Xiong Wei-Xin, Shen Ying, Dai Dao-Peng, Lu Lin, Zhang Qi, Zhang Rui-Yan, Shen Wei-Feng, Tao Rong
Department of Cardiology, Ruijin Hospital, Jiao Tong University School of Medicine, Shanghai 200025, China.
Chin Med J (Engl). 2015 Mar 20;128(6):727-32. doi: 10.4103/0366-6999.152465.
We investigated whether and to what extent the ratio between circulating fibrinogen (Fg) and its degradation products (FDP) reflects the severity of coronary artery disease (CAD) in type 2 diabetic patients.
Plasma levels of Fg and FDP were determined, and Fg/FDP ratio was calculated in 344 consecutive patients with type 2 diabetes and chest pain on exertion undergoing coronary angiography. The severity of CAD was evaluated by the number of significant CAD (>50% luminal diameter narrowing) and Gensini score.
Plasma Fg was higher, but Fg/FDP ratio was lower in patients with significant CAD (n = 255) compared with those without (n = 89), due to a disproportionate increase in FDP. Fg and FDP correlated positively, while Fg/FDP ratio negatively, with the number of diseased coronary arteries and the tertile of Gensini score (all P values for trend < 0.01). After adjusting for age, sex, risk factors for CAD, lipid profiles, glycosylated hemoglobin A1c, creatinine, leukocyte count, and high-sensitivity C-reactive protein, Fg/FDP ratio remained an independent determinant for multivessel coronary disease (MVD) (odds ratio [OR], 0.869; 95% confidence interval [CI], 0.788-0.958, P = 0.005) and high tertile of Gensini score (OR, 0.797, 95% CI, 0.682-0.930, P = 0.004). The area under the curve of Fg/FDP ratio was larger than that of Fg for predicting the presence of MVD (0.647 vs. 0.563, P = 0.048) and Gensini score ≥ 30 (0.656 vs. 0.538, P = 0.026).
Elevated plasma Fg and FDP level and reduced Fg/FDP ratio are associated with presence of CAD, and Fg/FDP ratio is superior to Fg in reflecting severe coronary atherosclerosis for patients with type 2 diabetes.
我们研究了循环纤维蛋白原（Fg）与其降解产物（FDP）的比值是否以及在何种程度上反映2型糖尿病患者冠状动脉疾病（CAD）的严重程度。
测定了344例因劳力性胸痛接受冠状动脉造影的2型糖尿病患者的血浆Fg和FDP水平，并计算Fg/FDP比值。通过显著CAD（管腔直径狭窄>50%）的数量和Gensini评分评估CAD的严重程度。
与无显著CAD的患者（n = 89）相比，有显著CAD的患者（n = 255）血浆Fg较高，但Fg/FDP比值较低，这是由于FDP不成比例地增加。Fg与FDP呈正相关，而Fg/FDP比值与病变冠状动脉数量和Gensini评分三分位数呈负相关（所有趋势P值<0.01）。在调整年龄、性别、CAD危险因素、血脂谱、糖化血红蛋白A1c、肌酐、白细胞计数和高敏C反应蛋白后，Fg/FDP比值仍然是多支冠状动脉疾病（MVD）（比值比[OR]，0.869；95%置信区间[CI]，0.788 - 0.958，P = 0.005）和高Gensini评分三分位数（OR，0.797，95% CI，0.682 - 0.930，P = 0.004）的独立决定因素。Fg/FDP比值曲线下面积在预测MVD存在（0.647对0.563，P = 0.048）和Gensini评分≥30（0.656对0.538，P = 0.026）方面大于Fg。
血浆Fg和FDP水平升高以及Fg/FDP比值降低与CAD的存在相关，并且在反映2型糖尿病患者严重冠状动脉粥样硬化方面，Fg/FDP比值优于Fg。
