胆红素与血脂的综合指数对冠心病诊断价值的探讨  

The predictive value of various lipid lipoprotein and bilirubin combinations for prediction of coronary heart disease

作　　者：杜戎[1] 梁国芬[1] 徐会圃[1] 

机构地区：[1]华中科技大学同济医学院心血管病研究所华中科技大学同济医学院附属协和医院心内科,武汉430022

出　　处：《临床心血管病杂志》2002年第12期617-619,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨胆红素与血脂的综合指数对冠心病 (CHD)的诊断价值。方法 :将 15 4例行冠状动脉 (冠脉 )造影术者 ,按照冠脉造影结果分为 3组 :CHD高度狭窄组、中度狭窄组 ,冠脉正常组 ,分析组间血脂、胆红素及综合指数的差异及其对CHD的预测符合率。结果 :CHD组患者血清总胆红素 (TBil)明显低于冠脉正常组 (P <0 .0 1) ,血清总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL C) ,LDL C [高密度脂蛋白胆固醇 (HDL C) +TBil]比值、TC (HDL C +TBil)比值水平明显高于冠脉正常组 (P <0 .0 5或P <0 .0 1)。进行判别分析 ,将LDL C (HDL C +TBil)与传统危险因素 (HDL C、LDL C、TC、年龄、收缩压、血糖 )同时引入模型 ,年龄与LDL C (HDL C +TBil)进入模型 ,显示出较其他各项指标与CHD更强的相关性 ,且对CHD的预测符合率为 5 8.6 % ,高于传统危险因素对CHD预测符合率 (P <0 .0 5 )。结论Objective:To study the significance of composite index of the serum bilirubin and serum lipid variables in predicting coronary heart disease rk.Methods:A total of 154 patients who had undergone coronary angiography entered the study. Their results of coronary angiography were investigated and they were divided into three groups: ① severe stenochoria ②middle stenochoria ③normal. Serum bilirubin, the traditional risk factors of cholesterol(TC), high density lipoprotein cholesterol(HDL C), Low density lipoprotein cholesterol(LDL C), triglycerides(TG) were tested by discriminant analysis as were TC/HDL C, LDL C/HDL C, TC/(HDL C+bilirubin) and LDL C/(HDL C+bilirubin).Results:Each of these bilirubin containing ratios was found to be an independent risk predictor when tested with the traditional risk factors. When the LDL C/(HDL C+bilirubin) ratio was included with the traditional risk predictors, it elevated the rate of overall correct Conformity of CHD from 44.7 % to 58.6 %.Conclusion:Serum bilirubin can be combined with LDL C/HDL C ratio, TC/HDL C ratios to improved the prediction of CHD.

关 键 词：胆红素 血脂 综合指数 冠心病 诊断 

分 类 号：R541.404[医药卫生—心血管疾病]