急性冠状动脉综合征患者血总胆红素、尿酸水平分析

Study of relationship between the levels of total serum bilirubin,uric acid and acute coronary syndrome

目的:探讨急性冠状动脉综合征(ACS)患者血清总胆红素、尿酸(UA)水平的变化。方法:将238例ACS患者分为ST段抬高急性心肌梗死(STEMI)组,非ST段抬高急性心肌梗死(NSTEMI)组,不稳定型心绞痛(UAP)组,检测血清总胆红素、UA、血糖、血脂等生化指标,部分ACS患者行冠状动脉造影检查。109例冠状动脉造影检查未见冠状动脉明显狭窄者作为对照组。结果:ACS各组患者血清总胆红素、UA、血糖显著高于对照组,差异有统计学意义(P<0.01或P<0.05)。STEMI组总胆红素、血糖显著高于NSTEMI组和UAP组患者,差异有统计学意义(P<0.01)。1周后复查,ACS各组患者血清总胆红素明显回降,与对照组比较差异无统计学意义(P>0.05)。结论:ACS患者血糖、UA升高,提示机体氧化应激加重;同时血清总胆红素升高,显示机体代偿性抗氧化程度加强。随病情逐渐稳定,胆红素回降。UA和胆红素可间接反映ACS机体氧化、抗氧化情况。胆红素对评估病情进程亦有一定帮助。

Objective：To study the relationship between serum total bilirubin, uric acid and coronary lesion in people with acute coronary syndromes. Method： Two hundred and thirty-eight patients with acute coronary syndromes were divided into the ST elevated myocardial infarction （STEMI） group, the non ST elevated myocardial infarction （NSTEMI） group, the unstable angina pectoris （UAP） group. Some of them were undergone diagnostic coronary angiography. One hundred and nine patients undergoing diagnostic coronary angiography who were detected without coronary heart disease were selected as the control group. Total bilirubin, uric acid, sugar, TC, TG, HDL, LDL were measured in all of the groups. The comparison was done between the four groups. Result： The levels of serum total bilirubin, sugar and uric acid of the patients with acute coronary syndromes were higher than those of the control group （P〈0.05 or P〈0.01）. The levels of serum total bilirubin and sugar of the STEMI group were higher than those of the NSTEMI group and the UAP group （P〈0.01）. After 1 week, there was no difference between the levels of serum total bilirubin of the ACS group and those of the control group （P〉0.05）. Conclusion：In the acute coronary syndrome patients, there are higher levels of serum bilirubin, sugar and uric acid. The level of uric acid may indicate oxidative activities of body, meanwhile the level of bilirubin can improve antioxidative activities of body. We can indirectly assess the oxidative and antioxidative activities by testing uric acid and bilirubin in acute coronary syndromes.