纤维蛋白原与白蛋白比值对NSTE-ACS患者院内发生主要心脏不良事件的预测价值

doi:10.3969/j.issn.1007-3205.2021.03.003

河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (3): 262-267.doi: 10.3969/j.issn.1007-3205.2021.03.003

纤维蛋白原与白蛋白比值对NSTE-ACS患者院内发生主要心脏不良事件的预测价值

1.甘肃省人民医院心内二科，甘肃兰州 730000；2.甘肃中医药大学研究生院，甘肃兰州 730000

出版日期:2021-03-25 发布日期:2021-04-01
作者简介:石磊（1994-），男，甘肃陇南人，甘肃省人民医院医学硕士研究生，从事冠心病诊治研究。
基金资助:
甘肃省卫生行业科研行动计划项目（GSWSKY2016-02）

The predictive value of fibrinogen-albumin ratio in major cardiac adverse events in NSTE-ACS patients

1.The Second Department of Cardiology, Gansu Provincial People′s Hospital, Gansu Province, Lanzhou
730000, China； 2.Graduate School of Gansu University of Traditional Chinese Medicine,
Gansu Province, Lanzhou 730000, China

Online:2021-03-25 Published:2021-04-01

摘要/Abstract

摘要： 目的探讨纤维蛋白原/白蛋白比值（fibrinogen to albumin ratio，FAR）对非ST段抬高型急性冠状动脉综合征（non-ST segment elevation acute coronary syndrome，NSTE-ACS）患者院内发生主要不良心脏事件(major adverse cardiac events,MACEs)的预测价值。
方法回顾性收集284例NSTE-ACS患者的临床资料。根据入院FAR值采用三分位数法分为FAR低分组（FAR≤8.0）94例, FAR中分组（FAR>8.0~9.6）101例，FAR高分组（FAR>9.6）89例。比较3组一般资料［性别、年龄、静息心率、糖尿病、高血压病史、体重指数(body mass index,BMI)］、实验室指标［血肌酐、空腹血糖、肌钙蛋白(troponin I,TnI)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、谷氨酸转氨酶(alanine aminotransferase，ALT)、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol，TC)、高密度脂蛋白胆固醇（high density liptein cholesterol，HDL-C）、低密度脂蛋白胆固醇（low density liptein cholesterol，HDL-C）］、左心室射血分数（left ventricular ejection fractions，LVEF）、Gensini评分、Grace评分、MACEs发生情况。应用Logistic多因素回归分析NSTE-ACS患者院内发生MACEs的影响因素，ROC曲线分析FAR对NSTE-ACS患者院内发生MACEs的预测价值。
结果 FAR高分组男性比例、BMI、TnI、AST、Gensini评分均显著高于FAR中分组和FAR低分组，LVEF低于FAR中分组和FAR低分组；而FAR中分组男性比例、BMI、TnI、AST、Gensini评分均显著高于FAR低分组，LVEF低于FAR低分组，差异有统计学意义( P＜0.05)。FAR高分组院内MACEs总发生率著高于FAR中分组和FAR低分组，FAR中分组院内MACEs总发生率著高于FAR低分组，差异有统计学意义( P＜0.05)。多因素Logistic回归分析显示,Gensin评分、FAR是NSTE-ACS患者院内发生MACEs的影响因素。ROC曲线结果显示，FAR预测NSTE-ACS患者院内发生MACEs的曲线下面积为0.725，敏感度为64.3%，特异度为83.1%。
结论 FAR、Gensin评分是NSTE-ACS患者发生MACEs独立危险因素，为其提供了新的早期预测指标。

关键词: 急性冠状动脉综合征, 纤维蛋白原, 白蛋白类

Abstract: Objective To investigate the predictive value of fibrinogen to albumin ratio(FAR) in major adverse cardiac events(MACEs) in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)during hospitalization.
Methods The clinical data of 284 patients with NSTE-ACS were collected retrospectively. According to the FAR at admission, they were divided into low FAR group(FAR≤8.0, n=94), medium FAR group(FAR＞8.0-9.6, n=101), and high FAR group(FAR＞9.6, n=89)using tertile method. The general data ［gender, age, resting heart rate, history of diabetesand hypertension, body mass index (BMI)］, laboratory indicators［serum creatinine(SCr), fasting blood glucose(FBG), troponin I(TnI), aspartate aminotransferase(AST), alanine aminotransferase(ALT), triglyceride(TG), total cholesterol (TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C)］, left ventricular ejection fractions(LVEF), Gensini score, Grace score, and MACEs occurrence in three groups were compared. Logistic multivariate regression analysis was used to analyze the influencing factors of MACEs during hospitalization in NSTE-ACS patients, and ROC curve was used to analyze the predictive value of FAR in MACEs during hospitalization in patients with NSTE-ACS.
Results Male proportion, BMI, TnI, AST, and Gensin scores were significantly higher in high FAR group than in medium and low FAR groups, and LVEF was significantly lower than medium and low FAR groups. Male proportion, BMI, TnI, AST, and Gensin scores were significantly higher and LVEF was significantly lower in medium FAR group than in low FAR group, with significant difference(P＜0.05). The total incidence of MACEs during hospitalization in high FAR group was higher than that of medium and low FAR groups. The total incidence of MACEs in medium FAR group was significantly higher than that of low FAR group, and the difference was statistically significant(P＜0.05). Multivariate Logistic regression analysis showed that Gensin score and FAR are influencing factors of occurrence of MACEs during hospitalzation in NSTE-ACS patients. ROC curve results showed that the area under the curve(AUC) of FAR in predicting MACEs during hospitalization in NSTE-ACS patients was 0.725, with a sensitivity of 64.3% and a specificity of 83.1%.
Conclusion FAR and Gensin scores are independent risk factors for the occurrence of MACEs, which provide new early predictors for NSTE-ACS patients.

