胆固醇及胆红素水平与冠心病、胆结石的关系探讨

Relationship between levels of serum cholesterol and coronary artery disease and gallstone

目的探讨胆红素、胆固醇代谢与冠心病(CAD)、胆结石及CAD合并胆结石(合并症)的关系。方法279例患者根据冠状动脉造影结果及是否有胆结石分为对照组93例,胆结石组19例,CAD组115例,合并症组52例,分别测定血清胆红素及胆固醇代谢水平。结果CAD组合并结石率高于CAD正常组。C组TB低于A组、B组,C、D组的IB、TC、HDL-C、LDL-C均不同于A组,B组HDL-C低于A组。结论胆固醇代谢异常是CAD及胆结石共同危险因素,胆红素浓度降低与CAD相关,胆结石导致的DB升高可能对冠心病发病无明确保护作用。

Objective To explore the relationship between serum cholesterol and coronary artery disease and gallstone. Methods According to coronary artery angiography（CAG）and gallstone, 279 patients were divided into four groups, including control group （93 cases）, gallstone group （19 cases）, CAD group （115 cases） and CAD accompanied gallstone group （52 cases）. The serum bilirubin in and cholesterol were measured. Results The serum total cholesterol （TC） and low density lipoprotein cholesterol （LDL-C） in gallstone group, CAD group and CAD accompanied gallstone group were significantly higher than those in control group （P〈 0. 05）, whereas the serum high density lipoprotein cholesterol （LDL-C） were significantly lower than those in control group （P〈0. 05 or P〈0. 01）. The serum direct bilirubin （DB） in gallstone group were higher than those in control group （P〈0. 05）. The serum total bilirubin （TB）, DE and indirect bilirubin （IB） in CAD group were markedly lower than those in control group （P〈0. 05）. The serum TB and IB in CAD accompanied gallstone group were markedly lower than those in control group （P〈0. 05）, but the difference of the serum DB was not significant （P〉0. 05）. The serum DB in CAD accompanied gallstone group were higher than those in CAD group （P〈0.05）. Conclusion The abnormal metabolism of cholesterol is common risk factor for CAD and gallstone. The reduced bilirubin concentration is related to CAD.