血胆红素水平与冠状动脉病变关系的初步探讨

Association between serum bilirubin and coronary lesions

目的探讨冠状动脉(冠脉)粥样硬化性心脏病(冠心病)患者血胆红素(BIL)水平与冠脉病变之间的关系。方法将630例行冠脉造影者,根据有无冠心病分为冠心病组(根据冠脉病变支数分为单支病变组、双支病变组和3支病变组)和对照组。分别测定各组研究对象血BIL的含量,分析它们与冠脉病变之间的关系。结果血间接胆红素(IBIL)在冠心病组[(5.73±2.69)μmol/L]低于对照组[(6.32±3.24)μmol/L](t=2.02,P<0.05),而总胆红素(TBIL)和直接胆红素(DBIL)在两组间差异均无统计学意义(F=3.49,P>0.05)。血IBIL在3支病变组低于双支、单支病变组和对照组(P<0.05),血TBIL随冠脉病变支数增加而减少,DBIL随冠脉病变支数增加而增加,但在各组间差异均无统计学意义(P>0.05)。多重线性回归及Logistic回归分析,在较正冠心病相关因素后,低水平血BIL并非冠心病独立危险因素,与冠脉病变程度无关。结论低水平血IBIL可作为冠心病冠脉病变程度的标志物之一,而非独立危险因素,为临床医生提供警示作用。

Objective To examine the association of serum total bilirubin （TBIL）, direct bilirubin （DBIL）, indirect bilirubin （IBIL） with coronary lesions. Methods A total of six hundred and thirty subjects who underwent elective coronary angiography （CAG） were divided into control subgroup and coronary atheroselerotic heart disease （CAD） group, patients were divided into single-, double- and triple-vessel disease groups according to the number of vessels with significant stenosis. The concentration of serum bilirubin（BIL） was determined. Results Serum IBIL level in CAD group [ （5.73 ± 2. 69） umol.L] was lower than that in control group I （6. 32 ± 3.24） umol/L, t = 2.02, P 〈 0. 05 ）, while there were no statistically differences in serum TBIL and DBIL between the two groups （P 〉 0. 05 ）. Serum IBIL level in triple-vessel disease group was lower than that in double-, single-vessel disease groups and control group （ all F = 3.49, P 〈 O. 05 ） , while there were no statistically differences in serum TBIL and DBIL levels among different vessel disease groups （ all P 〉 0. 05 ）. Multiple linear regression and multivariate logistic regression analyses showed that low serum BIL level was not independent risk factors for CAD after adjusted relative factors of CAD （ P 〉 0. 05 ）. Conclusion Low serum IBIL may be not an independent risk factor for incidence or severity of CAD.