血清胆红素水平与冠心病发病及冠状动脉病变程度的相关性  

Relationship between serum bilirubin and severity of coronary artery disease

作　　者：于海波[1] 韩雅玲[1] 荆全民[1] 张磊[1] 王祖禄[1] 刘海伟[1] 张岩[2] 霍勇[2] 

机构地区：[1]沈阳军区总医院心血管病研究所心内科,辽宁沈阳110016 [2]北京大学第一医院心内科

出　　处：《中国老年学杂志》2013年第14期3281-3283,共3页Chinese Journal of Gerontology

基　　金："十一五"国家科技支撑计划项目(No.2006BAI01A02)

摘　　要：目的探讨血清胆红素水平与冠心病(CAD)发病及冠状动脉病变程度的关系。方法收集9 847例行诊断性冠状动脉造影的疑诊CAD患者进行回顾性分析,以冠状动脉造影阳性(主要血管直径狭窄≥50%)作为诊断CAD的标准,将全部患者分为CAD和非CAD两组。冠状动脉造影病变程度采用Gensini积分评价,根据冠状动脉主要血管受累支数分为0支、单支、两支和三支病变组。分析血清胆红素水平与CAD发病及冠状动脉病变程度的关系。结果 9 847例患者中确诊CAD 6 419例(65.2%)。CAD组的总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)显著低于非CAD组(P<0.001),且TBIL、DBIL、IBIL水平越低,冠状动脉病变越严重。Logistic回归分析证实TBIL、DBIL是CAD的独立保护因素。结论血清胆红素水平降低患者的CAD发病率明显升高;血清胆红素水平越低,冠状动脉病变越严重;TBIL、DBIL是CAD的独立保护因素。Objective To determine the relationship between serum bilirubin and severity of coronary artery disease（CAD）.Methods 9 847 consecutive patients underwent coronary angiography were selected.Taking positive coronary angiography（stenosis of major vessels≥ 50%） as diagnostic standard of CAD,all patients were divided into two groups.CAD severity was assessed by Gensini score and number of arteries（0~3） with 50% stenosis in the angiography.The impact of serum bilirubin on the development of CAD and the severity of atherosclerotic process were observed.Results There were 6 419（65.2%） CAD patients in all 9 847 patients.The levels of total bilirubin（TBIL,P0.001）,direct bilirubin（DBIL,P=0.003）,indirect bilirubin（IBIL,P0.001） were lower in CAD group than those in non-CAD group.Furthermore,the lower TBIL,DBIL and IBIL（r1=-0.202,P10.001,r2=-0.213,P20.001） were,the more severe coronary artery stenosis was.Besides,Binary Logistic regression analysis showed that TBIL and DBIL were independent protective factors of CAD.Conclusions The incidence of CAD is larger with lower level of serum bilirubin.The lower level of serum bilirubin is,the more severe coronary artery stenosis is;TBIL and DBIL are independent protective factors of CAD.

关 键 词：冠心病 血清胆红素 动脉粥样硬化 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]