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目的探讨急性冠脉综合征(ACS)病人血清胆红素变化的临床意义。方法108例ACS病人分为ST段抬高的心肌梗死组(STEM I组,40例),非ST段抬高的心肌梗死组(NSTEM I组,30例),不稳定型心绞痛组(UAP组,38例),对照组45例为健康查体人员。108例病人中66例行冠状动脉造影后分为单支病变组(26例),双支病变组22例,三支病变组(18例),选择同期冠状动脉造影正常的30例非冠心病病人作为对照组。以上各组均测定血清总胆红素、直接胆红素等临床指标。结果对照组总胆红素、直接胆红素均高于其他各组(P<0.05);其中UAP组高于STEM I组(P<0.05)。造影正常组血清胆红素也高于其他三组(P<0.05),单支病变组高于多支病变组(P<0.05)。结论ACS病人血清胆红素低于正常人,低血清胆红素水平可能与ACS患者病情严重程度有关。
Objective To investigate the clinical significance of serum bilirubin in patients with acute coronary syndrome (ACS). Methods One hundred and eight patients with ACS were divided into three groups: ST-segment elevation myocardial infarction group (STEMI group, 40 cases), non-ST elevation myocardial infarction group (NSTEM I group, 30 cases), unstable angina group (UAP group) , 38 cases), 45 cases in the control group were physical examination. Among the 108 patients, 66 patients underwent coronary angiography and were divided into single vessel lesion group (26 cases), double vessel lesion group (22 cases) and triple vessel lesion group (18 vessel). Thirty patients with normal coronary angiography at the same period Patient served as control group. The above groups were measured serum total bilirubin, direct bilirubin and other clinical indicators. Results The levels of total bilirubin and direct bilirubin in the control group were higher than those in other groups (P <0.05). The UAP group was higher than the STEM I group (P <0.05). Serum bilirubin in normal control group was also higher than the other three groups (P <0.05), single vessel lesion group was higher than multi-vessel disease group (P <0.05). Conclusions Serum bilirubin in ACS patients is lower than that in normal people. The serum bilirubin level may be related to the severity of ACS patients.