血清胆红素水平与缺血性卒中的相关性研究  

The Relation of Serum Bilirubin and Acut Ischemic Stroke

作　　者：方婧[1] 黄新颖 王岩[1] 高冠群[1] 张卓伯[1] 

机构地区：[1]哈尔滨医科大学附属第四医院神经内科,黑龙江哈尔滨150001 [2]黑龙江省急救中心,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2013年第32期6382-6385,共4页Progress in Modern Biomedicine

基　　金："十一五"国家科技支撑计划重大项目(2006BAI04A02)

摘　　要：目的:脑卒中是威胁人类健康三大疾病之一,是我国成人致残的首要原因,其中80%是缺血性卒中。本文意在研究血清胆红素水平与缺血性卒中严重程度、发病机理以及颈动脉粥样硬化斑块的关系,以进一步为防治缺血性卒中的发生、发展提供新的途径。方法:选择缺血性脑卒中患者(观察组)150例和同期健康体检者(对照组)150例,分别测定两组的血清总胆红素水平(TBIL)、间接胆红素(DBIL)、直接胆红素(IBIL),并对病例组进行TOAST分型、NIHSS评分及颈部血管超声检查。比较两组间血清胆红素,及观察组内不同分型组间血清胆红素的差异。结果:缺血性卒中患者TBIL、DBIL水平显著高于正常对照组,差异具有统计学意义(P<0.05)。缺血性卒中患者按TOAST分型各亚型间血清TBIL、DBIL、IBIL水平差异无统计学意义(P>0.05)。中重型脑梗死组与轻型脑梗死组比较,血清TBIL、DBIL、IBIL浓度均明显升高,差别具有统计学意义(P<0.05)。缺血性卒中患者中有动脉粥样硬化斑块形成组血清TBIL、DBIL水平低于颈部动脉内膜光滑、完整者组,差别有统计学意义(P>0.05)。结论:缺血性卒中患者血清胆红素升高,参与急性应激反应,可能作为衡量缺血性卒中严重程度的指标之一;高水平血清胆红素可能预防颈动脉粥样硬化斑块的形成,从而预防缺血性卒中的发生。Objective： Stroke is one of the three major disease to threat human health. Stroke is the leading cause of adult disability in China. 80% of the stroke is ischemic stroke. This article is intended to study on the relationship of the serum bilirubin level in patients with ischemic stroke by the index of severity, onset mechanism and carotid atheromatous plaque. A new approach may be researched for prevention and control the occurrence and development of ischemic stroke. Methods： We have selected 150 examples of acute ischemic stroke （case group） and 150 examples of health people （control group） to measure the levels of serum bilirubin, respectively total serum bilirubin （TBIL）, indirect bilirubin （DBIL）, direct bilirubin （IBIL）. At the same time, the TOAST Classification, the NIH Stroke Scale and the carotid artery ultrasound examination of case group are calculated. The two groups of Serum Bilirubin level are compared. The levels of Serum Bilirubin of different types within the case group are analyzed. Results： The result of TBIL and DBIL in case group is higher than control group. The comparison of the two groups have significant difference （P〈0.05）. The result of TB1L, DBIL and IBIL in case group with TOAST classification have no difference. The comparison of these groups have no significant difference （P〉0.05）. Moderate and sever group has higher serum bilirubin concentration compared with mild group. The comparison of the two groups have significant difference （P 〈 0.05）. The level of TB1L and DBIL in plaque group is lower than no plaque group. The comparison of the two groups have significant difference （P〈0.05）. Conclusion： Elevated serum bilirubin in patients with ischemic stroke increases its participation in the acute stress reaction. Serum bilirubin may serve as one of the indicators measuring the severity of ischemic stroke. High levels of serum bilirubin may prevent the formation of carotid atherosclerotic plaques, to prevent the occurrence of ischem

关 键 词：血清胆红素 缺血性脑卒中 颈动脉斑块 

分 类 号：R743[医药卫生—神经病学与精神病学]