FAR 和 MPVPCR 与冠心病的相关性研究及诊断价值

张 桂彬, 赵 亚楠, 魏 宇涵, 吴 雨晴, 扈 家源, 董 博华, 包 乐, 杨 文琦
华北理工大学附属医院心内科 河北唐山 063000

摘要

目的：探讨纤维蛋白原/白蛋白比值(FAR)和平均血小板体积/血小板(MPVPCR)与冠心病相关性及诊断价值。方法：选择 2022 年 3 月-2022 年 9 月在河北省唐山市华北理工大学附属医院接受冠状动脉造影术患者 142 名，根据冠状动脉造影结果分为冠心病组(71 名)和对照组(71 名)。比较冠心病组与对照组间临床指标及实验室指标，将有统计学差异的指标纳入多因素 logistic 回归分析探讨冠心病的独立危险因素，再通过绘制 ROC 曲线确定 FAR、MPVPCR 及两者联合作用对冠心病的诊断价值。结果：冠心病组男性比例、有糖尿病、有吸烟、中性粒细胞(NE)、白细胞(WBC)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、甘油三酯(TG)、FAR、MPVPCR 较对照组高，高密度脂蛋白(HDL)、左室射血分数(LVEF)较对照组低，差异有统计学意义(P＜0.05)；多因素 logistic 回归分析显示糖尿病(OR=7.397,P＜0.01)、FAR×100(OR=33.456,P＜0.001)、MPVLR×100(OR=18.616,P＜0.001)是冠心病独立危险因素；FAR、MPVPCR 及两者联合预测诊断冠心病的曲线下面积(AUC)及其95%CI 分别为 0.855(0.792~0.918)、0.750(0.670~0.831)、0.904(0.852~0.955),二者联合预测冠心病的曲线下面积高于单个指标，差异有统计学意义(P＜0.05)。结论：FAR、MPVPCR 是冠心病独立危险因素，两者均可以预测冠心病的发生，且两者联合预测大于单个指标。

