冠心病患者血浆纤维蛋白原及D二聚体水平变化
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摘要
目的探究血浆纤维蛋白原、D-二聚体水平与冠心病及冠脉病变严重程度的关系。方法根据冠脉造影结果随机选择2018年6月～2018年12月在安徽医科大学第一附属医院心内科行冠状动脉造影检查的患者共174例,将研究对象分为冠心病组、冠脉硬化组和对照组,冠心病组进一步分为单支血管病变组和多支血管病变组;Gensini评分轻度组(<20分)和重度组(≥20分)。分别比较各组及各亚组间血浆纤维蛋白原及D二聚体水平的差异。结果冠心病组、冠脉硬化组和对照组三组间血浆纤维蛋白原和D二聚体水平差异均有统计学意义(P<0.05);冠心病组和对照组间纤维蛋白原及D二聚体水平差异均有统计学意义(P<0.05);D二聚体水平差异在冠心病组和冠脉硬化组间具有统计学意义(P<0.05);冠心病组和冠脉硬化组间纤维蛋白原水平差异、冠脉硬化组和对照组间纤维蛋白原、D二聚体水平差异均无统计学意义。冠心病组亚组分析:D二聚体水平在多支血管病变组明显高于单支血管病变组,在Gensini评分重度组明显高于轻度组,差异均具有统计学意义(P<0.05),纤维蛋白原水平在单支和多支血管病变组间、Gensini评分轻度和重度组间差异均无统计学意义。结论血浆纤维蛋白原、D-二聚体水平升高与冠心病的发生发展相关,D二聚体水平与冠脉病变严重程度呈正相关。
Objective To explore the relationship between plasma fibrinogen as well as D-dimer levels and the development of coronary artery disease as well as severity of coronary heart disease.Methods 174 patients who underwent coronary angiography were randomly selected from June 2018 to December 2018 in the Department of Cardiology,the First Affiliated Hospital of Anhui Medical University.The subjects were divided into coronary heart disease group,coronary atherosclerosis group and control group.The coronary heart disease group was further divided into single vessel disease group and multiple vessel disease group; Gensini score <20 and ≥20 group.The plasma fibrinogen and D dimer levels were compared between each group and each subgroup.Results There were significant differences in plasma fibrinogen and D-dimer levels among three groups(P<0.05).There were significant differences in fibrinogen and D dimer levels between CHD group and control group(P<0.05).There was significant difference in D dimer level between coronary heart disease group and coronary atherosclerosis group(P<0.05).There was no significant difference in fibrinogen level between coronary heart disease group and coronary atherosclerosis group and in fibrinogen and D dimer level between coronary atherosclerosis group and control group.Subgroup analysis of coronary heart disease group showed that D dimer level in multi-vessel disease group was significantly higher than that in single-vessel disease group,and significantly higher in Gensini score ≥20 group,and the difference was statistically significant(P<0.05).There was no significant difference in fibrinogen level between single-vessel and multi-vessel disease group as well as Gensini score <20 and ≥20 group.Conclusion The elevated levels of plasma fibrinogen and D-dimer are correlated with the occurrence and development of coronary heart disease and the level of D-dimer is positively correlated with the severity of coronary artery disease.
Objective To explore the relationship between plasma fibrinogen as well as D-dimer levels and the development of coronary artery disease as well as severity of coronary heart disease.Methods 174 patients who underwent coronary angiography were randomly selected from June 2018 to December 2018 in the Department of Cardiology,the First Affiliated Hospital of Anhui Medical University.The subjects were divided into coronary heart disease group,coronary atherosclerosis group and control group.The coronary heart disease group was further divided into single vessel disease group and multiple vessel disease group; Gensini score <20 and ≥20 group.The plasma fibrinogen and D dimer levels were compared between each group and each subgroup.Results There were significant differences in plasma fibrinogen and D-dimer levels among three groups(P<0.05).There were significant differences in fibrinogen and D dimer levels between CHD group and control group(P<0.05).There was significant difference in D dimer level between coronary heart disease group and coronary atherosclerosis group(P<0.05).There was no significant difference in fibrinogen level between coronary heart disease group and coronary atherosclerosis group and in fibrinogen and D dimer level between coronary atherosclerosis group and control group.Subgroup analysis of coronary heart disease group showed that D dimer level in multi-vessel disease group was significantly higher than that in single-vessel disease group,and significantly higher in Gensini score ≥20 group,and the difference was statistically significant(P<0.05).There was no significant difference in fibrinogen level between single-vessel and multi-vessel disease group as well as Gensini score <20 and ≥20 group.Conclusion The elevated levels of plasma fibrinogen and D-dimer are correlated with the occurrence and development of coronary heart disease and the level of D-dimer is positively correlated with the severity of coronary artery disease.
引文
[1]Gensini GG.A more meaningful scoring system for determining the severity of coronary heart disease[J].Am J Cardiol.1983;51(3):606.
[2]卫娟,张彩霞,王桂芬.血浆纤维蛋白原、D-二聚体与冠心病的关系与临床意义[J].内蒙古中医药,2012;(21):78-79.
[3]张顺莉,许邦龙,王晓晨等.纤维蛋白原、D-二聚体与冠脉病变程度的相关性研究[J].世界最新医学信息文摘,2017,17(64):22.
[4]Sato S,Nakamura M,Iida M et al.Plasma fibrinogen and coronary heart disease in urban Japanese[J].Am J Epidemiol,2000;152(5):420-423.
[5]Kotbi S,Mjabber A,Chadli A et al.Correlation between the plasma fibrinogen concentration and coronary heart disease severity in Moroccan patients with type 2 diabetes.Prospective study[J].Ann Endocrinol(Paris),2016;77(5):606-614.
[6]Zakai NA,McClure LA,Judd SE et al.D-dimer and the risk of stroke and coronary heart disease.The REasons for Geographic and Racial Differences in Stroke(REGARDS)Study[J].Thromb Haemost,2017;117(3):618-624.
[2]卫娟,张彩霞,王桂芬.血浆纤维蛋白原、D-二聚体与冠心病的关系与临床意义[J].内蒙古中医药,2012;(21):78-79.
[3]张顺莉,许邦龙,王晓晨等.纤维蛋白原、D-二聚体与冠脉病变程度的相关性研究[J].世界最新医学信息文摘,2017,17(64):22.
[4]Sato S,Nakamura M,Iida M et al.Plasma fibrinogen and coronary heart disease in urban Japanese[J].Am J Epidemiol,2000;152(5):420-423.
[5]Kotbi S,Mjabber A,Chadli A et al.Correlation between the plasma fibrinogen concentration and coronary heart disease severity in Moroccan patients with type 2 diabetes.Prospective study[J].Ann Endocrinol(Paris),2016;77(5):606-614.
[6]Zakai NA,McClure LA,Judd SE et al.D-dimer and the risk of stroke and coronary heart disease.The REasons for Geographic and Racial Differences in Stroke(REGARDS)Study[J].Thromb Haemost,2017;117(3):618-624.