纤维蛋白原与冠心病PCI介入治疗围术期心肌梗死的相关性

目的:探讨纤维蛋白原与冠心病介入治疗围术期心肌梗死的相关性。方法:2013年1月到2015年1月,选择在我院进行诊治的冠心病患者92例,都给予PCI介入手术治疗,在手术前后进行纤维蛋白原与心功能的测定,对围术期心肌梗死发生情况与临床资料进行调查与分析。结果:所有患者都介入手术治疗成功,术后LVESVI与LVEDVI值都明显低于术前(P0.05),而术后LVEF值明显高于术前(P0.05);术后患者的血浆纤维蛋白原值为3.66±0.42 g/L,明显低于术前的7.45±0.56 g/L(P0.05)。围手术期发生心肌梗死8例,发生率为8.7%。Spearman秩相关分析法结果显示心肌梗死发病与血浆纤维蛋白原、LVESVI、LVEDVI、LVEF值都存在明显相关性(P0.05),多元Logistic回归分析结果显示纤维蛋白原、LVESVI、LVEDVI、LVEF、年龄为导致冠心病围术期心肌梗死的主要危险因素(P0.05)。结论:介入手术治疗冠心病具有很好的效果,但是围术期心肌梗死的发生率比较高,纤维蛋白原能有效反应病变状况,在心肌梗死的发生发展中起着关键性作用。

The Correlation Analysis of Fibrinogen and Perioperative Myocardial Infarction following PCI in Patients with Coronary Heart Disease

Objective:To investigate the correlation between plasma fibrinogen and perioperative myocardial infarction following percutaneous coronary intervention (PCI) in patients with coronary heart disease.Methods:From January 2013 to January 2015, 92 patients with coronary artery disease from our hospital were selected and were given PCI, perioperative plasma fibrinogen level and cardiac function were examined, incidence of perioperative myocardial infarction and clinical data were investigated and analyzed.Results:PCI is successful in all the patients. The postoperative LVESVI and LVEDVI values were significantly lower than the preoperative values (P <0.05), and the postoperative LVEF values were significantly higher than the preoperative values (P <0.05); The postoperative plasma fibrinogen level was 3.66 ± 0.42 g/L, which was significantly lower than the preoperative value 7.45 ± 0.56 g/L (P <0.05). 8 patients developed a perioperative myocardial infarction, the incidence rate was 8.7%. Spearman rank correlation analysis showed that the incidence rate of myocardial infarction correlated with the plasma fibrinogen level, LVESVI, LVEDVI, LVEF values (P <0.05). Multivariate logistic regression analysis showed the plasma fibrinogen level, LVESVI, LVEDVI, LVEF and age were the main risk factors for perioperative myocardial infarction in patients with coronary heart disease (P <0.05).Conclusion:The PCI surgical treatment of coronary heart disease has good effects, but the incidence of perioperative myocardial infarction is relatively high. The plasma fibrinogen level can reflect the development of perioperative myocardial infarction and may play a key role in the development of this disease.