冠心病患者血清胆红素、超敏C反应蛋白及同型半胱氨酸的表达及临床意义

Clinical significance of the levels of serum bilirubin, high sensitivity C-reactive protein and homocysteine in patients with coronary heart disease

目的探讨冠心病（CHD）患者血清胆红素、超敏C反应蛋白（hs-CRP）和同型半胱氨酸（Hey）水平与冠心病之间的关系。方法选择2011年1月～2013年10月湖北医药学院附属太和医院确诊的CHD患者86例为CHD组，另外选择50例体检健康者作为对照组。观察组按病变支数分为单支病变和多支病变，其中单支病变组52例，多支病变组34例。测定胆红素、hs-CRP和Hcy的含量。结果CHD组hs-CRP[（16．04±5．19）mg／L]及Hcy[（27．42±5．14）μmol／L]水平均显著高于对照组[（1．57±1．53）mg／L、（7．49±1．56）μmol／L]，差异有统计学意义（P〈0．05）；多支病变组血hs-CRP[（17．05±5．25）mg／L]、Hey[（36．10±3．25）μmol／L]明显高于单支病变组[（8．16±3．17）mg／L、（22．08±4．92）μmol／L]和对照组[（1．57±1．53）mg／L、（7．49±1．56）μmol／L]，差异有统计学意义（P〈0．05）。CHD组总胆红素水平[（10．12±3．21）μmol／L]显著低于对照组[（14．02±5．11）μmol／L]，差异有统计学意义（P〈0．05）。多支病变组血总胆红素水平[（9．22±3．05）μmol／L]明显低于单支病变组[（11．39±4．57）μmol／L]和对照组[（14．02±5．11）μmol／L]，差异有统计学意义（P〈0．05）。结论胆红素、hs-CRP和Hcy与CHD发病关系密切，联合检测对CHD患者的诊断及疗效监测有重要临床实用价值。

Objective To explore the relationship between the serum bilirubin, high sensitivity C-reactive protein （hs-CRP） and homocysteine levels of coronary heart disease patients and coronary heart disease （CHD）. Methods 86 cases of patients diagnosed CHD in the Affiliated Taihe Hospital of Hubei Medical College from January 2011 to October 2013 were selected as the CHD group, 50 cases of healthy subjects were selected as the control group. Patients in CHD group were divided into single vessel subgroup （52 cases） and multi vessels subgroup （34 cases） according to the number of diseased vessels. The levels of bilirubin, hs-CRP and homocysteine were measured. Results The levels of serum hs-CRP and Hcy in CHD group [（16.04＋5.19） mg/L, （27.42±5.14） μmol/L] were significantly higher than those in the＂ control group [（1.57±1.53） mg/L, （7.49＋1.56）μmol/L], the difference were statistically significant （P 〈 0.05）. The levels of serum hs-CRP and Hey in the multi vessels subgroup [（17.05±5.25） mg/L, （36.10±3.25） μmol/L] were significantly higher than those in single vessel subgroup [（8.16＋3.17） mg/L, （22.08±4.92） μmol/L] and control group [（1.57＋1.53） mg/L, （7.49±1.56） μ mol/L], the differences were statistically significant （P 〈 0.05）. The levels of serum bilirubin in CHD group [（10.12±3.21） μmol/L] was significantly lower than that in control group [（14.02±5.11） μmol/L], the difference was statistically significant （P 〈 0.05）. The levels of serum bilirubin in the multi vessels subgroup [（9.22±3.05） μmol/L] was lower than those in single vessel subgroup [（11.39±4.57） μmol/L] and control group [（14.02±5.11） μmol/L], the dif- ferences were statistically significant （P 〈 0.05）. Conclusion The levels of bilirubin, hs-CRP and Hcy are closely re- lated with the CHD. The combined detection have important clinical value to the diagnosis and treatment monitoring of CHD.