Key words: acute coronary syndrome, fibrinogen, albumins

石磊, 李万鹏, 安军钰, 姬旺龙, 曹云山, 黄晏. 纤维蛋白原与白蛋白比值对NSTE-ACS患者院内发生主要心脏不良事件的预测价值[J]. 河北医科大学学报, 2021, 42(3): 262-267.

SHI Lei, LI Wan-peng, AN Jun-yu, JI Wang-long, CAO Yun-shan, HUANG Yan. The predictive value of fibrinogen-albumin ratio in major cardiac adverse events in NSTE-ACS patients[J]. Journal of Hebei Medical University, 2021, 42(3): 262-267.

[1]	陈莉, 任玉艳, 韩凌, 张宝亮. 白蛋白与纤维蛋白原比值对乳腺癌预后的影响 [J]. 河北医科大学学报, 2022, 43(12): 1423-1427.
[2]	强钰伟, 郝明辉, 郭明. ACS患者PCI后外周血单个核细胞中miR-326水平变化及意义[J]. 河北医科大学学报, 2021, 42(5): 509-513,530.
[3]	李影, 刘苗苗, 何严璐琦, 张洪珍. 治疗前系统免疫-炎症指数、纤维蛋白原对非小细胞肺癌预后的评估价值[J]. 河北医科大学学报, 2021, 42(5): 514-519.
[4]	吴婷婷1，曹秋梅1，唐俊楠2*. 2型糖尿病及非糖尿病患者的RDW与ACS冠状动脉病变严重程度的相关性分析[J]. 河北医科大学学报, 2020, 41(9): 1003-1006.
[5]	杨威威，孙锡红，秦丽，刘晓艳，张蕾，董欣. 产前低水平纤维蛋白原联合血栓弹力图检测与产后出血的相关性研究[J]. 河北医科大学学报, 2020, 41(1): 109-113.
[6]	熊〓英，马宏莲，罗红霞*. 卡前列素氨丁三醇在产后出血者中的临床效果及对FIB、DD水平的影响[J]. 河北医科大学学报, 2019, 40(7): 807-809，814.
[7]	刘〓伟1，邢新杰2，张晨峰1，宋〓达3，张〓明4，韩〓刚5. 不同类型急性冠状动脉综合征患者心率变异性的差异研究[J]. 河北医科大学学报, 2019, 40(5): 508-511.
[8]	刘建峰1，武〓艺2，郝〓鹏3，罗鸿宇4，华〓琦4*. 中性粒细胞淋巴细胞比值与急性冠状动脉综合征患者左心室收缩功能不全的相关性分析[J]. 河北医科大学学报, 2016, 37(9): 997-1000,1009.
[9]	张世阳 1,赵旭兰 1*,梁芳 1,范亚坤 1,杨磊 2,吕新湖 3. 老年急性冠状动脉综合征冠状动脉支架内再狭窄与非再狭窄患者脂蛋白a、尿微量白蛋白分析[J]. 河北医科大学学报, 2016, 37(2): 191-193.
[10]	曹辉彩1，赵家慧2，陈妹红3*，靳丽亚1，王之秀1，陈翼霖1. 酶法检测糖化白蛋白的性能验证及其在2型糖尿病患者中的临床应用价值[J]. 河北医科大学学报, 2016, 37(11): 1350-1353.
[11]	邹继红. 脑钠肽、和肽素和高敏C反应蛋白与急性冠状动脉综合征的相关性研究[J]. , 2015, 36(6): 688-688.
[12]	陈雪梅;顾明霞. 80岁以上高龄老人血压变异性与尿微量白蛋白关系探讨[J]. , 2015, 36(5): 513-513.
[13]	牛艳慧;王晓静;邵丽娇;靳红玲. 血清蛋白对重症慢性阻塞性肺疾病患者预后的预测价值[J]. , 2015, 36(4): 377-377.
[14]	赵召霞;高虹;徐运强;刘蓓;王荣霞;潘世扬. 高血压性脑出血患者血浆循环DNA与纤维蛋白原相关性研究[J]. , 2013, 34(3): 253-253.
[15]	徐方艳. 骨折患者血浆纤维蛋白原和D-二聚体联合检测的临床意义[J]. , 2013, 34(1): 44-44.

纤维蛋白原与白蛋白比值对NSTE-ACS患者院内发生主要心脏不良事件的预测价值

The predictive value of fibrinogen-albumin ratio in major cardiac adverse events in NSTE-ACS patients

HTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价