Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
Thromb Haemost. 2012 May;107(5):895-902. doi: 10.1160/TH11-10-0703. Epub 2012 Mar 8.
Elevated fibrinogen levels are strongly and consistently associated with incident coronary heart disease (CHD). A possible causal contribution of fibrinogen in the pathway leading to atherothrombotic cardiovascular disease complications has been suggested. However, for implementation in clinical practice, data on validity and reliability, which are still scarce, are needed that are still scarce, especially in subjects with a history of CHD. For the present study, levels of plasma fibrinogen were measured in 200 post-myocardial infarction (post-MI) patients aged 39-76 years, with approximately six blood samples collected at monthly intervals between May 2003 and March 2004, giving a total of 1,144 samples. Inter-individual variability (between-subject variance component, VCb and coefficient of variation, CVb), intra-individual and analytical variability (VCw+a and CVw+a), intraclass correlation coefficient (ICC) and the number of measurements required for an ICC of 0.75 were estimated to assess the reliability of serial fibrinogen measurements. Mean fibrinogen concentration of all subjects over all samples was 3.34 g/l (standard deviation 0.67). Between-subject variation for fibrinogen was VCb = 0.34 (CVb'=17.5%) whereas within-subject and analytical variation was estimated as VCw+a = 0.14 (CVw+a=11.0%). The variation was mainly explained by between-subject variability, shown by the proportion of total variance of 71.3%. Two different measurements were required to reach sufficient reliability, if subjects with extreme values were not excluded. The present study indicates a fairly good reproducibility of serial individual fibrinogen measurements in post-MI subjects.
纤维蛋白原水平升高与冠心病（CHD）的发生密切相关。有人提出，纤维蛋白原可能在导致动脉粥样硬化血栓形成性心血管疾病并发症的途径中起因果作用。然而，为了将其应用于临床实践，仍需要更多有关有效性和可靠性的数据，这些数据在有 CHD 病史的患者中仍然稀缺。在本研究中，测量了 200 名年龄在 39-76 岁的心肌梗死后（post-MI）患者的血浆纤维蛋白原水平，大约每月采集一次血样，共采集了 1144 份样本。在 2003 年 5 月至 2004 年 3 月期间收集，个体间变异性（个体间方差分量 Vcb 和变异系数 CVb）、个体内和分析变异性（个体内方差分量 VCw+a 和变异系数 CVw+a）、组内相关系数（ICC）和达到 ICC 为 0.75 的所需测量次数来评估连续纤维蛋白原测量的可靠性。所有样本中所有受试者的平均纤维蛋白原浓度为 3.34g/l（标准差 0.67）。纤维蛋白原的个体间变异性为 Vcb=0.34（CVb'=17.5%），而个体内和分析变异性估计为 VCw+a=0.14（CVw+a=11.0%）。这种变异性主要由个体间变异性解释，总方差的比例为 71.3%。如果不排除极端值的受试者，则需要两次不同的测量才能达到足够的可靠性。本研究表明，心肌梗死后患者的连续个体纤维蛋白原测量具有相当好的可重复性。
