临床胆红素浓度与吸烟和慢性阻塞性肺疾病的关系

Relationships between clinical bilirubin levels and smoking and chronic obstructive pulmonary disease

目的比较慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）患者和无COPD患者临床胆红素水平的差异并分析吸烟对胆红素水平的影响。方法统计分析符合条件的2011-05~2014-05主诊断为COPD的患者与没有COPD患者的总胆红素、间接胆红素和直接胆红素水平。结果 1吸烟患者总胆红素和间接胆红素水平降低,戒烟后可恢复至正常胆红素水平。吸烟COPD患者总胆红素和间接胆红素分别为（11.23±2.90）μmol/L和（7.67±2.58）μmol/L,吸烟无COPD患者分别为（11.42±3.88）μmol/L和（8.88±3.02）μmol/L,与不吸烟无COPD患者比较,差异有统计学意义（P〈0.05）。戒烟后COPD患者分别为（13.14±2.95）μmol/L和（9.42±2.95）μmol/L,无COPD患者分别为（14.75±2.94）μmol/L和（11.49±2.50）μmol/L,与不吸烟无COPD患者比较,差异未见统计学意义（P〉0.05）。2COPD组总体平均间接胆红素为8.92±2.83μmol/L,低于无COPD组（P〈0.05）。结论间接胆红素是体内胆红素发挥抗氧化作用的主要形式,未来可能作为临床抗氧化治疗的诊断指标。

Objective To compare the difference of total, indirect and direct bilirubin levels between chronic obstructive pulmonary disease（COPD）patients and non-COPD patients and analyze the influence of smoking on bilirubin levels. Methods The levels of total, indirect and direct bilirubin were detected in qualified patients with primary diagnosis of COPD and non-COPD from May 2011 to May 2014. Results （1）Smoking reduced total and indirect bilirubin levels, and after quitting smoking, the bilirubin levels recovered to the normal physiological level. The total and indirect bilirubin levels were （11.23 ± 2.90 ）μmol/L and （7.67 ±2.58 ）μmol/L in smoking/ COPD group and（ 11.42± 3.88）μmol/L and（ 8.88 ± 3.02 ）μ mol/L in smoking/no COPD group, which were significantly lower than in no smoking/no COPD group. After quitting smoking, the total and indirect bilirubin levels were （13. 14 ±2.95 ）μmol/L and （9.42 ±2.95 ） μmol/L in smoked/COPD group, and（ 14.75 ± 2.94） μmol/L and（ 11.49 ±2.50） μmol/L in smoked/no COPD group, which were not significantly different from no smoking/no COPD group （ P 〉 0.05 ）. （2）Average indiree bilirubin level in COPD group was （ 8.92 ±2.83 ）μmol/L, which was lower than that in no-COPD group（P 〈 0.05 ）. Conclusion Indirect bilirubin is a major form for antioxidantive effect in vivo and is promising to be a clinical diagnostic indicator for antioxidant therapy.