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术前血清胆红素预测冠心病支架再狭窄价值
引用本文:朱玲军,王孝雅,项美香,王建安. 术前血清胆红素预测冠心病支架再狭窄价值[J]. 中华急诊医学杂志, 2016, 0(8): 1031-1034. DOI: 10.3760/cma.j.issn.1671-0282.2016.08.013
作者姓名:朱玲军  王孝雅  项美香  王建安
作者单位:浙江大学医学院附属第二医院心血管内科,杭州,310009
基金项目:National Natural Science Foundation of China (81370346)国家自然科学基金(81370346)
摘    要:目的 探讨术前血清胆红素的水平与冠心病支架术后再狭窄的相关性.方法 纳入2013-2014年入住浙江大学医学院附属第二医院行冠脉造影接受支架植入治疗,并于术后6月到12月之间再次入院行冠脉造影复查的249例冠心病患者,根据支架内有无再狭窄分为支架内再狭窄组和无再狭窄组,通过比较两组患者术前血清胆红素的水平,分析其与冠心病支架内再狭窄的关系.结果 血清总胆红素(TBIL)冠心病支架内再狭窄组(9.93±3.871μmol/L)水平低于无再狭窄组(12.08±4.67) μmol/L,(P=0.000),血清直接胆红素(DBIL)冠心病支架内再狭窄组(3.17±1.60) μmoL/L水平低于无再狭窄组(3.89±1.83)μmol/L,(P =0.002),血清间接胆红素(IBIL)冠心病支架内再狭窄组(6.76±2.82)μmol/L水平低于无再狭窄组(8.17±3.39)μmol/L,(P =0.001);差异具有统计学意义(P<0.05).Spearman相关回归分析,结果显示,TBIL、DBIL、IBIL与再狭窄呈负相关,(P<0.05),血清胆红素越低,再狭窄发生率越高.结论 冠心病再狭窄患者血清TBIL、DBIL、IBIL偏低,再狭窄与血清TBIL、DBIL、IBIL相关性高.术前TBIL、DBIL、IBIL可作为冠心病支架内再狭窄的预测因素.

关 键 词:血清胆红素  冠心病  支架内再狭窄

The correlation between serum bilirubinlevels and instent-restenosis for coronary heart disease: an angiographic study
Abstract:Objective To study the correlation between serum bilirubin and restenosis after stent implantation of coronary heart disease (CHD).Methods Two hundred and fourtynine patients with CHD were divided into Instent-restenosis (ISR) of CHD group and non-ISR of CHD group according to their angiography findings.Theirserum bilirubin levels were compared and correlation between serum bilirubin level and ISR of CHD was studied.Results The serum bilirubin level was significantlylower in ISRof CHD group than in non-ISR group (P < 0.05),in TBIL (9.9322 ± 3.8748μmol/L) to (12.08 ±4.6679μmol/L)、DBIL (3.1744 ± 1.60μmol/L) to (3.8949 ± 1.825μmol/L)、IBIL (6.757 ±2.822μmol/L) to (8.174 ± 3.388μmol/L).Conclusions The serum bilirubinlevel is lower in CHD patients with ISR than in CHD patients with non-ISR,which is an indepent risk factor for ISR of CHD.
Keywords:Bilirubin  Coronary disease  Coronary angiography  ISR  Risk factors
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