冠心病患者血清前白蛋白及胆红素的临床意义

Clinical significance of serum prealbumin and bilirubin in patients with coronary heart disease

目的探讨冠心病患者血清前白蛋白（PAB）和胆红素水平变化及其临床意义。方法选取住院冠心病患者234例（冠心病组），其中稳定型心绞痛（SAP）80例，不稳定型心绞痛（UAP）84例，急性心肌梗死（AMI）70例；另选取同期住院的阵发性室上性心动过速患者77例作为对照组，分别测定血清PAB和胆红素水平并进行对比分析。结果冠心病组血清总胆红素（TBIL）、直接胆红素（DBIL）及间接胆红素（IBIL）水平分别为（11．8土6．1）、（4．8±1．0）和（7．7±2．7）μmol／L，均显著低于对照组[分别为（14．6±5．6）、（6．2±1.3）和（9．5±6．1）μmol／L]（P〈0．05）。在冠心病组中，TBIL、DBIL、IBIL水平从SAP、UAP到AMI逐渐降低，但差异无统计学意义（P〉0．05）。冠心病组血清PAB水平显著低于对照组[（205．55±5．68）mg／L比（229．78±9．62）mg／L]（P〈0．05），在冠心病组中，SAP、UAP、AMI患者血清PAB水平分别为（215．73±7．98）、（214．12±3．79）和（195．75±7．07）mg／L，随病情逐渐加重，血清PAB水平逐渐降低，但差异无统计学意义（P〉0．05）。结论血清PAB和胆红素水平与冠心病患者的发生及其严重程度有关，在一定程度上可作为临床监测冠心病发病及严重程度的重要生化指标。

Objective To investigate the changes and clinical significance of serum prealbumin （PAB） and bilirubin in patients with coronary heart disease （CHD）. Methods The levels of serum PAB and bilirubin were measured respectively in 234 patients with CHD （CHD group） and 77 patients with paroxysmal supraventricular tachycardia （PSVT, control group）, and the former group was divided into stable angina pectoris （SAP） group with 80 patients, unstable angina pectoris （UAP） group with 84 patients and acute myocardial infarction （AMI） group with 70 patients, according to the clinical manifestation. Results The levels of total bilirubin （TBIL）,direct bilimbin （DBIL） and indirect bilimbin （IBIL） in CHD group [ （11.8 ± 6.1 ）, （4.8 ± 1.0） and （7.7 ±2.7） μ mol/L] were significantly lower than those in control group [（14.6 ±5.6）, （6.2 ± 1.3） and （9.5 ± 6.1）μmol/L] （P 〈0.05）. The levels of TBIL, DBIL and IBIL decreased gradually from SAP group, UAP group to AMI group, but there was no significant difference among three groups （P 〉 0.05 ）. The levels of serum P AB in CHD group were also significantly, lower than those in control group [ （205.55 ± 5.68 ） mg/L vs. （ 229.78 ± 9.62） mg/L ] （P 〈 0.05 ）, and decreased gradually from SAP group, UAP group to AMI group [ （215.73 ± 7.98 i, （214.12 ± 3.79 ） and （ 195.75 ± 7.07 ） mg/L ], but there was no significant difference among three groups （P 〉 0.05）. Conclusion The levels of serum PAB and bilirubin are related to the severity of CHD ,and can be used as important biochemical indicators in monitoring the attack and severity in patients with CHD.