CAJ | 학술논문

目的：探讨平均血小板体积（MPV）联合纤维蛋白原（Fg）对 ACS 的预测价值，并在 ACS 患者中分析 MPV、Fg 与冠脉病变数的关系。方法2010年1月至2013年12月我院共收治胸痛、胸闷等症状住院患者432例，ACS 患者315例（ACS 组），冠脉造影阴性患者117例（对照组）。入院时检测 MPV 和 Fg，应用 ROC 曲线评估 MPV 和 Fg 单独以及两者联合对 ACS 的预测价值，比较 MPV、Fg 在不同冠脉病变数间的差异。结果MPV 和 Fg 均是 ACS 的显著预测因子（OR ＝1.32，P ＝0.00；OR ＝2.37，P ＝0.00），单独用 MPV 和 Fg 预测 ACS 曲线下面积（AUC）分别为0.63和0.70，当 MPV 与 Fg 联合时 AUC 增加到0.73；随着冠脉病变数增加，MPV 和 Fg 均显著逐渐升高。结论MPV 与 Fg 联合可以提高对 ACS 的预测价值，MPV 和 Fg 可作为 ACS 冠状动脉病变程度的预测指标。
목적：탐토평균혈소판체적（MPV）연합섬유단백원（Fg）대 ACS 적예측개치，병재 ACS 환자중분석 MPV、Fg 여관맥병변수적관계。방법2010년1월지2013년12월아원공수치흉통、흉민등증상주원환자432례，ACS 환자315례（ACS 조），관맥조영음성환자117례（대조조）。입원시검측 MPV 화 Fg，응용 ROC 곡선평고 MPV 화 Fg 단독이급량자연합대 ACS 적예측개치，비교 MPV、Fg 재불동관맥병변수간적차이。결과MPV 화 Fg 균시 ACS 적현저예측인자（OR ＝1.32，P ＝0.00；OR ＝2.37，P ＝0.00），단독용 MPV 화 Fg 예측 ACS 곡선하면적（AUC）분별위0.63화0.70，당 MPV 여 Fg 연합시 AUC 증가도0.73；수착관맥병변수증가，MPV 화 Fg 균현저축점승고。결론MPV 여 Fg 연합가이제고대 ACS 적예측개치，MPV 화 Fg 가작위 ACS 관상동맥병변정도적예측지표。
Objective To investigate whether mean platelet volume(MPV)and fibrinogen(Fg)can predict acute coronary syndrome (ACS),and investigate whether the combination of them could have a better performance in predicting ACS,lastly,to analyze the relationship of MPV and Fg with numbers of diseased coronary vessels in patients with ACS.Methods Totally 315 ACS patients and 117 control group patients with negative angiography were recruited in the study.MPV and Fg were measured on admission,respectively.The predictive value of MPV and Fg alone and the combination of them were assessed according to the application of ROC curve,respectively.The difference of MPV and Fg with different numbers of diseased vessels was compared.Results Multivariate analysis demonstrated that both MPV and Fg were sig-nificant predictors for ACS(OR =1.32,P =0.00;OR =2.37,P =0.00;respectively).The area under the ROC curve(AUC)was 0.63 and 0.70 when MPV and Fg was used alone in predicting ACS,whereas it increased to 0.73 when MPV combined with Fg;the level of MPV and Fg was significantly raised gradually with the increase of diseased vessels.Conclusion The combination of MPV with Fg could play a better role in predicting ACS,and MPV and Fg can be used as predictors for the extent of coronary artery lesion in patients with ACS.