血清总胆红素、血脂、血尿酸与冠心病发生发展的相关性研究分析

Correlation of total bilirubin,blood lipids and serum uric acid with the development of coronary heart disease

目的研究体内血清总胆红素、血脂、血尿酸的水平变化与冠心病发生发展的相关性。方法选择2009年3月～2011年11月笔者所在医院心内科收治的冠心病确诊患者124例(CHD组),同期行冠状造影正常者78例(对照组),空腹检测两组患者TBIL,血脂及SUA水平。CHD组根据造影结果,再分为单支病变组(40例)、双支病变组(40例)和多支病变组(44例)。采用Spearman等级相关分析TBIL、血脂及SUA水平与CHD病变程度的相关性。结果 CHD组TBIL水平明显低于对照组,差异有统计学意义(P<0.05)。CHD组高密度脂蛋白胆固醇明显低于对照组,差异有统计学意义(P<0.05);总胆固醇、低密度脂蛋白胆固醇、血清甘油三脂水平明显高于对照组,差异有统计学意义(P<0.01)。CHD组SUA水平明显高于对照组,差异有统计学意义(P<0.01)。血清TBIL、HDL-C水平与冠状动脉病变支数呈负相关性,随其支数增加浓度显著降低,差异有统计学意义(P<0.01);血清TC、TG、LDL-C、SUA水平与冠状动脉病变支数呈正相关性,随其支数增加浓度显著升高,差异有统计学意义(P<0.01)。结论 TBIL浓度降低、血脂异常、SUA浓度升高与CHD的发生及其病变程度关系密切,TBIL、血脂及SUA的检测对测评CHD的严重程度有一定的临床价值。

Objective To study the correlation of total bilirubin, blood lipids and serum uric acid with the severity of coronary heart disease. Methods 124 patients with CHD of our hospital from March 2009 to November 2011 were selected as CHD group and 78 healthy cases which underwent coronary angiography as control group. Both the two groups were limosis detected the level of TBIL, blood lipids and SUA. According to the coronary angiography results, the CHD group were allocated into three groups, one-vessel desease group（40 eases）, two-vessel desease group（40 cases）,and three-vessel desease group（44 cases）.The relationship between TBIL, blood lipids, SUA and CHD was analyzed by Spearman rank correlation. Results TBIL level of CHD group was significantly lower than control group （P 〈 0.05）.High density lipoprotein cholesterol of CHD group was significantly lower than control group （P 〈 0.05）.The levels of total cholesterol, low density lipoprotein cholesterol and triglyceride of CHD group were significantly higher than control group（P 〈 0.01）.SUA level of CHD group was significantly higher than control group （P 〈 0.01）.The levels of TBIL and HDL-C were negatively related with the severity of CHD. Their concentrations were significantly lower with the increase of the diseased vessles number （P 〈 0.01）.The levels of TC,TG,LDL-C and SUA were positively related with the severity of CHD. Their concentrations were significantly higher with the increase of diseased vessles number （P〈 0.01）. Conclusion The decreased TBIL, blood lipid abnormality and increased SUA are closely related with CHD. Therefore, the detection of TBIL, blood lipids and SUA in CHD diagnosis have highly clinical value.