目的探讨原发性高血压（EH）患者颈动脉粥样硬化斑块及性质与血浆纤维蛋白原（FIB）的关系。方法纳入EH患者404例，根据是否合并颈动脉硬化斑块分为斑块组（n=235）和无斑块组（n=169），对两组受试者血浆纤维蛋白原（FIB）水平及斑块性质（分为软斑块、硬斑块、混合斑块）进行比较，并运用多因素回归分析对颈动脉粥样硬化斑块性质与血压、血脂、血糖、FIB关系进行研究。结果①斑块组FIB及低密度脂蛋白胆固醇（LDL-C）明显高于无斑块组[FIB：（3.92±2.82）g/L vs.（3.23±1.62）g/L，P=0.032；LDL-C：（3.23±0.91）mmol/L vs.（2.95±0.82）mmol/L，P=0.047]，而HDL-C低于无斑块组[（1.17±0.31）mmol/L vs.（1.25±0.35）mmol/L，P=0.021）；②软斑块组患者血浆FIB水平高于混合斑块[（4.18±2.89）g/L vs.（3.84±2.16） g/L，P＜0.05]和硬斑块[（4.18±2.89）g/L vs.（3.69±2.21）g/L，P＜0.05]，混合斑块与硬斑块患者之间无明显差异；③高FIB血症者颈动脉斑块检出率及软斑块比例均显著高于FIB正常者（74.7%vs.42.9%，P＜0.05；32.5%vs.8.1%，P＜0.05）；④多元回归分析发现血FIB水平、LDL-C与颈动脉斑块成正相关，HDL-C与颈动脉斑块成负相关。结论高血压患者血浆FIB水平与颈动脉斑块，尤其是软斑块密切相关。
Objective To investigate the relationship between level of plasma fibrinogen (FIB) and carotid atherosclerotic plaques in patients with essential hypertension (EH). Methods EH patients (n=454) were chosen and divided, according to whether or not they had complicated carotid atherosclerotic plaques, into plaque group (n=235) and non-plaque group (n=169). The level of plasma FIB and the properties of plaques (soft plaques, hard plaques and compound plaques) were compared between two groups. The properties of plaques and levels of blood pressure, blood fat, blood sugar and FIB were analyzed by using multi-factor regression. Results ①The levels of FIB and LDL-C were significantly higher in plaque group than that in non-plaque group [FIB:(3.92±2.82) g/L vs. (3.23±1.62) g/L, P=0.032;LDL-C:(3.23±0.91) mmol/L vs. (2.95±0.82) mmol/L, P=0.047], and level of HDL-C was lower in plaque group than that in non-plaque group [(1.17±0.31) mmol/L vs. (1.25±0.35) mmol/L, P=0.021)].②The level of plasma FIB was significantly higher in soft plaque group than that in compound plaque group [(4.18 ±2.89) g/L vs. (3.84±2.16) g/L, P<0.05] and hard plaque group [(4.18±2.89) g/L vs. (3.69±2.21) g/L, P<0.05]. There was no significant difference between compound plaque group and hard plaque group. ③The detection rate of carotid atherosclerotic plaques and proportion of soft plaques were significantly higher in the patients with hyperfibrinogenemia than those with normal FIB level (74.7%vs. 42.9%, P<0.05;32.5%vs. 8.1%, P<0.05). ④The multi-factor regression showed that carotid atherosclerotic plaques were positively correlated to the levels of FIB and LDL-C and negatively to the level of HDL-C. Conclusion The level of plasma FIB is closely related to carotid atherosclerotic plaques, especially to soft plaques in hypertensive patients.