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目的:探讨血清胆红素水平与冠状动脉病变严重程度以及血脂水平的相关性。方法:冠状动脉造影患者92例,冠心病(CHD)患者67例,其中急性心肌梗死(AMI)17例,不稳定型心绞痛(UAP)30例,稳定型心绞痛(SAP)20例;正常对照组25例。采用比色法测定血清总胆红素(TB)、直接胆红素(DB)、间接胆红素(IB)水平;采用酶联免疫吸附法测定血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及甘油三酯(TG)水平。对胆红素水平与冠状动脉狭窄程度、病变支数、病变积分及TC、TG、LDL-C的关系进行分析。结果:CHD患者血清TB及IB水平明显低于对照组(P<0.01),TG、TC、LDL-C水平明显高于对照组(P<0.05~0.01)。血清TB、IB、DB水平与冠状动脉病变支数、病变积分、病变程度及LDL-C呈负相关,与TG、TC无明显相关。结论:血清胆红素代谢紊乱可能参与了冠心病的发生和发展,其水平在一定程度上与冠状动脉病变的严重性及血脂水平有关。
Objective: To investigate the correlation between serum bilirubin level and the severity of coronary artery disease and blood lipid levels. Methods: Coronary angiography was performed in 92 patients and 67 patients with coronary heart disease (CHD). Among them, 17 were acute myocardial infarction (AMI), 30 were unstable angina pectoris (UAP) and 20 were stable angina pectoris (SAP) 25 cases. Serum total bilirubin (TB), direct bilirubin (DB) and indirect bilirubin (IB) levels were measured by colorimetric method. Serum total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels. The level of bilirubin and the degree of coronary artery stenosis, lesion count, lesion score and TC, TG, LDL-C were analyzed. Results: The levels of serum TB and IB in patients with CHD were significantly lower than those in the control group (P <0.01). The levels of TG, TC and LDL-C in patients with CHD were significantly higher than those in the control group (P <0.05-0.01). Serum TB, IB and DB levels were negatively correlated with coronary artery lesion count, lesion score, degree of lesion and LDL-C, but not with TG and TC. Conclusion: The disorder of serum bilirubin metabolism may be involved in the occurrence and development of coronary heart disease. The level of serum bilirubin is to some extent related to the severity of coronary artery disease and blood lipid levels.