血清胆红素与冠心病冠脉病变程度关系的研究  

Relationship between serum bilirubin and coronary artery lesions degree in the coronary artery disease patients

作　　者：李妍妍[1] 周传伟[1] 王向明[1] 陈爱玲[1] 

机构地区：[1]江苏省南京医科大学第一附属医院老年科,210029

出　　处：《中华全科医学》2014年第5期670-672,共3页Chinese Journal of General Practice

基　　金：国家自然科学基金(81100073);南京医科大学优秀中青年教师支持计划(2013-2015;JX2161015034);江苏高校优势学科建设工程资助项目

摘　　要：目的了解冠心病患者血清胆红素水平与冠状动脉狭窄程度间的关系,评估血清胆红素预测冠状动脉狭窄严重程度的可能性。方法采用Gensini评分系统,将48例经皮冠状动脉介入治疗的冠心病患者分为冠心病轻度病变组、冠心病重度病变组。选取同期住院的25例非冠心病患者作为对照组,检测入选者血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)水平。结果对照组的TBIL为(16.81±5.87)μmol/L,DBIL为(6.28±2.68)μmol/L,IBIL为(12.14±2.78)μmol/L。冠心病轻度病变组的TBIL为(13.81±3.62)μmol/L,DBIL为(4.83±1.28)μmol/L,IBIL为(8.99±3.20)μmol/L。冠心病重度病变组的TBIL为(9.79±3.39)μmol/L,DBIL为(3.46±1.50)μmol/L,IBIL为(5.93±2.45)μmol/L。与对照组相比,冠心病组TBIL、DBIL、IBIL降低(P<0.05)。重度病变组TBIL、DBIL、IBIL水平较轻度病变组降低(P<0.05)。TBIL与Gensini评分呈负相关(r=-0.3816,P<0.01),IBIL与Gensini评分呈负相关(r=-0.4006,P<0.01),血管病变支数与Gensini评分正相关(r=0.647,P<0.01)。结论 BIL与冠脉狭窄程度负向相关,BIL可作为冠脉狭窄程度的预测因子。Objective To investigate the relationship between serum bilirubin and coronary artery stenosis degree in the coronary artery disease patients（CAD）. Methods According to Gensini marking system ,48 percutaneous coronary inter- vention CAD patients were divided into 2 groups as CAD mild lesion group and CAD severe lesion group. Additional 25 non-CAD hospitalized patients in the corresponding period were selected as control group. The serum total bilirubin （TBIL） , direct bilirubin（DBIL） , and indirect bilirubin （IBIL） were examined. Results In the control group, TBIL was （ 16.81 ＋ 5.87 ） μmol/L, DBIL was （ 6.28 ± 2.68 ） μmol/L, and IBIL was （ 12.14 ± 2.78 ） μmol/L. In the CAD mild lesion group,TBIL was （ 13.81 ± 3.62） μmol/L, DBIL was （4.83 ± 1.28 ） μmol/L, and IBIL was （ 8.99 ± 3.20） μmol/L. In the CAD severe lesion group, TB1L was （9.79 ± 3.39 ） μmol/L, DBIL was （ 3.46 ± 1.50） μmol/L, and IBIL was （ 5.93 ± 2.45 ） μmol/L. Serum TBIL, DBIL and IBIL numerical of CAD group were significantly lower than those of control group, the differences were statistically significant（ P 〈 0.05 ）. Serum TBIL, DBIL and IBIL numerical of CAD se- vere lesion group were significantly lower than those of CAD mild lesion group, the differences were also statistically signif- icant （ P 〈 0.05 ）. There was a negative correlation between TBIL, IBIL and Gensini grade （ TBIL： r = - 0.3816, P 〈 0.01 ; IBIL：r = -0.4006 ,P 〈 0.01 ）. There was a positive correlation between vaseulopathy and Gensini grade（ r = 0.647, P 〈 O. O1 ）. Conclusion Serum bilirubin level was significantly associated with coronary stenosis degree. The higher the coro- nary stenosis degree was, the lower the serum bilirubin level was. Serum bilirubin could be acted as the prediction index of the coronary stenosis degree.

关 键 词：胆红素 冠心病 GENSINI评分 

分 类 号：R541.4[医药卫生—心血管疾病] R446.11[医药卫生—内科学]