冠状动脉病变程度与血清尿酸、胆红素及血脂水平的相关性

目的:探讨血清尿酸、胆红素及血脂水平与冠状动脉狭窄的关系及意义。方法:对225例疑为冠心病的患者行冠脉造影并测定空腹血清尿酸,胆红素及血脂水平,采用Gensini评分系统衡量冠脉造影结果。依据冠脉造影结果,分为正常对照组(105例)和冠心病组(120例),冠心病组又分为单支病变组(43例)、双支病变组(38例)和多支病变组(39例),分析血清尿酸、胆红素及血脂水平在各组间的差异性,及与冠脉病变程度的相关性。结果:单因素方差分析显示,血清尿酸、总胆红素、间接胆红素、总胆固醇、甘油三酯、低密度脂蛋白-胆固醇及低密度脂蛋白-胆固醇/总胆红素比值在各组间的分布差异有显著性(除甘油三酯F=1.058,P0.05外余F=10.913～56.238,P0.001);多元线性回归分析显示,血清尿酸、总胆红素、直接胆红素、甘油三酯及低密度脂蛋白-胆固醇/总胆红素比值与冠状动脉狭窄程度的评分独立相关(β=0.268,-0.526,0.250,-0.039,0.316,P0.05～0.01)。结论:血清总胆红素浓度降低,尿酸、总胆固醇、甘油三酯及低密度脂蛋白-胆固醇/总胆红素比值升高是冠心病的危险因素,血清尿酸、胆红素与血脂联合检测在冠心病的诊断中具有重要意义。

Correlation among serum level of uric acid, bilirubin, blood lipid and coronary artery stenosis

Objective： To explore the correlation among serum level of uric acid, bilirubin, blood lipid and coronary artery stenosis. Methods： Detected serum uric acid, bilirubin and blood lipid levels of 225 patients admitted and performed coronary angiography （CAG）, the results of coronary angiography were analyzed by Gensini scoring system. The study population were divided into the normal control group of 105 patients and the observation groups of 120 patients based on the CAG results, and the observation group was divided into three groups： one vessel coronary disease group of 43 patients, two-vessel coronary disease group （38 patients） and multi-vessel coronary disease group （39 patients）, then the relationship among serum level of uric acid, bilirubin, blood lipid and coronary artery stenosis was analyzed. Results： The analysis of one way variance showed that there were significantly different in serum uric acid, total bilirubin （TBIL）, indirect bilirubin, total cholesterol, triglyceride （TG）, low density lipoprotein-cholesterol （LDL-C） levels and LDL-C/TBIL among all groups （F= 10. 913-26. 238, P〈0. 001, except TG F= 1. 058, P〈 0.05） ; Muitiple linear regression analysis showed that uric acid, TBIL, direct bilirubin, TG and LDL-C/TBIL had in,dependent association with the Gensini score （β= 0. 268, - 0. 526, 0. 250, - 0. 039, 0. 316, P〈0.05-〈0.01）. Conelusion： The increase of levels of serum uric acid, total cholesterol, triglyceride and LDL-C levels and the decrease of serum total bilirubin level are independent risk factors to coronary heart disease. Therefore, the combined detection of serum uric acid, bilirubin and blood lipid played an important role in diagnosis for coronary heart disease.