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目的 观察血清胆红素水平对冠心病的影响及胆红素与发作性心肌缺血、心率变异性的相关性。方法 对 78例冠心病患者 (冠心病组 ) ,根据有无发作性心肌缺血分为发作性心肌缺血组 32例 ,无发作性心肌缺血组 4 6例 ;31例健康者 (正常组 )均测定血清胆红素水平及应用Holter观察发作性心肌缺血并测定心率变异性指标 (ASDNN5、SDANN5、SDNN、RMSSD)。结果 冠心病组与正常组比较总胆红素、结合胆红素、非结合胆红素水平组间统计学有极显著性差异 (P <0 0 1) ,ASDNN5组间有显著性差异 (P <0 0 5 ) ,SDANN5、SDNN组间有极显著性差异 (P <0 0 1) ,而RMSSD组间差异无统计学意义 (P >0 0 5 ) ,发作性心肌缺血组与无发作性心肌缺血组胆红素水平无显著性差异 (P >0 0 5 ) ,总胆红素、结合胆红素、非结合胆红素分别与ASDNN5、SDANN5、SDNN、RMSSD采用直线相关分析计算r值均无统计学意义 (P >0 0 5 )。结论 低水平胆红素对冠心病的发生有明确的促进性作用 ,但对发作性心肌缺血无明显影响 ,胆红素与心率变异性之间无明显相关性 ,可能是两个相对独立的危险因素。
Objective To observe the effect of serum bilirubin on coronary heart disease and the relationship between bilirubin and myocardial ischemia and heart rate variability. Methods Seventy eight patients with CHD (coronary heart disease) were divided into 32 cases of paroxysmal myocardial ischemia and 46 cases of non-paroxysmal myocardial ischemia according to the presence or absence of episodic myocardial ischemia. Thirty-one healthy subjects (normal group ) Were measured serum bilirubin levels and Holter observation of myocardial ischemia and measured heart rate variability (ASDNN5, SDANN5, SDNN, RMSSD). Results There was a significant difference between the coronary heart disease group and the normal group in the statistics of total bilirubin, conjugated bilirubin, and unconjugated bilirubin (P <0.01), and significant difference was found between the groups of ASDNN5 (P (P <0.01), but there was no significant difference between the RMSSD groups (P> 0.05). There was no significant difference between the SDAN5 group and the SDNN group There was no significant difference in bilirubin levels between groups with acute myocardial ischemia (P> 0.05). The total bilirubin, conjugated bilirubin and unconjugated bilirubin were respectively calculated with linear correlation analysis with ASDNN5, SDANN5, SDNN and RMSSD r values were not statistically significant (P> 0.05). Conclusion Low-level bilirubin has a clear and promoting effect on the occurrence of coronary heart disease, but it has no obvious effect on the onset of myocardial ischemia. There is no significant correlation between bilirubin and heart rate variability, which may be two relatively independent Risk factors.