血清胆红素及氧化修饰低密度脂蛋白与冠状动脉病变的关系

目的:探讨血清胆红素及氧化修饰低密度脂蛋白(ox-LDL)与冠状动脉病变范围、程度及稳定性的关系。方法:将186例患者按冠状动脉造影结果分为冠心病组(120例)和对照组(66例),测定血清胆红素及血脂水平。结果:(1)冠心病组的胆红素均低于对照组(P<0.05),而ox-LDL,低密度脂蛋白胆固醇(LDL-C)及总胆固醇(TC)较对照组增高(P<0.05);(2)冠状动脉病变范围越大、狭窄程度越重、病变越不稳定,总胆红素(TBIL)水平越低、ox-LDL浓度越高(P<0.05)。结论:血清胆红素浓度降低使体内抗氧化活性减弱,可能引起LDL-C氧化修饰形成ox-LDL增多,从而促使冠心病的发生;TBIL及ox-LDL与冠状动脉病变的范围、程度及稳定性相关,对评价冠心病的预后和疗效有一定临床意义。

Correlations between serum bilirubin, oxidatively modifled low density lipoprotein and coronary artery lesion

Objective:To investigate correlation between serum bilirubin, oxidatively modified low density lipoprotein (ox-LDL) and the extent,severity and stability of coronary artery lesion. Methods: One hundred and eighty-six patients were divided into coronary heart disease group (n= 120) and control group (n = 66) according to the result of coronary angiographic examination. Their serum bilirubin, ox-LDL and other plasma lipids were measured. Results: (1) The concentration of bilirubin in patients with coronary heart disease was lower than that in control group (P<0. 05). The concentrations of ox-LDL,LDL-C and total cholesterol in coronary heart disease group were higher than those in controls gruop(P<0. 05). (2) Strong negative correlations existed between total bilirubin (TBIL) and the extent, severity and unstability of coronary artery lesions and positive correlation existed between ox-LDL and the above parameters (P<0. 05). Conclusion: Lower serum bilirubin concentration reduces the activities of antioxidants. It is possible that peroxidation of LDL-C leads to increase in ox-LDL and increases the rist of coronary heart disease. TBIL and ox-LDL are important in evaluating the extent,severity and stability of coronary artery lesions.