急性冠状动脉综合征与血清总胆红素及尿酸和纤维蛋白原血脂水平含量的相关性分析

目的：探讨急性冠状动脉综合征（ACS）与血清总胆红素（TBil）、尿酸（UA）及纤维蛋白原（FIB）含量的相关性。方法：采集空腹静脉血检测124例在本院心血管内科患者和74例健康体检者的血总胆红素、尿酸、纤维蛋白原、血脂水平含量。将ACS患者分为不稳定型心绞痛组和急性心肌梗死组，与对照组比较血清总胆红素、尿酸、纤维蛋白原、血脂水平含量的差异，并进行血清总胆红素与血脂Pearson直线相关，并分析其通过冠状动脉造影后95例冠状动脉病变程度的相关性。结果：不稳定型心绞痛组和急性心肌梗死组的血清总胆红素水平均明显低于对照组；尿酸、纤维蛋白原含量明显高于对照组，差异均有统计学意义（P〈0．01）。不稳定型心绞痛组和急性心肌梗死组之间血清总胆红素、尿酸、纤维蛋白原水平差异无统计学意义（P〉0．05）。血清总胆红素与总胆固醇、甘油三酯、低密度脂蛋白均呈负相关（P〈0．05）；与高密度脂蛋白呈正相关（P〈0．05）。尿酸和纤维蛋白原均随冠状动脉病变程度的加重而增高，与之呈正相关（P〈0．01）；血清总胆红素水平随冠状动脉病变程度的加重而降低，与之呈负相关（P〈0．01）。结论：尿酸和纤维蛋白原含量的升高及血清总胆红素含量的降低与ACS的发生和冠状动脉病变严重程度密切相关，高尿酸和纤维蛋白原及低血清总胆红素是冠状动脉病变严重的独立危险因素，对ACS发生的预测、诊断和防治有一定意义。

Correlation Analysis of Acute Coronary Syndrome and Serum Total bilirubin, Uric Acid, Fibrinogen Level

Objective： To investigate the correlation between acute coronary syndrome （ACS） and serum total bilirubin （TBil） , uric acid（UA） , fibrinogen（FIB） level. Methods：The fasting vein blood was gathered to examine the serum total bilirubin uric acid, fibrinogen and blood-lipid levels in 124 cases of ACS and 74 controls. The patients with ACS were divided into unstable angina pectoris group and acute myocardial infarction group. The difference of serum total bilirubin, uric acid, fibrinogen and blood-lipid levels was compared with control group. Pearson linear correlation analysis was carried out in serum total bilirubin and blood lipid. There were 75 patients who were performed with coronary angigraphy were grouped into 1-vessel-disease （ n = 29 ）, 2-vessel-disease （ n = 24） , 3-vissel-disease （ n = 22）. Serum total bilirubin , uric acid, fibrinogen level were determined in all the subjects. Also all the indexs were analysised the realationship with the degree of morbid coronary artery. Result：The serum total bilirubin were clearly lower in unstable angina pectoris group and acute myocardial infarction group than control group（P 〈 0.01 ）, the serum uric acid and fibrinogen were clearly higher（ P 〈0. 01 ）. There was no statistic difference in serum total bilirubin, uric acid and fibrinogen between unstable angina perctoris and acute myocardial infarction group （ P 〉 0.05 ）. The serum total bilirubin were negatively correlated with total cholesterol, triglyceride and low-density lipoprotein（ P 〈 0.05 ）, but positively correlated with high-density lipoprotein（P 〈 0.05 ）. The levels of serum uric acid and fibrinogen positively and the level of serum total bilirubin negatively related with severity of the degree of morbid coronary artery （ P 〈 0. 01）, Conclusion：The levels of elevated serum uric acid and fibrinogen, reduced serum total bilirubin are closely related with ACS and the sererity of CHD, as a independent risk factor. This might be used as guidance of the predietion diagnosis and treatment of ACS.