胆红素代谢与冠状动脉病变及血脂的关系

Relationship Between Bilirubin Metabolism Coronary Artery Disease and Lipids

目的探讨胆红素代谢与冠状动脉病变及血脂的关系。方法回顾性分析经冠状动脉造影确诊的冠心病(CAD)患者冠脉高度狭窄者42例、中度狭窄者25例及冠脉造影正常者34例的血清胆红素、血脂水平。结果CAD患者血清总胆红素(TBil)、直接胆红素(DBil)、间接胆红素(IBil)和高密度脂蛋白胆固醇(HDL-C)均低于冠脉造影正常者;总胆固醇(TC)、三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)高于冠脉造影正常者(P均<0.05);高度狭窄组与中度狭窄组之间其血清胆红素和血脂也有差异,但未达到统计学差异(P均>0.05)。将101例研究对象作为整体进行相关性分析,血清TBil、DBil和IBil与TC、TG和LDL-C均呈负相关,与HDL-C均呈正相关(P均<0.01)。结论胆红素代谢异常可能通过对血脂的影响在CAD的发生发展过程中发挥重要作用。

Objective To explore the relationship between bilirubin, coronary artery disease（CAD） and lipids. Methods The data of serum bilirubin and lipids in 42 CAD patients with strait coronary artery were reviewed, 25 CAD patients with middle coronary artery was determined by angiography were analysed retrospectively and compared and 34 control subjects angiography were normal. Results The serum levels of total bilirubin （ TBil ）, direct bilirubin （ DBil ）, indirect bilirubin （ IBil ） and high density lipoprotein cholesterol （HDL- C） in CAD group were markedly lower than those in normal group. The total cholesterol （TC）, triglycerides （TG） and the low density lipoprotein cholesterol （LDL - C） in CAD group were significantly higher than those in normal group（ P 〈 0.05）. The serum levels of bilirubin and lipids were different in straitness group and middle group, but the difference was not significant（ P 〉 0.05 ）. Serum TBil, DBil and IBil were negatively correlated with TC, TG and LDL - C, positively correlated with HDL - C （ P 〈 0.01 ）. Conclusion The metabolism abnormity of bilirubin may play an important role in the development of CAD by influencing lipids.