血清直接胆红素与冠状动脉轻度狭窄的关系

Correlation between serum direct bilirubin level and mild coronary stenosis

目的探讨血清直接胆红素与冠状动脉轻度狭窄的关系。方法经造影证实冠状动脉狭窄〈40%的患者335例,根据直接胆红素水平分为观察组166例（直接胆红素3.02（2.55,3.82）μmol/L）,对照组169例（直接胆红素1.82（1.51,2.11）μmol/L）,比较2组临床相关指标的变化。结果观察组男性比例（64.5%）、血红蛋白（143.0（131.0,152.0）g/L）及肌酐（73.00（62.00,83.00）μmol/L）水平高于对照组（40.8%、138.00（126.00,148.00）g/L、66.00（60.00,75.00）μmol/L）,高脂血症比例（55.4%）、白细胞计数（6.00（5.21,7.11）×10^9/L）、血小板计数（199.00（169.00,230.80）×10^9/L）、纤维蛋白原（2.58（2.30,2.86）g/L）水平低于对照组（67.5%、6.49（5.66,7.54）×10^9/L、217.00（189.50,252.30）×10^9/L、2.70（2.42,3.09）g/L）（P〈0.05）;观察组冠状动脉轻度狭窄率为44.0%,对照组为45.6%,2组比较差异无统计学意义（P〉0.05）;校正混杂因素后,直接胆红素的临床影响因素为性别（OR=0.388,95%CI：0.160~0.944,P=0.037）、高脂血症（OR=0.498,95%CI：0.301~0.824,P=0.007）和血小板计数（OR=0.994,95%CI：0.989~0.999,P=0.031）。结论血清直接胆红素并非冠状动脉轻度狭窄的临床影响因素。

Objective To analyze the correlation between serum direct bilirubin level and mild coronary stenosis.Methods A total of 335 patients with angiographically confirmed stenosis 40% in each major coronary artery were divided into observation group（n=166）（direct bilirubin：3.02（2.55,3.82）μmol/L）and control group（n=169）（direct bilirubin：1.82（1.51,2.11）μmol/L）.The clinical relavant factors were analyzed between two groups.Results The male ratio,hemoglobin level and creatinine level were significantly higher in observation group（64.5%,143.00（131.00,152.00）g/L,73.00（62.00,83.00）μmol/L）than those in control group（40.8%,138.00（126.00,148.00）g/L,66.00（60.00,75.00）μmol/L）（P〈0.05）,while hyperlipidemia ratio,white blood cell count,platelet count and fibrinogen were significantly lower in observation group（55.4%,6.00（5.21,7.11）×10^9/L,199.00（169.00,230.80）×10^9/L,2.58（2.30,2.86）g/L）than those in control group（67.5%,6.49（5.66,7.54）×10^9/L,217.00（189.50,252.30）×10^9/L,2.70（2.42,3.09）g/L）（P〈0.05）.There was no significant difference in the mild coronary stenosis rate between observation group（44.0%）and control group（45.6%）（P 0.05）.Multivariate analyses revealed that the sex（OR=0.388,95%CI：0.160 to 0.944,P=0.037）,hyperlipidemia（OR=0.498,95%CI：0.301 to 0.824,P=0.007）and platelet count（OR=0.994,95%CI：0.989 to 0.999,P=0.031）were the influential factors for direct bilirubin level.Conclusion Direct bilirubin level is not the influential factor for mild coronary stenosis.