直接胆红素水平与冠状动脉介入术后远期预后的关系

目的:探讨不同直接胆红素(DBIL)水平的急性冠状动脉综合征(ACS)患者临床特点是否存在差异,并分析患者经皮冠状动脉介入术(PCI)后临床不良事件的影响因素。方法:将本院行PCI治疗的ACS 128例患者作为研究对象,依据患者入院时DBIL含量,分为A组(DBIL<2.20μmol/L)44例、B组(DBIL:2.20~3.00μmol/L)41例、C组(DBIL>3.00μmol/L)43例。比较三组患者临床基本资料、血清学指标、冠状动脉病变情况、PCI支架数、住院时间、住院期间用药情况及术后24个月内临床不良事件发生率等差异。结果:三组性别、BMI、吸烟史、陈旧心肌梗死史、TC、TG、HGB、总胆红素(TBIL)、DBIL及LDL-C比较,均差异有统计学意义(P<0.05)。三组年龄、糖尿病、高血压、高脂血症、诊断类型、冠状动脉病变情况、PCI支架数、住院时间及住院期间用药情况的比较,均无统计学意义(P>0.05)。三组患者全因病死率比较,差异有统计学意义(P<0.05)。经多因素Cox回归分析显示,相比A组,B组、C组全因病死率明显升高(P<0.01)。结论:不同DBIL水平行PCI的ACS患者具有一定的临床特点,中、高水平DBIL的患者较低水平DBIL患者的术后远期全因病死率明显升高,DBIL水平是ACS患者PCI术后全因死亡的危险因素。

The relationship between the level of direct bilirubin and the long-term prognosis after percutaneous coronary intervention

Objective:To investigate the clinical characteristics of acute coronary syndrome(ACS)patients with different levels of direct bilirubin(DBIL),and to analyze the occurrence of adverse events after percutaneous coronary intervention(PCI).Methods:128 ACS patients treated with PCI in our hospital were divided into group A(DBIL<2.20 mol/L)44 cases,group B(DBIL 2.20-3.00 mol/L)41 cases and group C(DBIL>3.00μmol/L)43 cases.The basic clinical data,serological indicators,coronary artery disease,number of PCI stents,hospitalization time,drug use during hospitalization and the incidence of adverse clinical events within 24 months after operation were compared among the three groups.Results:There were significant differences in gender,BMI,smoking history,old myocardial infarction history,TC,TG,HGB,total bilirubin(TBIL),DBIL and LDL-C among the three groups(P<0.05).There was no significant difference in age,diabetes mellitus,hypertension,hyperlipidemia,diagnosis type,coronary artery disease,number of PCI stents,hospitalization time and drug use during hospitalization among the three groups(P>0.05).There was significant difference in all-cause mortality among the three groups(P<0.05).Compared with group A,all-cause mortality increased significantly in group B and group C(P<0.01).Conclusions:ACS patients with PCI at different DBIL levels have different clinical characteristics.The long-term all-cause mortality of patients with moderate and high DBIL levels is significantly higher than that of patients with low DBIL levels.DBIL level is an independent risk factor for all-cause mortality of ACS patients after PCI.