胆红素与缺血性脑卒中预后相关性研究

目的:探讨胆红素与缺血性脑卒中预后的相关性，为临床判断缺血性脑卒中预后提供参考。方法:选取缺血性脑卒中60例作为病例组，选择同期体检的健康志愿者60名作为对照组，检测并比较2组血清胆红素水平；治疗2周后根据疗效将病例组分为病情改善组（A组）和治疗无效或加重组（B组），比较2组患者血清胆红素水平，分析间接胆红素与患者最大梗死直径的相关关系。结果:病例组患者入院时总胆红素、直接胆红素及间接胆红素均高于对照组（P<0.05～P<0.01）；治疗2周后，2组患者总胆红素、直接胆红素和间接胆红素均较入院时明显降低（P<0.01），且治疗2周后A组患者总胆红素及间接胆红素均显著高于B组（P<0.01）；A组患者最大梗死直径显著低于B组，且间接胆红素水平明显高于B组（P<0.01），A组和B组最大脑梗死直径与间接胆红素均呈负相关关系（P<0.05）。结论:缺血性脑卒中早期会有胆红素水平升高，低胆红素血症提示患者病情严重，预后较差。

The correlative study of bilirubin with the prognosis of ischemic stroke

Objective: To investigate the correlation of bilirubin with the prognosis of ischemic stroke for providing the reference in judging the prognosis of ischemic stroke.Methods: Sixty patients with ischemic stroke and 60 healthy people were divided into the case group and control group,respectively.The levels of bilirubin between two groups were compared.After 2 weeks of treatment,the case group were subdivided into group A(symptom improvement) and group B(treatment failure or symptom aggravation),the levels of serum bilirubin between two groups were compared,and the correlation of indirect bilirubin with the max infarct diameter was analyzed.Results: At admission,the levels of the total bilirubin,direct bilirubin and indirect bilirubin in case group were higher than those in control group(P<0.05 to P<0.01).After 2 weeks of treatment,the levels of serum total bilirubin,direct bilirubin and indirect bilirubin in two groups decreased significantly(P<0.01),the levels of serum total bilirubin and indirect bilirubin in group A were significantly higher than those in group B(P< 0.01).After treatment,the max infarct diameter in group A was significantly less than that in group B,and the level of indirect bilirubin in group A was significantly higher than that in group B(P< 0.01).The max infarct diameters in group A and B were negatively correlation with the levels of indirect bilirubin(P<0.05).Conclusions: The serum bilirubin level increases in early ischemic stroke,the hyperbilirubinemia indicates the serious condition and poor prognosis.