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目的探讨血浆纤维蛋白原、血尿酸、脂蛋白(α)与冠脉病变的关系及意义。方法检测254例冠心病患者与64例对照组(非冠心病患者)血浆中纤维蛋白原、血尿酸、脂蛋白(α)。并于入院后2～7d对冠心病患者进行冠脉造影,采用Gensini冠脉评分系统将冠心病患者分为冠脉轻度病变组(A组)(<20分)、冠脉重度病变组(B组)(20～40分)和冠脉极重度病变组(C组)(>40分);同时根据临床分为心肌梗死组和不稳定心绞痛组。结果与对照组相比,A、B、C3组年龄、纤维蛋白原、血尿酸、脂蛋白(α)差异有统计学意义(P<0.01);B、C组与A组在纤维蛋白原、尿酸水平上有明显差异(P<0.05);C组与A、B2组脂蛋白(α)差异有统计学意义(P<0.05)。急性心肌梗死组血浆纤维蛋白原、脂蛋白(α)均高于不稳定型心绞痛组,差异具有统计学意义(P<0.01)。冠心病组血浆纤维蛋白原与血尿酸,血浆纤维蛋白原与脂蛋白(α)之间均无相关性(P>0.05),但血尿酸与脂蛋白(α)之间存在相关性(P<0.05)。结论冠心病患者有更高水平的血浆纤维蛋白原、血尿酸、脂蛋白(α),其水平与冠脉病变严重程度相关。血浆纤维蛋白原为冠心病的独立危险因素,血尿酸对冠心病的致病作用可能与血脂改变有关。
Objective To investigate the relationship between plasma fibrinogen, serum uric acid and lipoprotein (α) and coronary artery disease. Methods Plasma levels of fibrinogen, serum uric acid and lipoprotein (α) were measured in 254 patients with coronary heart disease and 64 healthy controls (non-patients with coronary heart disease). Coronary angiography was performed in patients with coronary heart disease 2 ~ 7 days after admission. Patients with coronary artery disease were divided into mild coronary lesion group (group A) (<20 points), severe coronary artery disease group (group C) Group B) (20-40 points) and severe coronary disease group (Group C) (> 40 points). At the same time, they were divided into myocardial infarction group and unstable angina group according to the clinical data. Results Compared with the control group, there were significant differences in age, fibrinogen, serum uric acid, and lipoprotein (α) between groups A, B and C3 (P <0.01) The level of uric acid was significantly different (P <0.05). The difference of lipoprotein (α) between group C and groups A and B2 was statistically significant (P <0.05). The plasma levels of fibrinogen and lipoprotein (α) in AMI group were significantly higher than those in unstable angina pectoris group (P <0.01). There was no correlation between plasma fibrinogen and serum uric acid, plasma fibrinogen and lipoprotein (α) in coronary heart disease group (P> 0.05), but there was a correlation between serum uric acid and lipoprotein (α) (P < 0.05). Conclusions Patients with coronary heart disease have higher levels of plasma fibrinogen, serum uric acid and lipoprotein (α), which are correlated with the severity of coronary artery disease. Plasma fibrinogen as an independent risk factor for coronary heart disease, serum uric acid on the pathogenesis of coronary heart disease may be related to changes in blood lipids.