CAJ | 학술논문

目的：探讨冠心病患者超重、肥胖与血栓前状态标志物之间的相关性。方法：选择2013～2014年来院就诊的，经冠脉造影确诊为冠心病（CHD）的288名患者，根据BMI被分为CHD对照组（106例）、超重组（121例）和肥胖组（61例），对比三组患者的血栓前状态标志物：纤维蛋白原（Fg）、血浆D-二聚体（D-D），血管假性血友病因子（vWF），抗凝血酶Ⅲ（AT-III），纤溶酶原激活物抑制剂-1（PAI-1）水平的差别，并进行相关性分析。结果：与CHD对照组比较，超重和肥胖组的患者血甘油三酯（TG）、总胆固醇（TC）、空腹血糖、平均动脉压水平，高血压和糖尿病患病率均显著升高（P＜0.05或＜0.01）。与CHD对照组相比，超重和肥胖组Fg [（2.89±0.60） g／L比（3.54±0.63） g／L比（3.92±0.94） g／L]，D-D [（282.13±73.15） ng／ml比（390.04±73.54） ng／ml比（471.92±80.38） ng／ml]，vWF [（108.62±24.66）％比（138.45±25.96）％比（161.20±29.39）％]和 PAI-1[（6.97±1.28） ng／ml比（9.60±1.73） ng／ml比（12.33±2.16） ng／ml]水平均显著升高（P均＜0.01），且肥胖组的显著高于超重组的（P＜0.01或＜0.05）；肥胖组的AT-III水平[（89.94±17.99）％比（69.89±20.22）％]显著下降（P＜0.05）。Pearson相关分析显示：BMI和血栓前标志物呈显著正相关（FIB：r＝0.536， P＜0.001；D-D：r＝0.250， P＜0.001；vWF：r＝0.611， P＜0.001；PAI-1：r＝0.788， P＜0.001）。结论：在冠心病患者BMI与血栓前状态标志物呈正相关关系。
목적：탐토관심병환자초중、비반여혈전전상태표지물지간적상관성。방법：선택2013～2014년래원취진적，경관맥조영학진위관심병（CHD）적288명환자，근거BMI피분위CHD대조조（106례）、초중조（121례）화비반조（61례），대비삼조환자적혈전전상태표지물：섬유단백원（Fg）、혈장D-이취체（D-D），혈관가성혈우병인자（vWF），항응혈매Ⅲ（AT-III），섬용매원격활물억제제-1（PAI-1）수평적차별，병진행상관성분석。결과：여CHD대조조비교，초중화비반조적환자혈감유삼지（TG）、총담고순（TC）、공복혈당、평균동맥압수평，고혈압화당뇨병환병솔균현저승고（P＜0.05혹＜0.01）。여CHD대조조상비，초중화비반조Fg [（2.89±0.60） g／L비（3.54±0.63） g／L비（3.92±0.94） g／L]，D-D [（282.13±73.15） ng／ml비（390.04±73.54） ng／ml비（471.92±80.38） ng／ml]，vWF [（108.62±24.66）％비（138.45±25.96）％비（161.20±29.39）％]화 PAI-1[（6.97±1.28） ng／ml비（9.60±1.73） ng／ml비（12.33±2.16） ng／ml]수평균현저승고（P균＜0.01），차비반조적현저고우초중조적（P＜0.01혹＜0.05）；비반조적AT-III수평[（89.94±17.99）％비（69.89±20.22）％]현저하강（P＜0.05）。Pearson상관분석현시：BMI화혈전전표지물정현저정상관（FIB：r＝0.536， P＜0.001；D-D：r＝0.250， P＜0.001；vWF：r＝0.611， P＜0.001；PAI-1：r＝0.788， P＜0.001）。결론：재관심병환자BMI여혈전전상태표지물정정상관관계。
Objective:To explore the correlation among overweight ,obesity and markers of prethrombotic state in patients with coronary heart disease (CHD) .Methods:A total of 288 patients to hospital from 2013 to 2014 and di-agnosed as CHD by coronary angiography were selected .According to body mass index (BMI) ,they were divided into CHD control group (n= 106) ,overweight group (n= 121) and obesity group (n= 61) .Levels of fibrinogen (Fg) ,plasma D dimmer (D-D) ,von Willebrand factor (vWF) ,antithrombin Ⅲ (AT-Ⅲ) and plasminogen activator inhibitor (PAI)-1 were compared among three groups ,then received correlation analysis . Results:Compared with CHD control group ,there were significant rise in levels of triglyceride ,total cholesterol ,fasting blood glucose and mean arterial pressure ,morbidity rates of hypertension and diabetes mellitus in overweight group and obesity group , P<0.05 or <0.01. Compared with CHD control group ,there were significant rise in levels of Fg [ (2.89 ± 0.60) g/L vs .(3.54 ± 0.63) g/L vs .(3.92 ± 0.94) g/L] ,D-D [ (282.13 ± 73.15) ng/ml vs .(390.04 ± 73.54) ng/ml vs . (471.92 ± 80.38) ng/ml] ,vWF [ (108.62 ± 24.66)% vs .(138.45 ± 25.96)% vs .(161.20 ± 29.39)% ] and PAI-1 [ (6.97 ± 1.28) ng/ml vs .(9.60 ± 1.73) ng/ml vs .(12.33 ± 2.16) ng/ml] in overweight group and obesity group , P<0.01 all ,and those of obesity group were significantly higher than those of overweight group , P<0.01 or <0.05 ;AT-Ⅲ level [ (89.94 ± 17.99)% vs .(69.89 ± 20.22)% ] significantly reduced in obesity group (P<0.05) . Pearson correlation analysis indicated that BMI was positively correlated with markers of prethrombotic state [Fg:r=0.536 ,P<0.001 ;D-D:r= 0.250 , P< 0.001 ;vWF :r= 0.611 , P< 0.001 ;PAI-1:r=0.788 , P< 0.001) . Conclusion:BMI is positively correlated with markers of prothrombotic state in CHD patients .