ACS患者血浆纤维蛋白原与冠状动脉病变严重程度的关系

Objective: To explore the relationship between the plasma fibrinogen(FIB) level and the severity of coronary artery disease in acute coronary syndrome(ACS) patients.Methods: The 1106 patients with ACS(case group) and 294 patients with normal coronary angiography(control group) were selected in the study. The severity of coronary artery was evaluated by Gensini score and the number of coronary artery stenosis. The plasma FIB was detected by Von Clauss method. According to the FIB level, they were divided into T1 group(FIB≤2.83 g/L), T2 group(2.83 g/LResults:① The plasma FIB level of patients in the case group was significantly higher than that of the control group(3.28±1.02) g/L vs.(2.98±0.65) g/L, P<0.01.② Gensini score in T3 group>T2 group>T1 group(all P<0.05), the number of coronary artery lesions in T3 group was significantly more than that in T2 and T1 groups(2.27±0.82) vs.(2.05±0.84),(2.27±0.82) vs.(1.94± 0.86) respectively, both P<0.05, the proportion of patients with coronary stenosis≥75% in the T3 and T2 groups was significantly higher than that in the T1 group[82.6% vs. 69.8%, 78.7% vs. 69.8% respectively, both P<0.05];③ The FIB level of the three-vessel lesion group>the double-vessel lesion group>the single-vessel lesion group(all P<0.05). The FIB level of the severe stenosis group>the moderate stenosis group>the mild stenosis group(all P<0.05). The FIB levels of the STEMI group and the NSTEMI group were significantly higher than that of the UA group[(3.47±1.56) g/L vs.(3.15±0.71) g/L,(3.51±0.96) g/L vs.(3.15±0.71) g/L, respectively, both P<0.01).(4) Spearman's correlation analysis showed that plasma FIB level in ACS patients was correlated with Gensini score(rs=0.201, P<0.001) and the number of coronary artery lesions(rs=0.171, P<0.001) positively. Multivariate Logistic regression analysis, after adjusting for confounders, showed that FIB was one of the risk factors for the high Gensini score of coronary lesions in patients with ACS(OR=1.38, 95%CI1.20-1.60, P<0.001).Conclusion: The level of plasma FIB in ACS patients was positively correlated with Gensini score and the number of coronary lesions. Plasma FIB was one of the risk factors for evaluating the severity of coronary lesions.