脑梗塞患者胆红素变化的研究

The Study of Serum Bilirubin Inpatients with Cerebral Infarction

目的:研究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73例和非大面积脑梗塞组130例,分别检测其卒中发生后24 h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100例健康者对照比较。结果:脑梗塞患者急性期(24 h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);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),其中TBiL及IBiL降低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。结论:低胆红素血症可能是脑梗塞的一个独立危险因素。

Objective：To study the clinical implication between serum bilirubin with cerebral infarction（CI）.Methods：A total of 203 CI patients were divided into massive CI group（73 patients）and non-massive group（130 patients）.Serum total bilirubin,direct bilirubin,and indirect bilirubin were measured in 24 hour and 2 weeks after infarction onset.Another 100 healthy subjects served as the control.Results：In 24 hour,both CI groups had high serum bilirubin levels than the control did;the massive CI group had the highest compared to the non-massive and the control groups（P0.01）.In 2 weeks,both CI groups had significantly lower serum bilirubin levels than the control did（P0.01）,with greater reduction in total and indirect bilirubin.Conclusions：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.Hypo-bilirubin may be an independent risk factor for CI.