冠心病患者血清总胆红素及尿酸水平性别差异

目的探讨冠心病患者血清总胆红素、尿酸水平在男女性别间的差别。方法入选行冠状动脉造影（CAG）的住院病例227例,确诊冠心病者140例,选择CAG正常的患者87例作为对照组。分别测定两组中不同性别的TBIL、UA及部分相关危险因素的含量,分析其在男女性别之间的差异。结果①两组中不同性别之间危险因素水平均值t检验显示：冠心病组女性发病年龄较男性高,合并糖尿病和（或）高血压的比例高,与男性组比较有统计学意义;男性吸烟比例较女性高。对照组除吸烟外,各危险因素在不同性别间无统计学意义。②多因素二元Logistic回归分析显示：年龄、糖尿病、低HDL-c及高尿酸血症是冠心病的最显著的独立危险因素,而TBIL（P〉0.05）被排除在外。性别分组后,男性组年龄（P=0.001）、尿酸（P=0.003）为最显著的独立危险因素;女性组则以糖尿病及高胆固醇血症为最显著的独立危险因素（P=0.001）。结论年龄、糖尿病、低HDL-c、高尿酸血症是冠心病最显著的独立危险因素。但其他危险因素如高LDL-c、低胆红素亦不可忽视,并且各危险因素在不同性别中危险程度有所不同。总胆红素不是冠心病的独立相关因素,可能通过其它相关因素间接对冠心病的发生起作用。

Gender-related Differences of Serum Bilirubin and Uric Acid in Patients with Coronary Arteries Disease

Objective To evaluate the differences of serum total bilirubin,uric acid level between the male and female.Methods The 227 patients whom undergone coronary angiography were chose.Among them,140 cases were diagnosed coronary arteries disease(CAD),while the rest 87 patients were normal as a control group.Each group’s total bilirubin,Uric acid and part of the content of related risk factors were measured,which difference between the male and female was analysed.Results ①T test for the mean values of risk factors level in both gender groups showed that:In coronary arteries disease group,the proportion of the mean age,complicating diabetes and(or)high blood pressure of the females were higher than the male,and the difference was statistically significant.However,The smoking proportion of men is higher than women’s.In the control group,the difference of all risk factors is not significant statistical significant except smoking.②Multi-logistic regression analysis showed that age,diabetes,low-HDL-c and high-UA were the most independent risk factors for CAD,and TBIL was excluded(P>0.05).Age(P=0.001)and uric acid(P=0.003)were the most independent risk factors for the male,whereas,diabetes and high-TC were the most important risk factors for the female(P=0.001).Conclusion Age,type-2-diabete,low-HDL-c,high-UA are the most notable independent risk factors of CAD.But other risk factors such as high LDL-c,total bilirubin can not be ignored,and the risk extent of each risk factor is different between the male and female.Total bilirubin is not the independent related factor of coronary heart disease,maybe indirectly effects the coronary heart disease through other related factors.