引用本文:王顺利,汤建民,王丰云,赵一品,来桂棵,王 同.纤维蛋白原/白蛋白比值诊断急性ST段抬高型心肌梗死患者PCI术后冠状动脉无复流的价值[J].中国临床新医学,2019,12(12):1287-1291.
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纤维蛋白原/白蛋白比值诊断急性ST段抬高型心肌梗死患者PCI术后冠状动脉无复流的价值
王顺利,汤建民,王丰云,赵一品,来桂棵,王 同
450014 河南,郑州大学第二附属医院心内科
摘要:
[摘要] 目的 探讨纤维蛋白原/白蛋白比值(FAR)对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)术后冠状动脉无复流的诊断价值。方法 回顾性分析2016-12~2018-12于该院确诊为STEMI并在12 h内急诊行PCI患者218例的临床资料。根据PCI术后是否发生冠状动脉复流将患者分为复流组(n=168)和无复流组(n=50),比较两组患者临床基线资料以及各项检验结果,采用多因素Logistic回归分析筛选冠状动脉无复流的影响因素,采用ROC曲线法评价FAR值对诊断冠状动脉无复流的价值。结果 无复流组左心室射血分数(LVEF)和白蛋白水平低于复流组,而纤维蛋白原、高敏C反应蛋白(hs-CRP)、FAR水平高于复流组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,较高水平的FAR和纤维蛋白原是冠状动脉无复流发生的危险因素,而较高水平的白蛋白是其发生的抑制因素。ROC曲线结果显示,FAR诊断冠状动脉无复流的曲线下面积为0.750,诊断临界值为10.82,诊断临界值对应的灵敏度为83.3%,特异度为64.0%,具有诊断价值(P<0.05)。结论 FAR是STEMI患者PCI术后冠状动脉无复流的影响因素,并对冠状动脉无复流具有一定的诊断价值。
关键词:  心肌梗死  冠状动脉无复流  纤维蛋白原  白蛋白
DOI:10.3969/j.issn.1674-3806.2019.12.08
分类号:R 542.2
基金项目:河南省科技攻关计划项目(编号:162102310516)
The value of fibrinogen to albumin ratio in diagnosis of no-reflow of coronary artery after PCI in patients with acute ST-segment elevation myocardial infarction
WANG Shun-li, TANG Jian-min, WANG Feng-yun, et al.
Department of Cardiology, the Second Affiliated Hospital of Zhengzhou University, Henan 450014, China
Abstract:
[Abstract] Objective To explore the diagnostic value of fibrinogen to albumin ratio(FAR) for no-reflow of coronary artery after emergency percutaneous coronary intervention(PCI) in patients with acute ST-segment elevation myocardial infarction(STEMI). Methods The clinical data of 218 patients who were diagnosed with STEMI and treated with emergency PCI within 12 hours in our hospital from December 2016 to December 2018 were retrospectively analyzed. The patients were divided into reflow of coronary artery group(n=168) and no-reflow of coronary artery group(n=50) according to whether there was reflow of coronary artery after PCI. The clinical baseline data and medical laboratory results were compared between the two groups. Multivariate Logistic regression analysis was used to screen the influencing factors of no-reflow coronary artery. Receiver operating characteristic(ROC) curve was used to evaluate the value of FAR in diagnosis of no-reflow coronary artery. Results The levels of left ventricular ejection fraction(LVEF) and albumin in the no-reflow of coronary artery group were significantly lower than those in the reflow of coronary artery group, while the levels of fibrinogen, high-sensitivity C-reactive protein(hs-CRP) and FAR in the no-reflow of coronary artery group were significantly higher than those in the reflow of coronary artery group(P<0.05). Multivariate Logistic regression analysis showed that higher levels of FAR and fibrinogen were the risk factors of no-reflow of coronary artery, while higher level of albumin was the inhibiting factor. The ROC curve showed that the area under the curve of FAR in diagnosing no-reflow of coronary artery was 0.750, and the diagnostic threshold was 10.82. The sensitivity and specificity of the diagnostic threshold were 83.3% and 64.0%, respectively, which had diagnostic value on no-reflow of coronary artery in patients with acute STEMI(P<0.05). Conclusion FAR is the influencing factor of no-reflow coronary artery in STEMI patients after PCI, and it has certain value in the diagnosis of no-reflow coronary artery.
Key words:  Myocardial infarction  No-reflow of coronary artery  Fibrinogen  Albumin