老年冠心病患者冠状动脉狭窄程度与血清胆红素水平的相关性

目的：探讨老年心血管病患者的冠脉狭窄程度与血清胆红素水平的关系及意义。方法：对264例老年冠心病患者行冠脉造影并测定血清胆红素水平。依据冠脉造影结果,患者被分为正常对照组（68例）和冠心病组（196例）,其中冠心病组又分为轻度组（66例）、中度组（64例）和重度组（66例）。结果：单因素方差分析显示,与正常对照组比较,冠心病轻、中、重组间血清总胆红素[（20.52±6.12）μmol/L比（18.07±5.81）μmol/L比（14.22±5.19）μmol/L比（15.63±6.30）μmol/L]、间接胆红素[（18.80±5.21）μmol/L比（15.46±6.71）μmol/L比（11.63±3.42）μmol/L比（13.37±4.35）μmol/L]水平显著下降（P〈0.05～〈0.01）;多元线性回归分析显示,血清总胆红素及间接胆红素与冠状动脉狭窄程度的评分呈明显负相关（其偏相关系数分别为-8.976、-2.492,P〈0.05）。结论：胆红素水平与老年心血管疾病的发生发展及其严重程度有密切相关,血清总胆红素和间接胆红素水平可作为临床预测冠脉病变严重程度和病变范围的一个良好指标。

Relationship between serum level of bilirubin and extent of coronary artery stenosis in aged patients with coronary heart disease

Objective:To investigate relationship between serum level of bilirubin and extent of coronary artery stenosis in aged patients with cardiovascular diseases and its significance.Methods:A total of 264 aged patients with coronary heart disease(CHD) underwent coronary angiography and measurement of serum level of bilirubin.According to results of coronary angiography,patients were divided into normal control group(n=68) and CHD group(n=196),and CHD group was further divided into mild group(n=66),moderate group(n=64) and severe group(n=66).Results:One-factor ANOVA analysis indicated compared with normal control group,the serum levels of total bilirubin [(20.52±6.12) μmol/L vs.(18.07±5.81) μmol/L vs.(14.22±5.19) μmol/L vs.(15.63±6.30) μmol/L]and indirect bilirubin [(18.80±5.21) μmol/L vs.(15.46±6.71) μmol/L vs.(11.63±3.42) μmol/L vs.(13.37±4.35) μmol/L]significantly decreased in mild CHD group,moderate CHD group and severe CHD group(P<0.05~<0.01);the multiple linear regression analysis indicated that serum levels of total bilirubin and indirect bilirubin were significant negative correlations with scores of coronary artery stenosis(partial correlation coefficients were-8.976 and-2.492 respectively,P<0.05).Conclusion:Level of bilirubin is closely related with incidence,development and severity of cardiovascular diseases in aged patients,total and indirect bilirubin can be used for good indicators for predicting severity and range of lesions in coronary artery disease.