摘要
目的分析老年急性冠脉综合征(ACS)患者入院时纤维蛋白原(Fib)、血栓弹力图[TEG(K值)、TEG(α角)]与冠状动脉复杂病变是否具有相关性。方法选取2018年6月至2021年6月于连云港市第二人民医院经冠状动脉造影确诊为ACS的老年患者183例,按冠状动脉病变程度分为复杂病变组(111例)、非复杂病变组(72例),选取同期冠状动脉造影排除冠心病的老年患者60例作为对照组,比较组间Fib、TEG(K值)、TEG(α角)水平差异。统计学方法采用单因素方差分析、Kruskall-Wallis检验、χ^(2)检验、二元logistic回归分析、受试者工作特征曲线(ROC)。结果老年ACS患者冠状动脉复杂病变组Fib水平高于非复杂病变组及对照组[(4.23±1.05)g/L比(3.84±0.71)g/L、(3.76±0.81)g/L],差异有统计学意义(F=2.530,P=0.012);复杂病变组TEG(K值)低于非复杂病变组及对照组[(2.18±0.42)min比(2.32±0.59)min、(2.41±0.74)min],差异有统计学意义(F=2.130,P=0.036);二元logistic回归分析结果显示Fib是老年ACS患者冠状动脉复杂病变的危险因素(OR=2.023,P=0.015),TEG(K值)是老年ACS患者冠状动脉复杂病变的保护因素(OR=0.591,P=0.018);通过ROC分析,Fib联合TEG(K值)预测老年ACS患者冠状动脉复杂病变的曲线下面积为0.756,灵敏度和特异度分别为76.68%和63.52%,最佳截断值分别为4.67 g/L和2.07 min。结论老年ACS患者入院时Fib和TEG(K值)水平与冠状动脉复杂病变相关,对冠状动脉复杂病变有预测价值,Fib为冠状动脉复杂病变的独立危险因素,而TEG(K值)为冠状动脉复杂病变的保护因素。
Objective To investigate the correlations between fibrinogen(Fib)and thromboelastogram(TEG)(K value,αangle)and complex coronary artery lesions in elderly patients with acute coronary syndrome(ACS).Methods A total of 183 elderly patients with ACS confirmed by coronary angiography admitted to The Second People's Hospital of Lianyungang City from June 2018 to June 2021 were enrolled in this study.According to the degree of involved coronary artery lesions,they were divided into a complex lesion group(111 cases)and a uncomplex lesion group(72 cases),and sixty elderly patients without coronary heart disease excluded by coronary angiography during the same period were selected as the control group.The Fib and TEG(K value,αangle)were compared among the three groups.One-way analysis of variance,Kruskall-Wallis test,χ^(2) test,binary logistic regression analysis,and receiver operating characteristic curve(ROC)were used for statistical analysis.Results The Fib level of the complex lesion group[(4.23±1.05)g/L]was significantly higher than that in the uncomplex lesion group[(3.84±0.71)g/L]and the control group[(3.76±0.81)g/L](F=2.530,P=0.012).The TEG(K value)of the complex lesion group[(2.18±0.42)min]was significantly lower than that in the uncomplex lesion group[(2.32±0.59)min]and the control group[(2.41±0.74)min](F=2.130,P=0.036).Binary logistic regression analysis showed that Fib level was a risk factor for complex coronary artery lesions in elderly ACS patients(OR=2.023,P=0.015),and TEG(K value)was a protective factor for complex coronary artery lesions(OR=0.591,P=0.018).ROC analysis indicated that the area under the curve predicted by Fib combined with TEG(K value)for complex coronary artery lesions in elderly ACS patients was 0.756,the sensitivity and specificity were 76.68%and 63.52%,the optimal cut-off values were 4.67 g/L and 2.07 min,respectively.Conclusions Fib and TEG(K value)at admission are not only associated with,but also show predictive values for complex coronary artery lesions in elderly ACS patie
作者
杨小云
申潇竹
赵晓斐
谢春辉
赵金燕
胡广云
Yang Xiaoyun;Shen Xiaozhu;Zhao Xiaofei;Xie Chunhui;Zhao Jinyan;Hu Guangyun(Center of Geriatrics,The Second People's Hospital of Lianyungang City,Lianyungang 222006,China)
出处
《国际医药卫生导报》
2022年第22期3113-3117,共5页
International Medicine and Health Guidance News
基金
江苏省老年健康科研资助项目(LD2021034)。
