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目的:探讨血浆D-二聚体(D-dimer,D-D)和纤维蛋白原(Fg)检测在冠心病(CHD)早期诊断中的临床价值。方法:将412例患者根据冠脉造影结果分为对照组(冠脉狭窄程度<50%)、冠脉狭窄单支组、双支组和多支组(冠脉狭窄程度≥50%)。另外根据入院诊断分为对照(NC)、稳定性心绞痛(SAP)、不稳定性心绞痛(UAP)和急性心肌梗死(AMI)组。所有患者均测定D-D及Fg浓度,并比较各组差异。结果:AMI组D-D、Fg及肌酸激酶同工酶(CK-MB)明显高于NC组(P<0.05),AMI组Fg及CK-MB明显高于SAP、UAP组(P<0.05)。多支组D-D、Fg及CK-MB明显高于对照组、单支组(P<0.05),双支组Fg明显高于单支组(P<0.05),多支组CK-MB明显高于双支组(P<0.05)。D-D、Fg和CK-MB的曲线下面积(AUC)分别为0.612、0.589、0.692。结论:D-D、Fg和CK-MB水平检测有助于CHD的分型诊断,且与冠状动脉病变程度相关。
Objective: To investigate the clinical value of plasma D-dimer (D-D) and fibrinogen (Fg) in the early diagnosis of coronary heart disease (CHD). Methods: According to the results of coronary angiography, 412 patients were divided into control group (coronary stenosis <50%), coronary artery stenosis group, double branch group and multiple branch group (coronary stenosis≥50%). In addition, according to admission diagnosis is divided into control (NC), stable angina (SAP), unstable angina (UAP) and acute myocardial infarction (AMI) group. All patients were measured D-D and Fg concentrations, and compare the differences between groups. Results: The D-D, Fg and CK-MB in AMI group were significantly higher than those in NC group (P <0.05). The Fg and CK-MB in AMI group were significantly higher than those in SAP and UAP group (P <0.05). The DD, Fg and CK-MB in multi-branch group were significantly higher than those in control group and single branch group (P <0.05). Fg in double branch group was significantly higher than that in single branch group (P <0.05) Double support group (P <0.05). The area under the curve (AUC) of D-D, Fg and CK-MB were 0.612, 0.589 and 0.692, respectively. Conclusion: The detection of D-D, Fg and CK-MB levels is helpful for the diagnosis of CHD and is related to the severity of coronary artery disease.