胆红素浓度与冠心病和高血压病发生风险的相关性

Relationship between serum level of bilirubin and the risk of both coronary artery disease and hypertension

目的探讨胆红素浓度与冠心病和高血压病发生风险的相关性,为心血管疾病的病因学研究以及治疗提供依据。方法以曾接受冠状动脉造影检查的患者为研究对象,从中选取冠心病212例、高血压198例以及冠心病合并高血压384例为病例组,冠状动脉造影阴性197例为阴性对照组。比较病例组和对照组以及病例组组间胆红素水平,统计学处理采用Wilcoxon秩和检验、卡方检验、Logistic回归分析。结果各病例组分别与对照组相比,总胆红素、直接胆红素、间接胆红素差异均具有统计学意义(P<0.001)。冠心病组和冠心病合并高血压组相比,总胆红素和间接胆红素差异具有统计学意义,P值分别为0.0299和0.0277。高血压组和冠心病合并高血压组相比,总胆红素、直接胆红素、间接胆红素差异均具有统计学意义,P值分别为0.0007、0.0006和0.0128。多因素Logistic回归分析表明:血清总胆红素浓度和冠心病、高血压发生负相关,OR值分别为0.832(P<0.001)、0.928(P=0.004)。这种相关性在不吸烟亚组和男性亚组更为显著。结论除了已知的危险因素外,血清胆红素低浓度也是冠心病、高血压的独立危险因素。

Objective To provide a target for the etiology research and treatment strategy of cardiovascular disease,, and to analyse the relationship between serum level of bilirubin and the risk of both coronary artery disease and hypertension. Methods Patients who underwent coronary angiography were enrolled. All these cases were divided into case groups and negative control group, case groups including coronary heart disease group （CHD）, hypertension group, andgroup of subjects who are subjected to both coronary heart disease and hypertension, while coronary angiography negative group as the negative control. The serum level of bilirubinwere detected in each group, in order to find out if there is any statistically difference between the case groups and control group, or among the case groups. Differences were evaluated using SAS8.0 and SPSS17.0, and the data were assessed by Wilcoxonrs signed-rank test, Chi square test and Logistic regression analysis. Results A total of 991 cases were involved in this study. The levels of total bilirubin, direct bilirubin or indirect bilirubin, in three case groups were statistically significant （P^0.01） when compared to control group, respectively. Furthermore, the levels of total bilirubin and indirect bilirubin were statistically significant in CHD or Hypertension when compared to the group who are subjected to both CHD and Hypertension （P ~ 0. 05）, respectively. Logistic regression analysis revealed the level of total bilirubin levels was negatively correlation with coronary artery disease （OR..0. 832, P%0. 001） or hypertension （OR：0. 928,P = 0. 004） , respectively. This correlation was more significant in non-smoking subgroup and male subgroup. Conclusion In addition to the known risk factors, low serum level of bilirubin was one of the new independent risk factors for cardiovascular disease and Hypertension.