心型脂肪酸结合蛋白与Stanford B型主动脉夹层患者预后的关系研究

摘要

目的 探讨心型脂肪酸结合蛋白(H-FABP)与Stanford B型主动脉夹层患者预后的关系.方法 选取2010年10月—2016年10月重庆三峡中心医院总院、重庆三峡中心医院急救分院、重庆三峡中心医院百安分院、重庆三峡中心医院平湖分院收治的Stanford B型主动脉夹层患者141例,根据预后分为预后良好组71例和预后不良组70例.比较两组患者一般资料和实验室检查指标,H-FABP与Stanford B型主动脉夹层患者预后的关系分析采用单因素、多因素Logistic回归分析.结果 两组患者性别、年龄、治疗方案、总胆固醇、低密度脂蛋白胆固醇、三酰甘油及空腹血糖比较,差异无统计学意义(P>0.05);预后良好组患者中低血压、白细胞计数增高、H-FABP阳性者所占比例低于预后不良组(P<0.05).单因素Logistic回归分析结果显示,H-FABP是Stanford B型主动脉夹层患者预后的影响因素〔OR=1.67,95％CI(2.44,11.62),P=0.01〕;校正年龄、治疗方案、低血压及白细胞计数增高后,多因素Logistic回归分析结果显示,H-FABP是Stanford B型主动脉夹层患者预后的独立影响因素〔OR=3.73,95％CI(1.02,13.67),P=0.04〕.结论 H-FABP是Stanford B型主动脉夹层患者预后的独立影响因素,血清H-FABP水平≥7μg/L者预后较差,应引起临床重视.%Objective To investigate the relationship between heart-type fatty acid binding protein(H-FABP) and prognosis in patients with Stanford B type aortic dissection.Methods From October 2010 to October 2016,a total of 141 patients with Stanford B type aortic dissection were selected in General Hospital,Emergency Branch,Baian Branch and Pinghu Branch of Chongqing Three Gorges Central Hospital,and they were divided into A group(with good prognosis,n=71)and B group(with poor prognosis,n=70)according to the prognosis. General information and laboratory examination results were compared between the two groups,univariate and multivariate Logistic regression analysis were used to analyze the relationship between H-FABP and prognosis in patients with Stanford B type aortic dissection.Results No statistically significant differences of gender,age,therapeutic regimen,TC,LDL-C,TG or FPG was found between the two groups(P>0.05);proportion of patients with hypotension,with WBC elevation,with positive H-FABP in A group was statistically significantly lower than that in B group,respectively(P<0.05). Univariate Logistic regression analysis results showed that,H-FABP was one of influencing factor of prognosis in patients with Stanford B type aortic dissection〔OR=1.67,95％CI(2.44,11.62), P=0.01〕;after correction of age,therapeutic regimen,hypotension and WBC elevation,multivariate Logistic regression analysis results showed that,H-FABP was an independent influencing factor of prognosis in patients with Stanford B type aortic dissection〔OR=3.73,95％CI(1.02,13.67),P=0.04〕.Conclusion H-FABP is an independent influencing factor of prognosis in patients with Stanford B type aortic dissection,the prognosis in patients with serum H-FABP level equal or over 7μg/L is relatively poor,which should pay attention to.