关键词

关键词：纤维蛋白原；白蛋白；平均血小板体积；血小板；冠心病

参考

[1]王杨淦,梁芳.老年冠心病慢病管理指南[J].中西医结合研究,2023,15(01):30-42. [2]《中国心血管健康与疾病报告 2021》要点解读[J].中国心血管杂志,2022,27(04):305-318. [3]Li M, Tang C, Luo E,et al. Relation of Fibrinogen-to-Albumin Ratio to Severity of Coronary Artery Disease and Long-Term Prognosis in Patients with Non-ST Elevation Acute Coronary Syndrome. Biomed Res Int. 2020 Aug 17;2020:1860268. [4]Sinha A, Rivera AS, Chadha SA,et al. Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases. Front Cardiovasc Med. 2021 Nov 10;8:757738. [5]Gao XY, Zhou BY, Zhang MZ,et al.Association between fibrinogen level and the severity of coronary stenosis in 418 male patients with myocardial infarction younger than 35 years old. Oncotarget. 2017 Jun 20;8(46):81361-81368. [6]Undas A, Zabczyk M. Antithrombotic medications and their impact on fibrin clot structure and function. J Physiol Pharmacol. 2018 Aug;69(4). [7]Zhang K, Li J, Wang Y,et al. Hydroxybutyl chitosan/diatom-biosilica composite sponge for hemorrhage control. Carbohydr Polym. 2020 May 15;236:116051. [8]Hwang KT, Chung JK, Roh EY,et al. Prognostic Influence of Preoperative Fibrinogen to Albumin Ratio for Breast Cancer. J Breast Cancer. 2017 Sep;20(3):254-263. [9]Karahan O, Acet H, Ertaş F,et al.The relationship between fibrinogen to albumin ratio and severity of coronary artery disease in patients with STEMI. Am J Emerg Med. 2016 Jun;34(6):1037-42. [10]赵一品.Value of fibrinogen to albumin ratio on predicting spontaneous recanalization of infarct-related artery in patients with acute ST-segment elevation myocardial infarctionl[J].China Medical Abstracts(Internal Medicine),2019,36(02):88-89. [11]Song L, Chen RZ, Zhao XX,et al.Mean Platelet Volume/Platelet Count Ratio and Culprit Plaque Morphologies: An Optical Coherence Tomography Study in Patients with ST Segment Elevation Myocardial Infarction. J Cardiovasc Transl Res. 2021 Dec;14(6):1093-1103. [12]Pusuroglu H, Cizgici AY, Demir AR, ,et al. Long-Term Prognostic Value of Mean Platelet Volume in Patients with Hypertension. Acta Cardiol Sin. 2021 Sep;37(5):504-511. [13]徐涛良,夏梦远,倪润泽.纤维蛋白原/白蛋白比值和平均血小板体积与冠状动脉病变程度的相关性研究[J].中国心血管病研究,2022,20(11):967-972. [14]Gozdas HT, Ince N. Elevated mean platelet volume to platelet ratio predicts advanced fibrosis in chronic hepatitis C. Eur J Gastroenterol Hepatol. 2020 Apr;32(4):524-527. [15]Ham SY, Yoon HJ, Nam SB,et al. Prognostic value of neutrophil/lymphocyte ratio and mean platelet volume/platelet ratio for 1-year mortality in critically ill patients. Sci Rep. 2020 Dec 9;10(1):21513. [16]Tian C, Song J, He D, et al. Predictive Value of Mean Platelet Volume/Platelet Count for Prognosis in Acute Myocardial Infarction. Int Heart J. 2018 Mar 30;59(2):286-292. [17]Ösken A, Hacı R, Dinç Asarcıklı L, et al. Mean platelet volume/platelet count ratio as a predictor of stent thrombosis in patients with ST-segment-elevation myocardial infarction. Ir J Med Sci. 2021 Aug;190(3):1095-1102. [18]Tüysüz ME, Dedemoğlu M. High mean platelet volume to platelet count ratio as a predictor on poor outcomes after CABG. Gen Thorac Cardiovasc Surg. 2020 May;68(5):459-466. [19]中华医学会心血管病分会介入心脏病学组、中国医师协会心血管内科医师分会、血栓防治专业委员会和中华心血管病杂志编辑委员会稳定性冠心病诊断和治疗指南[J]。中华心血管病杂志，2018,46(9):680-694 [20]Tayefi M, Tajfard M, Saffar S, et al. hs-CRP is strongly associated with coronary heart disease (CHD): A data mining approach using decision tree algorithm. Comput Methods Programs Biomed. 2017 Apr;141:105-109. [21]Zhang DP, Mao XF, Wu TT, et al.The Fibrinogen-to-Albumin Ratio Is Associated With Outcomes in Patients With Coronary Artery Disease Who Underwent Percutaneous Coronary Intervention. Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620933008. [22]Mulvihill JN, Faradji A, Oberling F, et al. Surface passivation by human albumin of plasmapheresis circuits reduces platelet accumulation and thrombus formation. Experimental and clinical studies. J Biomed Mater Res. 1990 Feb;24(2):155-63. [23]An Q, Liu W, Yang Y, et al. Preoperative fibrinogen-to-albumin ratio, a potential prognostic factor for patients with stage IB-IIA cervical cancer. BMC Cancer. 2020 Jul 25;20(1):691. [24] Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004 Nov-Dec;17(6):432-7. [25]Tekin YK, Engin A. An Evaluation of the Different Serum Markers Associated with Mortality in Crimean-Congo Hemorrhagic Fever. Rambam Maimonides Med J. 2020 Oct 14;11(4):e0032. [26]Iida H, Kaibori M, Matsui K, et al.Ratio of mean platelet volume to platelet count is a potential surrogate marker predicting liver cirrhosis. World J Hepatol. 2018 Jan 27;10(1):82-87. [27]Djordjevic D, Rondovic G, Surbatovic M, et al.Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume-to-Platelet Count Ratio as Biomarkers in Critically Ill and Injured Patients: Which Ratio to Choose to Predict Outcome and Nature of Bacteremia? Mediators Inflamm. 2018 Jul 15;2018:3758068. [28]Tekin YK, Tekin G. Mean Platelet Volume-to-Platelet Count Ratio, Mean Platelet Volume-to-Lymphocyte Ratio, and Red Blood Cell Distribution Width-Platelet Count Ratio as Markers of Inflammation in Patients with Ascending Thoracic Aortic Aneurysm. Braz J Cardiovasc Surg. 2020 Apr 1;35(2):175-180. [29]朱海燕,胡玲玲,王静.纤维蛋白原/白蛋白比值对于冠心病患者的诊断价值及其与冠状动脉病变严重程度的相关性[J].中国卫生检验杂志,2021,31(10):1219-1222+1225. [30]刘舒予,于复超,魏芹.纤维蛋白原/白蛋白比值与冠脉病变严重程度的相关性分析及其临床应用价值[J].解放军医学院学报,2022,43(05):558-562+569. 第一作者：姓名：张桂彬，性别：男，民族：汉族，出生年月：1997 年 10 月，籍贯：河北省霸州市，学历：在读硕士研究生，专业：内科学（临床医学） 通讯作者：姓名：杨文琦，性别：女，民族：汉族，出生年月：1972 年 06 月，籍贯：河北省沧州市，学历：博士研究生，专业：心血管内科