血清胆红素水平与冠状动脉病变严重程度相关性分析

目的：探讨血清胆红素水平与冠状动脉病变严重程度以及血脂水平的相关性。方法：冠状动脉造影患者92例,冠心病（CHD）患者67例,其中急性心肌梗死（AMI）17例,不稳定型心绞痛（UAP）30例,稳定型心绞痛（SAP）20例;正常对照组25例。采用比色法测定血清总胆红素（TB）、直接胆红素（DB）、间接胆红素（IB）水平;采用酶联免疫吸附法测定血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）及甘油三酯（TG）水平。对胆红素水平与冠状动脉狭窄程度、病变支数、病变积分及TC、TG、LDL-C的关系进行分析。结果：CHD患者血清TB及IB水平明显低于对照组（P〈0.01）,TG、TC、LDL-C水平明显高于对照组（P〈0.05-0.01）。血清TB、IB、DB水平与冠状动脉病变支数、病变积分、病变程度及LDL-C呈负相关,与TG、TC无明显相关。结论：血清胆红素代谢紊乱可能参与了冠心病的发生和发展,其水平在一定程度上与冠状动脉病变的严重性及血脂水平有关。

The relative analysis between the serum level of bilirubin and the severity of coronary heart disease

Objectives: To investigate the correlation between the bilirubin level in serum and the severity of coronary heart disease, 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 92 patients by coronary angiography, with 47 cases of acute coronary syndrome, including 17 patients of acute myocardial infarction(AMI), and 30 patients of unstable angina pectoris (UAP), and 20 patients of stable angina pectoris (SAP), and 25 healthy controls. The relation ships were analyzed between levels of total bilirubin and severity of coronary stenosis, and number of diseased coronary arteries, and scores of lesion, and TC, TG, LDL-C. Results: The levels of TB, DB, IB in SAP, UAP and AMI group were significantly lower than those in control group (P<0.05), there was no obvious difference in DB between CHD group and control group(P=0.213), but the levels of TG, TC, LDL-C in SAP and UAP and AMI group were significantly higher than those in control group (P<0.05). There was significant negative correlation of the serum levels of TB, DB, IB, and severity of coronary stenosis, number of diseased coronary arteries, scores of lesion 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 severity of coronary heart disease and blood lipid level.