低血清胆红素与脑卒中死亡率预测研究

Low Serum Bilirubin Level as an Independent Predictor of Incidence of Death in Patients with Stroke

目的:胆红素与男性心血管疾病危险性增加之间存在关联,但其与卒中的关系目前尚不清楚。方法:检测不同类型脑血管病患者及健康对照组的血清胆红素水平,观察血清胆红素对脑卒中患者死亡率的影响。结果:缺血性脑卒中组和出血性脑卒中组患者基础血清胆红素水平显著低于健康对照组(P<0.01),治疗14d后较基础值有所下降(P<0.05),出院时又有所回升(P<0.05),但仍未达到健康对照组水平(P<0.05)。低胆红素血症卒中显示更高的死亡率(与正常胆红素亚组比较,P<0.05或P<0.01)。此外,无论是缺血性脑卒中患者生存亚组或是出血性脑卒中生存患者亚组均与其死亡患者亚组血清胆红素水平存在显著差异(P<0.01),缺血性脑卒中生存亚组和出血性脑卒中存在亚组虽然也存在差异,但差异不显著,死亡亚组间比较亦然。结论:低水平胆红素与脑卒中患者高死亡率相关。

Objective：The level of bilirubin is known to be associate with increased risk of cardiovascular disease in men,but its ralationship with the stroke is unclear.Methods：Serum bilirubin levels were measured in patients with cerebrovascular disease and healthy controls,and the effect of the serum bilirubin on mortality of stroke were observed.Results：The serum bilirubin levels were significantly lower in ischemic stroke and hemorrhagic stroke patients than that in healthy control group（P〈0.01）,and there were declined 14th day after treatment compared with a base value（P〈0.05）,the level of serum bilirubin the time at discharge was recoved（P〈0.05）but did not reach the levels in healthy controls（P〈0.05）.Low bilirubinemia in patients with stroke showed higher mortality rates（compared with normal bilirubin sub group,P〈0.05 orP〈 0.01）.In addition,the levels of serum bilirubin in the patients of survival subgroups with ischemic stroke or hemorrhagic stroke was higher than that patients of death subgroups（P〈0.01）,and there was difference between ischemic stroke survival subgroup or hemorrhagic stroke survival subgroup and death sub group but the difference was not significant.Conclusion：Lower levels of bilirubin in patients w ith cerebral stroke associated with a higher incidence of death.