血浆总胆红素浓度与经皮冠状动脉介入治疗后支架内再狭窄的研究

目的探讨冠状动脉粥样硬化性心脏病（冠心病）患者血浆总胆红素（total bilirubin，TBIL）浓度与冠状动脉支架内再狭窄的关系。方法选择241例接受经皮冠状动脉介入（percotaneous coronary intervention，PCI）治疗以及术后1年内再次接受冠状动脉造影（CAG）检查的患者，根据影像结果分为再狭窄组和非再狭窄组，分别在PCI治疗前、出院前及复查冠状动脉造影前测定血浆TBIL浓度。比较分析两组相应的TBIL浓度。结果再狭窄组PCI治疗前、出院前及复查冠状动脉造影前的TBIL浓度与非再狭窄组分别进行比较，差异有统计学意义（P〈0．05）。多因素Logistic回归分析结果显示，血浆TBIL浓度是预测再狭窄的独立危险因子（P〈0．05）。结论血浆TBIL浓度与PCI治疗后再狭窄密切相关．是预测PCI治疗后再狭窄的独立预测因子。

Relationship of total bilirubin concentration and coronary in-stent restenosis after percutaneous coronary intervention

Objectives To study the relationship between total bilirubin （TBIL） concentration and coronary in-stent restenosis. Methods A total of 241 patients with acute coronary syndrome （ACS） or stable angina pectoris （SAP） successfully treated with percutaneous coronary intervention （PCI） were examined with a follow-up coronary angiography after one year. Study subjects were divided into in-stent restenosis （ISR） group and no ISR group. Blood samples for TBIL were obtained, compared and analyzed before PCI, at hospital discharge and before angiographic follow-up betwen the two groups. Results Patients with in-stent restenosis had significantly higher plasma concentrations of TBIL than their counterparts without in-stent restenosis before PCI, at hospital discharge and before angiographic follow-up （P〈 0.05）. Multivariate Logistic regression analysis revealed that high TBIL concentration was an independent predictor of ISR （P〈0.05）. Conclusions TBIL concentration can be used as a predictive factor for in-stent restenosis after PCI.