老年冠心病患者胆红素水平变化的临床价值

目的研究老年冠心病患者血胆红素水平变化的临床价值.方法入选住院老年患者644例,将474例冠心病患者作为冠心病组;170例无冠心病患者作为非冠心病组.记录所有研究对象基本资料,检测血胆红素、血脂、肝功,同时进行心脏超声检测,并进行相关分析.结果冠心病组的总胆红素(TB)、间接胆红素(IB)显著低于非冠心病组(P<0.01),并与有无冠心病、冠心病严重程度、血脑钠肽(BNP)、室间隔厚度、左室后壁厚度呈负相关,与左室短轴缩短率呈正相关.而直接胆红素(DB)的水平在两组之间无统计学差异,与上述指标也均无统计学意义上的相关性.Logistic回归显示IB是冠心病的一个独立保护因素.结论在老年冠心病人群中胆红素(TB、IB)水平降低,在生理范围内轻度升高的胆红素是冠心病的一个保护因素,同时也是冠心病人群心功能的一个保护因素.

Clinical value of bilirubin levels in elderly coronary heart disease patients

Objective To study the clinical value of bilirubin levels in elderly coronary heart disease(CHD) patients.Methods Six hundred and forty-four elderly patients admitted to our hospital were divided into CHD group(n=474) and non-CHD group(n=170).Their basic data were recorded and their serum bilirubin,lipid,hepatic enzyme levels were measured.The patients underwent chocardiography.Results The total bilirubin(TB) and indirect bilirubin(IB) levels were significantly lower in CHD group than in non-CHD group(8.748±3.301 vs 9.753±3.682,5.711±2.692 vs 6.655±2.838,P<0.01),and negatively correlated with CHD(rs=-0.129,rs=-0.159,P<0.01) and its severity(rs=-0.116,rs=-0.132,P<0.01),BNP level(rs=-0.161,rs=-0.191,P≤0.01),interventricular septal thickness(rs=-0.103,rs=-0.124,P ≤0.01),and posterior left ventricular thickness(rs=-0.093,rs=-0.118,P<0.01),while positively correlated with the left ventricular shortening fraction(rs=0.104,rs=0.122,P<0.01).However,no significant difference was found in direct bilirubin(DB) level between the two groups.Logistic regression analysis showed that the IB was an independent protective factor for CHD(OR: 0.929,95%CI: 0.865-0.998,P<0.05).Conclusion The bilirubin level is low in elderly CHD patients and the slightly elevated serum bilirubin level within the normal range is an independent protective factor for CHD and cardiac function in CHD patients.