纤维蛋白原与白蛋白比值对老年疑似冠心病病人冠脉病变程度的预测价值

doi:10.3969/j.issn.1003-9198.2023.08.013

摘要/Abstract

摘要： 目的研究纤维蛋白原与白蛋白比值(fibrinogen to albumin ratio, FAR)预测老年疑似冠心病病人冠脉病变程度的价值。方法选取2018年1月至2022年5月因疑似冠心病于河北省人民医院首次行冠脉造影检查的老年病人533例。冠脉病变程度依据Gensini评分分为冠脉重度病变组(Gensini评分＞48分)及轻中度病变组(Gensini评分≤48分),根据ROC曲线得出FAR预测老年疑似冠心病病人冠脉重度病变的截断点。采用Spearman相关系数评估FAR与Gensini评分的相关性,采用多因素Logistic逐步回归分析冠脉重度病变的独立危险因素。结果 FAR预测老年疑似冠心病病人冠脉重度病变的最佳临界值为0.076(AUC为0.710,灵敏度为61.1%,特异度为76.2%,P＜0.001)。FAR与Gensini评分呈正相关(r=0.440,P＜0.001)。多因素Logistic逐步回归分析显示,在老年疑似冠心病病人中,FAR＞0.076、载脂蛋白B水平高、脂蛋白(a)水平高、有糖尿病史的病人冠脉重度病变风险增加(P＜0.05),而HDL-C及LVEF水平高的病人冠脉重度病变风险降低(P＜0.05)。结论 FAR与老年疑似冠心病病人的冠脉病变程度有明确的相关性,FAR＞0.076是冠脉重度病变的独立危险因素。

关键词: 纤维蛋白原与白蛋白比值, 冠脉病变严重程度, 老年人, 预测价值

Abstract: Objective To investigate the value of fibrinogen to albumin ratio(FAR) in predicting the severity of coronary artery lesions in the elderly patients with suspected coronary artery disease(CAD). Methods Five hundred and thirty-three elderly patients with suspected CAD who underwent coronary angiography for the first time in Hebei General Hospital from January 2018 to May 2022 were selected. All patients were divided into the group with severe coronary lesions(Gensini score>48) and the group with mild to moderate lesions(Gensini score≤48) according to the Gensini score. Receiver operating characteristic (ROC) curve was used to get the cut-off point of FAR to predict severe coronary artery lesions in the elderly patients with suspected CAD. Spearman correlation analysis was used to assess the correlation between FAR and Gensini score. The risk factors for severe coronary artery lesions were analyzed by multivariate Logistic regression. Results The best cut-off value of FAR to predict severe coronary lesions in the elderly patients with suspected CAD was 0.076, with the area under the curve(AUC) of 0.710, sensitivity of 61.1%, specificity of 76.2%(P<0.001). There was a positive correlation between FAR and Gensini score(r=0.440, P<0.001). Multivariate Logistic stepwise regression analysis showed that FAR >0.076, high levels of apolipoprotein B, lipoprotein(a), and a history of diabetes were risk factors of severe CAD (P<0.05), whereas high levels of high density cholesterol(HDL-C) and left ventricular ejection fractions (LVEF) were protective factors of severe CAD (P<0.05) in the elderly patients with suspected CAD. Conclusions There is a significant correlation between FAR and the degree of CAD in the elderly patients with suspected CAD, and FAR>0.076 is an independent risk factor for severe CAD.

Key words: fibrinogen to albumin ratio, severity of coronary artery lesions, aged, predictive value

中图分类号:

R 543.31

王朝阳, 赵丽娜, 梁浩, 陈淑霞, 谷剑. 纤维蛋白原与白蛋白比值对老年疑似冠心病病人冠脉病变程度的预测价值[J]. 实用老年医学, 2023, 37(8): 806-810.

WANG Zhao-yang, ZHAO Li-na, LIANG Hao, CHEN Shu-xia, GU Jian. Predictive value of fibrinogen to albumin ratio on the severity of coronary lesions in elderly patients with suspected coronary artery disease[J]. Practical Geriatrics, 2023, 37(8): 806-810.

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