血清胆红素和血脂的综合指数对冠心病的预测价值

目的探讨血清胆红素和血脂的综合指数与冠心病的关系。方法应用冠脉造影技术将120例患者分2组：冠心病组与对照组。测定血清总胆红素（TBIL）、高密度脂蛋白胆固醇（HDLC）、低密度脂蛋白胆固醇（LDLC）、总胆固醇（TC）等指标，并计算出其综合指数：TC／（HDLC＋TBIL）和LDLC／（HDLC＋TBIL），探讨其与冠心病的关系。结果冠心病组血清TBIL及HDLC水平均明显低于对照组（均P〈0．01），TC／（HDLC＋TBIL）和LDLC／（HDLC＋TBIL）水平高于对照组（均P〈0．01）。经多变量的losistic回归分析，LDLC／（HDLC＋TBIL）比值作为冠心病独立的危险因素优于其他传统的单一指标。ROC曲线显示，LDLC／（HDLC＋TBIL）比值曲线下面积最大。结论低血清胆红素水平是冠心病的独立危险因素，血清胆红素和血脂的综合指数是冠心病一个较好的辅助预测指标。

The value of composite indexes of serum bilirubin and blood lipid combination to predicting coronary heart disease

Objective To study the relations between composite indexes of serum bilirubin,blood lipid variables and coronary heart disease(CHD).Methods A total of 120 patients underwent coronary angiography was entered the study.They were divided into two groups based on their results of coronary angiography:CHD group and normal group.Serum total bilirubin(TBIL),high density lipoprotein cholesterol(HDLC),low density lipoprotein cholesterol(LDLC),total cholesterol(TC),TC/(HDLC TBIL),LDLC/(HDLC TBIL)and other traditional indexes were tested.The relations were investigated between two groups.Results TBIL and HDLC were significantly lower in CHD group than those of normal group(all P<0.01).TC/(HDLC TBIL)and LDLC/(HDLC TBIL)of CHD group were significantly higher than those of normal group((all P<0.01).LDLC/(HDLC TBIL)ratio was a independent risk factor of CHD by logistic regression analysis,and it was better compared with other traditional separate indexes.Area under receiver operator characteristic curve revealed the LDLC/(HDLC TBIL)ratio was the biggest of all the indexes.Conclusions The lower serum bilirubin is a independent risk factor of CHD.LDLC/(HDLC TBIL)ratio is a better predictor for CHD,and the higher the ratio,the greater the risk of developing of CHD would be.