血清胆红素与冠状动脉病变严重程度及血脂水平的关系

目的　探讨血清胆红素水平与冠状动脉病变严重程度及血脂水平的相关性。方法　经冠状动脉造影 (CAG)确诊的冠心病 (CHD)患者 5 6例 ,其中急性冠状动脉综合征 (ACS)患者 4 3例 ,包括急性心肌梗死 (AMI) 15例 ,不稳定性心绞痛 (UAP) 2 8例 ;稳定性心绞痛 (SAP) 13例 ;另设CAG排除CHD患者 2 0例作为对照组。运用比色法及酶法测定血清总胆红素 (TB)、直接胆红素 (DB)、总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL C)及甘油三酯 (TG)水平 ,间接胆红素 (IB)水平通过计算得出。以冠状动脉病变支数、冠状动脉病变积分、冠状动脉狭窄程度三者作为评价冠状动脉病变严重程度的的指标。结果　CHD组中SAP、UAP、AMI患者血清TB及IB水平明显低于对照组 ,而DB水平在CHD组与对照组之间差异无显著性意义 ,血清TB、IB、DB水平与冠状动脉病变支数、冠状动脉病变积分、冠状动脉病变程度呈明显负相关 ;与LDL C水平呈负相关 ,与TG ,TC无明显相关性。结论　人体内胆红素代谢紊乱可能和心血管事件发生相关 ,且其水平在一定程度上与冠状动脉病变严重性及血脂水平有关。

The relation between the serum level of bilirubin and the severity of coronary heart disease and the level of blood lipids

Objectives To investigate the correlation between the bilirubin level in serum and the severity of coronary heart diseases,blood lipid level.Methods The levels of total bilirubin(TB),direct bilirubin(DB),indirect bilirubin(IB) and blood lipid were determined by colorimetry and enzymatic assay in 56 patients with coronary heart disease(CHD) diagnosed by CAG,including 43 ACS patients and 13 SAP patients,and 20 healthy controls.Results The levels of TB and IB in CHD group were significantly lower than those in control group,but there was no obvious difference in DB between CHD group and control group.There was significant negative correlation between the serum levels of TB 、DB、IB and severity of coronary stenosis,number of diseased coronary arreries,score of lesions and LDL-C,but there was no obvious correlation between them and TC,TG.Conclusion The metabolic disturbance of the bilirubin in vivo may be related with the occurrence of cardiovascular events and the total bilirubin level in serum may be related with the severity of coronary heart diseases and blood lipid level.