血清胆红素和同型半胱氨酸水平变化与冠心病临床类型的关系分析  

Changes of serum bilirubin and homocysteine levels and clinical types of coronary heart disease

作　　者：葛婕丽 黄淑田[1] 姚冰琪 台鸣娟 台润东 路申潞 GE Jieli;HUANG Shutian;YAO Bingqi;TAI Mingjuan;TAI Rundong;LU Shenlu(The Second Hospitai of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院,山西太原030001

出　　处：《临床医药实践》2020年第6期422-424,456,共4页Proceeding of Clinical Medicine

摘　　要：目的:探讨血清胆红素、同型半胱氨酸(Hcy)水平变化与冠心病(CHD)临床类型的关系。方法:选取因胸痛入院的患者190例,根据冠脉造影结果分为对照组52例,CHD组138例。CHD组又分为3个亚组:稳定型心绞痛(SAP)组45例,不稳定型心绞痛(UAP)组51例,急性心梗(AMI)组42例。分别测定患者血清胆红素、Hcy及炎症因子指标。结果:CHD组血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)水平均低于对照组(P<0.05),同型半胱氨酸(Hcy)、白细胞(WBC)水平高于对照组(P<0.05)。与SAP组比较,AMI组TBIL和IBIL水平均显著降低(P<0.05),Hcy和WBC水平均显著升高(P<0.05);与UAP组比较,AMI组TBIL水平显著降低(P<0.05),WBC水平显著升高(P<0.05);与SAP组比较,UAP组TBIL水平显著降低(P<0.05),Hcy水平显著升高(P<0.05)。Logistic回归显示,血清胆红素、Hcy和WBC是CHD的独立危险因素(P<0.05)。结论:血清胆红素、Hcy和WBC可作为CHD的独立危险因素,其水平变化在CHD患者临床类型的诊断中具有参考价值。Objective:To explore the correlation betweentheserum levelsof bilirubin and homocysteine and clinical types of coronary heart disease(CHD).Methods:All 190 patients admitted for coronary angiography surgery due to chest pain were selected.All patients were divided into control group with 52 cases and CHD group with 138 cases by coronary angiography.The CHD group was further divided into three subgroups:45 cases in the stable angina(SAP)group,51 cases in the unstable angina(UAP)group,and 42 cases in the acute myocardial infarction(AMI)group.Serum bilirubin,Hcy and inflammatory factor were measured separately.Results:The levels of total bilirubin(TBIL),direct bilirubin(DBIL)and indirect bilirubin(IBIL)in the CHD group were lower than those in the control group(P<0.05),and the levels of homocysteine(Hcy)and white blood cells(WBC)were higher than those in the control group(P<0.05).Compared with SAP group,TBIL and IBIL levels in AMI group were significantly lower(P<0.05),Hcy and WBC levels were significantly higher(P<0.05).Compared with UAP group,TBIL level in AMI group decreased significantly(P<0.05),WBC level were significantly higher(P<0.05).Compared with SAP group,TBIL level in UAP group were significantly lower(P<0.05),Hcy level were significantly higher(P<0.05).Logistic regression analysis indicated that it was concluded that serum IBIL,Hcy and WBC were independent risk factors for CHD.Conclusion:The serum IBIL,Hcy and WBC can be used as an independent risk factor for CHD,and its level changes have reference value in the diagnosis of clinical types.

关 键 词：冠心病 胆红素 同型半胱氨酸 炎症因子 

分 类 号：R457[医药卫生—治疗学]