血清胆红素水平与冠状动脉狭窄病变程度及血脂的关系

Relationship between serum bilirubin level and lesions of coronary atherogenesis and serum lipid.

目的探讨血清胆红素水平与冠状动脉狭窄病变程度及血脂的关系。方法将152例已行冠状动脉造影患者分为冠心病组(狭窄≥50%)及对照组(冠状动脉造影正常者),比较两组间血清总胆红素(TB IL)、直接胆红素(DB IL)、间接胆红素(IB IL)及血脂水平,并对胆红素与血脂进行直线相关分析。结果冠心病组血清TB IL低于对照组(P<0.05),总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)均高于对照组(P<0.05或P<0.01。冠心病组中单支病变和中度狭窄患者血清TB IL和DB IL水平均低于对照组(P<0.05),多支病变和重度狭窄患者血清TB IL、DB IL和IB IL水平低于单支病变和中度狭窄患者以及对照组(P<0.05或P<0.01)。相关分析显示,血清胆红素与TC、TG和LDL-C呈显著负相关。结论胆红素影响血脂代谢。低胆红素血症患者易患冠心病,血清胆红素水平越低,冠状动脉狭窄病变程度越重。

Objective To explore the relationship between serum bilirubin level and severity of coronary atherogenesis and serum lipid, Methords 152 patients undergoing diagnostic coronary angiography were divided into two groups： the coronary heart disease （CHD） group（ 50% diameter narrowing） and the control group （coronary angiography is normal）, then comparison was done between the two groups of the level of serum total bilirubin （ TBIL）, direct bilirubin （ DBIL）, indirect bilirubin （IBIL） and serum lipid. Line correlation analysis was also don between serum bilirubin and serum lipid. Results The level of serum TB1L of the CHD group is much lower than that of the control group（ P 〈 0. 05, respectively）. The level of serum total cholesterol （ TC ） , triglycerides （TG） and low density lipoprotein cholesterol （ LDL - C ） of the CHD group is much higih than that of the contrlol group（ P 〈 0.05 or P 〈 0.01, respectively）. Serum levels of TBIL and DBIL in patients with single -vessel disease and medium coronary atherogenesis were markedly lower than that of the control group（ P 〈 0.05, respectively）. Serum levels of TBIL, DBIL and IBIL in patients with multiple - vessel disease and severe coronary atherogenesis were significantly decreased coropared with those in patients with single - vessel disease and medium coronary atherogenesis and control group （ P〈0.05 or P〈0.01, respectively）. It also showed there was a significant mad negative correlation between serum bilirubin and TC, TG, LDL - C. Conclusion Bilirubin afffects the metabolism of serum lipids. Low level of serum bilirubin cause CHD is easy. Those with lower bilirubin levels showed a more severe lesions of coronary atherogenesis.