老年冠心病合并糖尿病患者不同冠脉病变程度与胆红素水平相关性分析  

Relationship between bilirubin level and coronary artery lesions in elderly patients with coronary heart disease complicated with diabetes mellitus

作　　者：黄玉艳[1] 陈然[1] 刘赵云[1] 

机构地区：[1]长沙市中心医院心血管内科,湖南省长沙市410004

出　　处：《实用老年医学》2016年第4期317-319,共3页Practical Geriatrics

摘　　要：目的探讨老年冠心病合并糖尿病患者不同冠脉病变程度与胆红素(TBI)水平相关性。方法选取2012年5月至2014年11月我院收治的117例老年冠心病合并糖尿病患者,根据冠脉病变程度分为单支病变组(38例)、双支病变组(40例)和三支病变组(39例),比较不同冠脉病变组患者TBI水平差异,并分析不同冠脉病变程度(Gensini积分)与TBI的相关性。结果 3组间年龄、体质量指数(BMI)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、TBI差异有统计学意义(P<0.05或0.01)。随冠脉病变支数增加,TC、TG、LDL水平升高,HDL、TBI水平降低(P<0.05)。单因素及多因素线性回归分析显示,糖尿病病程、空腹血糖、糖化血红蛋白、TBI等因素是影响患者冠状动脉病变严重程度的独立危险因素(P<0.05)。结论老年冠心病合并糖尿病患者TBI水平降低与冠脉动脉病变支数及狭窄程度相关,检测血清胆红素水平可在一定程度上反映冠脉病变程度。Objective To explore the relationship between bilirubin（ TBI） and the severity of coronary artery lesions in elderly patients with coronary artery disease complicated with diabetes mellitus. Methods A total of 117 elderly patients with coronary artery disease complicated with diabetes mellitus from May 2012 to November 2014 in our hospital were enrolled. They were divided into single-vessel disease group（ 38 cases）,double-vessel disease group（ 40patients）,and ternate-vessel lesion group（ 39 cases） according to the severity of coronary artery. The level of TBI between the three groups was compared. The correlation of TBI with coronary lesions was analyzed. Results Age,body mass index（ BMI）,total cholesterol（ TC）,triglyceride（ TG）,low-density lipoprotein（ LDL）,high-density lipoprotein（ HDL）,TBI were significantly different between the three groups（ P0. 05）. With the increase of the number of coronary artery lesion,the levels of TC,TG,LDL were increased,and the levels of HDL and TBI were decreased（ P0. 05）. The univariate and multivariate linear regression analysis showed that course of diabetes,fasting plasma glucose,glycated hemoglobin,bilirubin were independent risk factors for the degree of coronary artery disease in the patients with diabetes（ P0. 05）. Conclusions The results show that bilirubin level is negatively related to the severity degree of coronary artery lesions in the elderly patients with coronary artery disease and diabetes mellitus. Serum bilirubin level may reflect the degree of coronary artery disease to a certain extent.

关 键 词：糖尿病 冠脉病变 胆红素 老年人 

分 类 号：R541.4[医药卫生—心血管疾病]