血清总胆红素浓度与动脉粥样硬化性血栓性脑梗死的关系

目的　探讨血清总胆红素浓度在动脉粥样硬化性血栓性脑梗死发病中的作用。方法　选择动脉粥样硬化性血栓性脑梗死患者 32 7例和对照组 380例 ,并将病例与对照配对 93对。采清晨空腹肘静脉血测定血清总胆红素浓度 ,比较两组间血清总胆红素浓度的差异 ,并进一步利用病例对照配对研究 ,对低浓度血清总胆红素与动脉粥样硬化性血栓性脑梗死的关系进行分析。结果　病例组血清总胆红素浓度显著低于对照组 (u =5 5 7,P <0 0 1) ;病例组和对照组血清总胆红素低、中、高浓度构成不同 ,病例组低浓度的比例高于对照组 ,高浓度的比例低于对照组 (x2 =6 6 0 1,P <0 0 1) ;病例对照配对分析表明 ,低浓度血清总胆红素与动脉粥样硬化性血栓性脑梗死有关 ,与非低浓度组相比 ,低浓度可使动脉粥样硬化性血栓性脑梗死的危险性增加 1 0 5倍 (OR =2 0 5 ,x2 =6 2 2 ,P <0 0 5 )。结论　低浓度血清总胆红素可能与动脉粥样硬化性血栓脑梗死的发病之间存在相关性

A Case-Control Study on Atherosclerotic Thrombotic Cerebral Infarction and Serum Total Bilirubin

Objective This paper is to discuss the role of the concentration of serum total bilirubin in the etiology of atherosclerotic thrombotic cerebral infarction.Methods Compare the concentration of fast serum total bilirubin in 327 patients with atherosclerotic thrombotic cerebral infarction (group A) and 380 control persons without atherosclerotic thrombotic cerebral infarction (group B).Results The concentration of fast serum total bilirubin in group A is significantly lower than that in group B( u=5 57,P <0 01).The concentration of fast serum total bilirubin normally is 1 7～20 5μmol/L.According to the concentration of fast serum total bilirubin,it is divided into 3 categories:<9 0μmol/L-low concentration;9 0～15μmol/L-middle concentration;>15μmol/L-high concentration.The ratio of low concentration in group A is higher than that in group B and the ratio of high concentration in group A is lower than that in group B( x 2=66 1,P <0 01).It indicated that the lower serum total bilirubin is related to the etiology of atherosclerotic thrombotic cerebral infarction.Compared with non-lower concentration,lower concentration will do more harm to thrombotic cerebral infarction(OR=2 05, x 2=6 22,P <0 05).Conclusions There is a relationship between the lower concentration of serum total bilirubin and the etiology of atherosclerotic thrombotic cerebral infarction.