血清胆红素对肺源性心脏病合并冠心病的临床意义

目的探讨血清总胆红素浓度对肺源性心脏病（肺心病）合并冠心病的临床意义。方法 35例住院确诊为肺心病合并冠心病患者分为肺冠组30例、事件组5例,另设同期健康体检者35例为对照组,分别测定3组血清总胆红素浓度、血清天门冬氨酸转氨酶（AST）、磷酸肌酸激酶（CK）、磷酸肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）,将测定值进行比较。结果对照组血清总胆红素浓度高于肺冠组和事件组,差异有统计学意义（P〈0.01）,肺冠组和事件组AST、CK、CK-MB、LDH均高于对照组,差异均有统计学意义（P〈0.05和P〈0.01）,事件组AST、CK、CK-MB、LDH均高于肺冠组,差异有统计学意义（P〈0.01）。结论肺心病合并冠心病患者血清总胆红素水平降低,血清总胆红素与心肌酶呈负相关性,提示病情危重,预后差。血清总胆红素可作为肺心病合并冠心病的诊断和预后判断指标。

The clinical meaning of Serum Total Bilirubin(STB) to pulmonary heart disease with coronary heart disease

Objective To discuss the meaning of serum total bilirubin（S-TB） concentration to pulmonary heart disease（PHD） with coronary heart disease（CHD）.Methods 35 cases of PHD with CHD were divided into PHD with CHD group of 30 cases and affair group of 5 cases.Set up 35 cases of healthy check-up as the control group.Mesured the concentration of STB,AST,CK,CK-MB,LDH in serum respectively,and compared the results.Results Compared with the PHD with CHD group and the affair group,the control group＇s concentration of STB was higher（P 0.01）,while AST,CK,CK-MB,LDH were lower（P 0.05 and P 0.01）.AST,CK,CK-MB,LDH of the affair group were all higher than PHD with CHD group（P 0.01）.All the differences above were statistically significant.Conclusion The drop of STB level and the negative correlation between STB and myocardial enzyme suggest that the state of illness is critical and the prognosis is bad.STB can be an index to diagnose and evaluate prognosis.