老年人血清总胆红素和尿酸及C-反应蛋白水平与冠脉病变严重程度的关系

目的 探讨冠心病患者血清总胆红素(TBil)、血尿酸(SUA)和C-反应蛋白(CRP)与冠脉病变程度及斑块稳定性的关系.方法 根据冠脉造影(CAG)结果将178例老年患者分为2组,冠心痛组116例和非冠心病组(对照组)62例,其中冠心病组又分为3个亚组:单支病变组(SV组,37例)、双支病变组(DV组,41例)、多支病变组(MV组,38例),分别测定血清TBil、SUA和CRP水平,并分析它们与冠脉病变程度及斑块稳定性的关系.结果 冠心病组SUA和CRP水平均明显高于对照组,而冠心痛组血清TBil水平均明显低于对照组,差异均具有显著性(P＜0.05);冠心病各亚组之间比较显示,SUA和CRP水平越高,冠脉病变越严重,而血清TBil水平越低,冠脉病变越严重(P＜0.05);SUA和CRP均随冠状动脉病变程度的加重而增高,与之呈正相关;TBil水平随冠状动脉病变程度的加重而降低,与之呈负相关(P＜0.05);与病变稳定组比较,病变不稳定组CRP明显升高,TBil明显降低(P＜0.05),而SUA无差异性(P＞0.05).结论 SUA和CRP水平的升高及TBil含量的降低与冠心病的发生和冠脉病变严重程度密切相关,高SUA、CRP及低TBil可能是冠脉病变严重的独立危险因素.

The Relation Between Pulse Pressure, Serum Uric Acid and Total Bilirubin and the Severity of Coronary artery in Elder People

Objective To investigate the relationship between total bilimbin(TBil), serum uric acid(SUA), C-reactive protein(CRP) and the severity of coronary artery and its steadiness in elder people.Methods According to coronary angiography, one hundred seventy-eight elder patients divided into two groups: The coronary heart disease(CHD) group and non-CHD group(control group). The CHD group were further divided into three subgroups: single vessels(SV)disease group, double vessels(DV) disease group and multi-vessels (MV)disease group. The level of TBil , SUA and CRP were measured, and to analyze the relation between TBil ,SUA and ERr and the severity of coronary artery and its steadiness.Results The levels of SUA and CRP in CHD groups were significantly higher than that of control group(P<0.05), The level of TBil in CHD groups was significantly lower than that of control group (P<0.05). Those with higher SUA and CRP , and lower TBil showed more severe the Severity of coronary artery. The levels of SUA and ERr positively and the level of TBil negatively related with severity of coronary artery (P(0.05). compare with stable pathology group, The levels of CRP were significantly higher and the level of TBil was significantly lower in unstable pathology group, but the levels of SUA was not significant (P>0.05).Conelusion The levels of elevated SUA and CRP, reduced TBil are closely related with CHD and the severity of coronary artery. The higher level of SUA, CRP and the lower level of TBil maybe were independent risk factor for CHD and the severity of coronary artery in elder patients.