早发冠心病和早期冠状动脉硬化人群血清胆红素、尿酸及血脂水平的变化

Changes of serum bilirubin,uric acid and lipid levels in patients with premature coronary artery lesions and coronary artery disease

目的探讨血清胆红素、尿酸及血脂水平在早发冠心病(pCAD)和早期冠状动脉硬化(pCAL)人群中的临床意义。方法行冠状动脉造影术(CAG)患者371例分为三组:A组,134例,至少一支主要冠脉管腔狭窄≥50%(pCAD);B组,103例,冠脉管腔狭窄<50%(pCAL);C组,134例,冠脉正常。检测三组血清胆红素、尿酸及血脂水平。结果与C组比较,B组血清总胆红素(TBIL)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoAl)和ApoA1/ApoB显著降低,而尿酸、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)显著增高(P<0.05)。与B组比较,A组TBIL和直接胆红素(DBIL)均显著降低(P<0.05)。相关分析显示,TBIL和DBIL与冠脉狭窄程度呈负相关,而尿酸与冠脉狭窄程度呈正相关。结论中青年人群中出现血清低胆红素、高尿酸及血脂异常,提示可能为早发冠心病和早期冠状动脉硬化指征。

Objective To investigate the changes of serum bilirubin,uric acid and blood lipids in the patients with premature coronary artery lesions（pCAL,coronary artery stenosis50%） and premature coronary artery disease（pCAD,coronary artery stenosis≥50%）.Methods Coronary angiography（CAG） was performed in 371 patients,who were divided into three groups of A（134 pCAD cases）,B（103 pCAL cases） and C（134 cases without coronary artery stenosis）.Serum bilirubin,uric acid（UA） and blood lipids were analyzed.Results Compared with group C,serum total bilirubin（TBIL）,high density lipoprotein-cholesterol（HDL-C）,apolipoprotein A1（ApoAl） and ApoA1/ApoB were lower,while UA,total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C） and apolipoprotein B（ApoB） were higher in group B（P0.05）.Compared with group B,serum TBIL and DBIL in group A were lower（P0.05）.Correlation analysis showed that serum TBIL and DBIL were negatively,but serum UA was positively correlated with coronary artery stenosis.Conclusion The low serum bilirubin,high uric acid and abnormal blood lipids may indicate the posibility of pCAL and pCAD in young people.