摘要
目的分析纤维蛋白原/白蛋白比值(fibrinogen to albumin ratio,FAR)对ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后发生支架内再狭窄(in-stent restenosis,ISR)的诊断价值.方法对2016年1月至2017年12月我院收治的39例PCI术后发生ISR的STEMI患者(研究组)以及同期行PCI术后未发生ISR的75例STEMI患者(对照组)进行回顾性分析.记录并比较两组患者人院后、进行干预前的生化指标、超声心动图指标以及相关手术资料.采用多因素Logistic回归法分析ISR发生的危险因素,应用ROC曲线分析FAR对PCI术后ISR的诊断价值.结果两组空腹血糖、糖化血红蛋白、餐后2h血糖、总胆固醇、低密度脂蛋白、纤维蛋白原以及白蛋白比较未见统计学差异(P>0.05);与对照组比较,研究组左心室射血分数明显降低,而FAR值明显升高,差异有统计学意义(t=2.660、3.142,P=0.009、0.002).两组靶病变血管、置入支架的类型、支架个数、支架直径以及PCI术后所服药物比较未见统计学差异(P>0.05);与对照组比较,研究组患者支架长度明显较长,差异有统计学意义(t=3.374,P=0.001).多因素Logistic回归分析结果显示,较大的FAR(OR=8.382,95%CI2.769~25.377,P=0.000)和支架长度(OR=1.852,95%CI1.125~3.050,P=0.015)是ISR发生的独立危险因素,而较大的左心室射血分数是ISR发生的保护因素(OR=0.879,95%CI 0.800~0.966,P=0.007).ROC曲线分析结果显示,FAR预测PCI术后ISR发生的曲线下面积为0.702(95%CI0.642~0.787),最佳诊断临界值为1.17,此时FAR对ISR发生的敏感度为69.72%,特异度为71.34%.结论FAR和支架长度是ISR发生的独立危险因素,而左心室射血分数是ISR发生的保护因素.FAR升高可独立预测PCI术后ISR的发生.
Objective To explore the diagnostic value of fibrinogen to albumin ratio(FAR)for in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods 39 cases of STEMI patients(study group)with ISR after PCI and 75 cases of STEMI patients(control group)without ISR after PCI treated in our hospital from January 2016 to December 2017 were selected for retrospective analysis.The biochemical index,echocardiographic index and related operative data of the two groups after admission and before intervention was recorded and compared.Multivariate Logistic regression was used to analyze the risk factors of ISR and ROC curve was used to analyze the diagnostic value of FAR for ISR after PCI.Results There was no significant difference in fasting blood glucose,glycated hemoglobin,2 hours postprandial blood sugar,total cholesterol,low density lipoprotein,fibrinogen and albumin between the two groups(P>0.05).Compared with the control group,the left ventricular ejection fraction in the study group decreased significantly,while the FAR value increased significantly(t=2.660,3.142;P=0.009,0.002).There was no significant difference in target lesion vessels,type of stent,number of sten,stent diameter and drug taken after PCI between the two groups(P>0.05).Compared with the control group,the stent length in the study group was significantly longer and the difference was statistically significant(t=3.374,P=0.001).Multivariate Logistic regression analysis showed that larger FAR(OR=8.382,95%CI 2.769-25.377,P=0.000)and stent length(OR=1.852,95%CI 1.125-3.050,P=0.015)were independent risk factor for ISR,while larger left ventricular ejection fraction was a protective factor for ISR(OR=0.879,95%CI 0.800-0.966,P=0.007).ROC curve analysis showed that the area under the curve of FAR predicting ISR after PCI was 0.702(95%CI 0.642-0.787)and the optimal diagnostic threshold was 1.17;at this time,the sensitivity and specificity of FAR to ISR was 69.72%,and 71.34%,respective
作者
蔡文灿
刘彦明
钱春艳
陈伟娟
CAI Wen-can;LIU Yan-ming;QIAN Chun-yan;CHEN Wei-juan(Laboratory Department,Yue Bei People's Hospital,Shaoguan 512026,China)
出处
《中国心血管病研究》
CAS
2019年第11期989-993,共5页
Chinese Journal of Cardiovascular Research
基金
广东省自然科学基金项目(2016A030310377)。
