急性脑梗死患者血尿酸及血胆红素和颈动脉粥样硬化斑块性质的相关性研究

Study on relationship between serum uric acid and bilirubin level with carotid plaque in acute cerebral infarction patients

目的探讨急性脑梗死患者血尿酸及血胆红素水平和颈动脉粥样硬化斑块性质之间的关系。方法选取2010年10月至2011年7月在苏州大学附属第二医院住院治疗的急性脑梗死患者165例,根据颈动脉彩超结果首先将患者分为无斑块组47例及有斑块组118例两组,根据患者性质进一步分为无斑块组47例、稳定斑块组70例及不稳定斑块组35例,比较各组血尿酸、血总胆红素及直接胆红素之间的差异。结果 (1)有斑块组血尿酸水平轻度高于无斑块组,两组比较差异无统计学意义(P=0.353),有斑块组总胆红素(P=0.003)及直接胆红素(P=0.001)明显低于无斑块组。(2)无斑块、稳定斑块及不稳定斑块三组血尿酸水平分别为(317.6±179.2)μmol/L、(287.8±152.2)μmol/L、(331.2±177)μmol/L,不稳定斑块组血尿酸水平明显高于稳定斑块组(P=0.013);无斑块、稳定斑块及不稳定斑块三组血总胆红素水平分别为(17.8±14.0)μmol/L、(15.0±13.9)μmol/L、(13.8±10.0)μmol/L,三组血直接胆红素水平分别为(6.2±5.2)μmol/L、(5.0±4.2)μmol/L、(4.8±3.4)μmol/L,不稳定斑块组总胆红素(P=0.008)及直接胆红素(P=0.006)明显低于无斑块组,稳定斑块组总胆红素(P=0.027)及直接胆红素(P=0.006)明显低于无斑块组,不稳定斑块组血总胆红素及血直接胆红素低于稳定斑块组,两组比较差异无统计学意义。结论急性脑梗死患者中高血尿酸、低血总胆红素及低血直接胆红素和颈动脉不稳定斑块密切相关。

Objective To study the relationship between serum uric acid and bilirubin level with carotid plaque in acute cerebral infarction patients. Methods 165 patients with acute cerebral infarction from October 2010 to July 2011 in our hospital were screened for carotid plaque by duplex color Doppler and firstly classified into no plaque group （n = 47 ） and plaque group （n = 118 ）, secondly divided into no plaque group （ n = 47 ）, stable plaque group （ n = 70） and unstable plaque group （ n = 35 ）. Compare the difference of serum uric acid and bilirubin level in each group. Results （ 1 ） The level of serum uric acid in plaque group mild higher then no plaque group, while no statistically significant difference in the two group （ P = 0.353 ）. The level of total serum bilirubin （ P = 0. 003 ） and direct serum bilirubin （ P = 0. 001 ） in plaque group significant lower than no plaque group. （2） The level of serum uric acid in no plaque group, stable plaque group and unstable plaque group were （317.6 ± 179.2 ） μmol/L, （287.8 ± 152.2 ） μmol/L and （331.2 ± 177）p.moL/L respectively. And the level of serum uric acid in unstable plaque group significant higher than stable plaque group （ P = 0013 ）. The level of total serum bilirubin in no plaque group, stable plaque group and unstable plaque group were （17.8 ± 14.0）μmol/L, （15.0 ± 13.9 ）μmol/L and （13.8 ± 10.0） μmol/L respectively. The level of direct serum bilimbin in no plaque group, stable plaque group and unstable plaque group were （6.2 ± 5.2 ）μmol/L, （5. 0 ± 4. 2 ） μmol/L and （4. 8 ±3.4 ） μmol/L respectively. The level of total serum bilimbin （ P = 0. 008 ） and direct serum bilirubin （ P = 0. 006 ） in unstable plaque group significant lower than no plaque group. The level of total serum bilirubin （ P = 0.027 ） and direct serum bilirubin （ P = 0. 006 ） in stable plaque group significant lower than no plaque group. The level of total serum bilirubin （ P = 0.384 ） and direct serum bilirubin （ P = 0.689 ） in unstable plaque group lower than stable plaque group. Conclusions The higher serum uric acid, lower total serum bilirubin and lower direct serum bilirubin have a significant relationship with unstable plaque in in acute cerebral infarction patients.