脑梗塞患者血清胆红素变化及其临床意义

Detection of Serum Bilirubin in Cerebral Infarction Patients and Its Clinical Significance

目的:观察脑梗塞患者血清胆红素含量的变化及其临床意义。方法:186例脑梗塞患者分为大面积脑梗塞组67例和非大面积脑梗塞组119例,分别检测其卒中发生后24小时内和2周时的血清总胆红素(TBiL)、直接胆红素(DBiL)及间接胆红素(IBiL)水平,并与110例健康者对照比较。结果:脑梗塞患者急性期(24小时内)血清胆红素水平与对照组比较,明显增加,而大面积脑梗塞组血清胆红素较对照组、非大面积脑梗塞组明显增高(P<0.01～0.05);恢复期(2周时)脑梗塞组患者的血清胆红素较对照组明显降低(P<0.01～0.05),其中TBiL及IBiL降低更明显。结论:脑梗塞急性期血清胆红素明显升高可能是大面积脑梗塞的早期特征,对脑梗塞患者的病情及预后评估具有重要价值,尤其在未得到影像学证实时更具有临床意义。低胆红素血症可能是脑梗塞的一个独立危险因素。

Objective：To observe the change of serum bilirubin in patients with cerebral infarction（CI） and to explore its clinical implication. Methods：A total of 186 CI patients were divided into massive CI group（67 patients） and non-massive group（ 119 patients）. Serum total bilirubin,direct bilirubin, and indirect billirubin were measured in 24 hour and 2 weeks after infarction onset. Another 110 healthy subjects served as the control. Results：In 24- hour, both CI groups had higher serum bilirubin levels than the control did; the massive CI group had the highest as compared to the non-massive and the control groups （P 〈 0.01 - 0.05 ）. In 2 weeks, both CI groups had significantly lower serum bilirubin levels than the control did （P 〈 0.01 - 0.05 ） , with greater reduction in total and indirect bilirubin. Conclusion：The remarkable increase of serum bilirubin in 24 hour after infarction which may be an early sign for massive CI is important to help evaluate the diagnosis and prognosis of CI, especially when the diagnosis has not been confirmed by CT or MRI. Hypobilirubinemia may be an independent risk factor for CI.