血清胆红素水平与颈动脉粥样硬化斑块相关性分析

目的 探讨血清总胆红素（total bilirubin，TBIL）水平与颈动脉粥样硬化（carotid atherosclerosis，CAS）斑块之间的相关性。方法 选取2009年9～10月开滦集团公司在职高级管理人员475例进行健康体检，测定血清TBIL水平，同时用彩色多普勒超声诊断仪进行颈部血管超声检测，根据颈动脉粥样硬化斑块的有无分为颈动脉粥样硬化斑块组（n=111）和无颈动脉粥样硬化斑块组（对照组）（n=364）。观察两组间血清TBIL水平是否具有差异；同时将血清TBIL水平按四分位数分为四组，分析颈动脉粥样硬化斑块与血清TBIL水平之间的关系。结果 ①颈动脉粥样硬化斑块组血清TBIL水平低于对照组，差别有统计学意义（12.61±5.17 μmol/L vs 13.83±5.31 μmol/L，P =0.033）。②不同血清TBIL水平者的颈动脉粥样硬化斑块检出率没有达到统计学差异，但随着血清TBIL水平的升高，颈动脉粥样硬化斑块检出率呈现逐渐减低趋势。③血清TBIL水平位于最高四分位者发生颈动脉粥样硬化斑块的风险显著低于血清TBIL水平位于最低四分位者［优势比（odds ratio，OR）为0.43，95%可信区间（confidence interval，CI）在0.23～0.81之间］。④校正其他影响因素后，TBIL仍为颈动脉粥样硬化斑块形成的保护性因素。结论 TBIL水平与颈动脉粥样硬化斑块的发生有一定相关性，高水平TBIL对颈动脉粥样硬化斑块形成有一定的保护作用。

Relationship Between Serum Bilirubin and Carotid Atherosclerotic Plaque in Physical Examination Population

Objective To investigate the relationship between the bilirubin level in serum and carotid atherosclerotic plaque. Methods We selected 475 subjects of Kaluan Group who had received a physical examination in the period from September to October in 2009. The subjects were divided into two groups according to carotid artery plague examined with colour doppler ultrasonography（1 11 cases of carotid atherosclerotic plaque group and 364 cases of control group） and were divided into four groups according to the level of total bilirubin. Results（2）There was significant difference（P〈0.05） in group of carotid atherosclerotic plaque（12.61±5.17 μmol/L） compared to in control group（13.83±5.31 μmol/L）. There was no significant difference（P=0.067） in different serum bilirubin levels. However, the formation rate of carotid atherosclerotic plague showed decrease trend with the serum bilirubin level increased. （3）Higher serum bilirubin level is one of the protective factors for carotid atherosclerotic plaque（OR 0.43; 95%CI 0.23-0.81）. Qcorrecting other affected factors, higher serum bilirubin level still is a protective factor for carotid atherosclerotic plaque. Conclusion There was some relationship between serum bilirubin and carotid atherosclerotic plaque. Higher serum bilirubin level had certain protective effects on artery atherosclerotic plaque. Key Words] Carotid stenosis; Bilirubin; ultrasonography