急性冠脉综合征患者血清胆红素水平的相关研究

目的探讨人血清胆红素水平与急性冠脉综合征患者病变程度的关系。方法以80例行冠脉造影的患者为研究对象,其中确诊为急性冠脉综合征的67例为试验组,包括ST段抬高型心肌梗死29例,非ST段抬高型心肌梗死18例,不稳定型心绞痛20例;造影结果为阴性的非冠心病患者13例为对照组,包括X综合征患者8例,心血管神经症患者5例。所有研究对象均依据Gensini评分而分为4组,同时检测患者胆红素及各项生化指标。结果(1)急性冠脉综合征患者各组血清直接胆红素、间接胆红素与总胆红素水平均低于正常对照组(P<0.05)。随冠状动脉狭窄程度加重,胆红素水平逐渐下降。(2)血清胆红素水平与冠状动脉的狭窄程度、低密度脂蛋白、甘油三酯呈负相关(P<0.05),与高密度脂蛋白呈正相关。结论血清胆红素水平随冠状动脉狭窄程度的加重呈进行性下降,低胆红素血症可能是急性冠脉综合征发生发展的独立危险因素。

Correlative Study on Concentrations of Serum Bilirubin in Patients with Acute Coronary Syndrome

Objective To explore the relationship between the levels of serum bilirubin and the severity of coronary artery atherosclerosis.Method In this study,80 patients who accepted coronary angiography were divided into 2 groups according to Gensini scoring system:test group(67 cases) were acute coronary syndrome(ACS) patients,including 29 cases of ST-elevated myocardial infarction(STEMI),18 cases of non-ST-elevated myocardial infarction(NSTEMI) and 20 cases of unstable angina;control group(13 cases) were negative non-coronary heart disease patients,including 8 cases of syndrome X and 5 cases of cardiovascular neurosis.Serum bilirubin and related parameters were measured.Results (1)Compared with control group,the concentrations of direct bilirubin,indirect bilirubion and total bilirubin significantly reduced in test group.Along with the aggravation of coronary artery stenosis,the levels of bilirubin decreased in these patients.(2)Serum bilirubin level was negatively correlated with the extent of coronary artery stenosis,low density lipoprotein and triglyceride,while it was positively correlated with the high density lipoprotein(P<0.05).Conclusions The levels of serum bilirubin decrease progressively along with the aggravation of coronary stenosis.Low bulirubinemia is the independent risk factor of acute coronary syndrome.