脑梗死患者血清胆红素及血脂变化的临床意义探讨

目的 观察脑梗死患者血清胆红素水平的变化，探讨其与血脂浓度变化的关系及临床意义。方法 选择脑梗死患者组64例和对照组32例，应用生化方法（全自动生化分析仪）测定血清总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（IBIL）及血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、脂蛋白-α（Lp-α）、载脂蛋白A1（ApoA）、载脂蛋白B（ApoB）浓度，并进行统计学分析。结果脑梗死患者血清TBIL、IBIL浓度显著高于对照组，有显著性差异（P〈0．01），DBIL浓度也明显高于对照组，有显著性差异（P〈0．05）；血清TC、TG、LDL及ApoA浓度较对照组增高，有显著性差异（P〈0．01），HDL、ApoB浓度较对照组低，有显著性差异（P〈0．05）；Lpia浓度也较对照组升高，但无统计学意义（P〉0．05）；且血清IBIL浓度与LDL浓度呈正相关（r=0．213，P〈0．05）。结论 胆红素、血脂的异常变化与脑梗死的发生、发展有一定关系。

Clinical Significance of Serum Bilirubin and Blood-Lipid Level in Patients with Cerebral Infarction

Objective To explore the change of serum bilirubin and blood-lipid level in patients with cerebral infarction. Methods Serum total bilirubin, direct bilirubin, indirect bilirubin, total cholesterol, triglycerides, serum high-density lipoprotein cholesterol, serum low-density lipoprotein cholesterol, lipoproteina,apolipoprotein A1, apolipoprotein B was measured in 64 patients with cerebral infarction （the observed group） and 32 healthy controls. Apply SPSS 10.0 for windows to deal with all data, T test was used to compare between the groups. Results Serum bilirubin in patients in the observed group total bilirubin 16. 464± 7. 442μmol/L,direct bilirubin 3. 264± 1. 719 μmol/L,indirect bilirubin 13. 201± 6. 130 μmol/L was higher than＇the patients in the control group. P 〈0.01 （TBIL）, P 〈0.05 （IBIL） ;the level of indirect bilirubin was in positive correlation with the concentration of lowdensity lipoprotein cholesterol （ r = 0.213, P 〈 0.05 ）. Serum total cholesterol, triglycerides, serum high-density lipoprotein cholesterol, apolipoprotein B was significantly increased in patients in the observed group （P 〈0.01 ） ,serum low-density lipoprotein cholesterol, apolipoprotein A1 in patients in the observed group was significantly decreased in the patients in the observed group（ P 〈 0.01 ）. Conclusion It suggested that there were pathophysiological relationships between cerebral infarction and serum levels of bilirubin and blood-lipid.