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目的研究血浆凝血因子水平与低年龄段(<60岁)急性心肌梗死的关系及其诊断低年龄段急性心肌梗死的价值。方法选择在山东省菏泽市立医院心内科住院就诊的160例低年龄段急性心肌梗死患者作为观察组,160例同期住院就诊的低年龄段非急性心肌梗死患者作为对照组。采用酶联免疫双抗夹心法检测其血浆凝血酶原(FⅡ)、促凝血酶原激酶原(FⅦ)、血友病因子Ⅷ(FⅧ)、纤维蛋白原(Fg)和血管性血友病因子(vWF)的水平,通过单因素和多因素分析研究凝血因子与低年龄段急性心肌梗死的关系,并通过诊断试验评价与受试者工作特征曲线(ROC)分析其诊断低年龄段急性心肌梗死的价值。结果单因素分析显示,FⅡ、FⅦ、FⅧ和Fg的水平在观察组和对照组之间比较差异有统计学意义(P<0.05),vWF的水平比较差异无统计学意义(P>0.05)。多因素分析显示,FⅡ≥14.27μg/L和Fg≥22.99μg/L是低年龄段急性心肌梗死的独立危险因素;通过FⅡ的水平诊断低年龄段急性心肌梗死的价值较低,而通过Fg的水平诊断低年龄段急性心肌梗死的最佳截断值为22.99μg/L,其ROC曲线下面积为0.709,诊断价值中等,灵敏度(91.88%)和阴性预测值较高(86.02%),假阴性率较低(13.98%),正确率尚可(70.94%)。结论凝血因子FⅡ≥14.27μg/L和Fg≥22.99μg/L是低年龄段急性心肌梗死的独立危险因素,检测Fg的水平有可能对诊断低年龄段急性心肌梗死具有提示意义。
Objective To investigate the relationship between plasma clotting factor levels and acute myocardial infarction in low age group (<60 years old) and its value in diagnosing acute myocardial infarction in lower age group. Methods A total of 160 low-age acute myocardial infarction patients admitted to Department of Cardiology, Heze Municipal Hospital of Shandong Province, were selected as the observation group and 160 low-age non-acute myocardial infarction patients hospitalized during the same period as the control group. The plasma levels of prothrombin (FⅡ), prothromboplastin (FⅦ), hemophilia FⅧ, fibrinogen (Fg) and von Willebrand factor (vWF), the relationship between clotting factor and acute myocardial infarction in the lower age group was studied by univariate and multivariate analysis, and the diagnosis of acute myocardial infarction in the lower age group by diagnostic test evaluation and receiver operating characteristic curve (ROC) the value of. Results Univariate analysis showed that the levels of FⅡ, FⅦ, FⅧ and Fg were significantly different between the observation group and the control group (P <0.05). There was no significant difference in the levels of vWF between the two groups (P> 0.05). Multivariate analysis showed that FⅡ≥14.27μg / L and Fg≥22.99μg / L were independent risk factors for acute myocardial infarction in the lower age group. The value of FⅡ for the diagnosis of acute myocardial infarction in lower age group was lower, but Fg The best cut-off value of low-level acute myocardial infarction was 22.99 μg / L, and the area under ROC curve was 0.709. The diagnostic value was moderate, the sensitivity was 91.88% and the negative predictive value was 86.02% Lower (13.98%), the correct rate was acceptable (70.94%). Conclusion FⅡ≥14.27μg / L and Fg≥22.99μg / L are independent risk factors for acute myocardial infarction in the lower age group. Detecting the level of Fg may have implications for the diagnosis of acute myocardial infarction in the lower age group.