,以冠心病患者年龄、糖尿病、高血压、吸烟、hsCRP、体质量指数(BMI)、甘油三酯(TG)、血清总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、载脂蛋白A(APOA)、载脂蛋白B(APOB)、APOA/APOB、尿酸(URI)、白细胞计数(WBC)为自变量进行多元逐步回归分析。结果(1)冠心病患者单支、双支、三支以上病变组Fg均显著高于非冠心病组(P值均<0.01)。在控制年龄、性别影响因素之后,对Fg和lg冠状动脉Gensini评分采用偏相关分析,二者呈正相关(r=0.513,P<0.001)。(2)冠心病双支病变组、三支以上病变组hsCRP明显高于非冠心病组、单支组(P<0.05),Pearson相关分析Fg与hsCRP呈线性正相关(r=0.376,P<0.001)。(3)以Fg为因变量的多元逐步回归分析发现,仅hsCRP、吸烟、糖尿病进入回归方程(F=12.67,P<0.001),标准化回归系数分别为0.178(P=0.003)、-0.239(P=0.018)、-0.283(P=0.031)。结论Fg浓度与冠状动脉粥样硬化的病变范围和严重程度相关,对临床和冠状动脉病变的严重性有一定预测价值;Fg与hsCRP呈正相关性;吸烟、糖尿病是冠心病患者血Fg水平的影响因素。
Objective To study the relationship serum fibrinogen and high sensitivity C-reactive protein between the severity of coronary artery disease. Methods 82 patients suspected of coronary artery disease（CAD） were studied with coronary angiography. The extent and severity of coronary artery was diagnosed by the number of disease vessels and the Gensini cumulative index. Meanwhile, Fg and hs-CRP of all patients was measured when admission by method of magnetic bead and chemoluminescence. Subsequently, the relationship serum fibrinogen and high sensitivity C-reactive protein between the severity of coronary artery lesion in patients was analyzed. In CAD patients, age,diabetes, hypertension, smoking, hs-CRP, BMI, TG, TC, HDL-C, LDL-C, APO-A, APO-B, APO-A/APO-B, URI and WBC counts supposed as independent variable were analyzed by a multiple stepwise regression analysis with Fg as dependent variable. Results （1） The levels of Fg in CAD patients with single and double, multiple disease vessels were all significantly higher than that in non-CAD patients（P〈0.01）. Partial correlation analysis showed that Fg was positively correlated with Gensini cumulative index by controlled influential factor such as age and gender（r=0. 513, P〈0. 001）. （2）The levels of hs-CRP in CAD patients with double and multiple disease vessels were obviously higher than that in CAD patients with single disease vessels and in non-CAD patients（all P〈0.05）. Fg was positively correlated with hs-CRP in all patients （r=0. 376, P〈0.001）. （3）In a multiple stepwise regression analysis, only hs-CRP, smoking and diabetes were positive predictors of Fg after adjusting for all potentially confounding variables（F=-12.6, P〈 0.001）, standardize regression coefficient volue was 0. 178（P=0. 003）, -0. 239（P=0. 018）,-0. 283（P =0.031） respectively. Conclusion The positive correlation between Fg and the extent and severity of coronary artery lesion indicate that Fg levels may predict the severity of coronary artery lesion. Fg levels was positively correlated with hs-CRP in all patients. Both smoking and diabetes affect the levels of Fg in CAD patients.
出处
《福建医科大学学报》
2006年第2期150-153,共4页
Journal of Fujian Medical University
