血清胆红素与早发冠心病关系的研究

目的：探讨血清胆红素水平与早发冠心病的关系。方法：以196例行冠状动脉造影的患者（年龄≤55岁）为研究对象，按照冠脉造影结果分为早发冠心病组（76例）和正常对照组（120例），检测两组血清胆红素水平，分析其与冠脉病变程度关系。结果：与正常对照组比较，早发冠心病组总胆红素[TBIL，（14．65±5．49）μmol／L比（12．78±4．35）μmol／L]、直接胆红素[DBIL，（3．83±2．12）μmol／L比（3．11±1．83）μmol／L]、间接胆红素[IBIL，（11．53±4．83）μmol／L比（9．07±4．16）μmol／L]均明显降低（P均〈0．05）。随胆红素水平降低，冠状动脉病变支数增加。多支病变组TBIL水平明显低于单支、双支病变组[（10．20±2．41）μmol／L比（13．81±4．38）μmol／L，（12．98±4．53）／μmol／L]；IBIL水平明显低于单支病变组[（7．24±2．73）μmol／L比（10．30±3．36）μmol／L]，P〈0．05～〈0．01。多因素Logistic回归分析显示TBIL与冠心病危险性呈负相关（r=-0．476，P〈0．01）。结论：低血清胆红素可能是早发冠心病的独立危险因素。血清胆红素可以预测动脉粥样硬化严重程度。

Relatlonship between serum bilirubin and premature coronary heart disease

Objective： To study correlation between serum level of bilirubin and premature coronary heart disease （CHD）. Methods： According to results of coronary angiography of 196 patients （≤55 years old）, they were divided into premature CHD group （n=76） and normal control group （n=120）. Serum level of bilirubin was measured in the two groups and its correlation with severity of coronary artery disease was analyzed. Results： Compared with normal control group, levels of total bilirubin [TBIL, （14.65±5.49）μmol/L vs. （12.78±4.35） μmol/L], direct bilirubin [DBIL, （3.83±2.12）μmol/L vs. （3.11 ± 1.83） μmol/L] and indirect bilirubin [IBIL, （11.53±4.83） μmol/L vs,19.07 ± 4.16）μmol/L] significantly decreased in premature CHD group （ P〈0.05 all）. In premature CHD group, level of TBIL of multiple coronary arteries with lesions decreased than those of single and double coro- nary arteries with lesions group [- （10. 20±2. 41） μmol/L vs. （13.81±4.38） μmol/L, （12.98±4.53）μmol/L, and IBIL level decreased than that of single coronary arteries with lesions group [（7.24±2.73） μmol/L vs. （10.30 ±3.36） btmol/L], P〈0.05〈0.01. As level of bilirubin decreased, branches of coronary arteries with lesions increased. Multiple factor Logistic regression analysis indicated that TBIL was negatively correlated with risk of CHD （r =-0. 476, P〈0. 01）. Conclusion.. Low level of serum bilirubin may be an independent risk factor for premature coronary heart disease. It may be used to predict the severity of atherosclerosis.