脑梗死患者胆红素水平与颅内动脉粥样硬化性狭窄的相关性研究

Study on the relationship between bilirubin levels and intracranial atherosclerotic stenosis in patients with cerebral infarction

目的探讨脑梗死患者血清胆红素水平与颅内动脉粥样硬化性狭窄的相关性。方法将2015年1月至2016年12月收治的脑梗死患者100例纳入本研究,其中对照组为无狭窄或轻度狭窄患者(50例),试验组为中度、重度狭窄及闭塞者(50例)。根据颅内动脉的狭窄程度将试验组的50例患者分为2个亚组。比较不同组间血清胆红素水平。采用Logistic多因素回归模型分析颅内动脉粥样硬化性狭窄的相关危险因素。结果试验组血清TBIL(t=3.149,P=0.002)、IBIL(t=2.757,P=0.007)和DBIL(t=2.041,P=0.044)均明显低于对照组,差异有统计学意义。重度狭窄及闭塞组血清TBIL(t=2.036,P=0.047)、IBIL(t=2.051,P=0.046)和DBIL(t=2.097,P=0.041)均明显低于中度狭窄组。Logistic逐步回归分析显示,高血压(r=0.833,P=0.789)、糖尿病(r=-0.076,P=0.032)与颅内动脉狭窄均呈正相关,而TBIL(r=-0.076,P=0.032)与颅内动脉狭窄呈负相关。结论血清胆红素与颅内动脉粥样硬化性狭窄呈负相关,即血清胆红素含量越低,发生颅内动脉狭窄的风险越大。

Objective To investigate the correlation between serum bilirubin levels and intracranial atherosclerotic stenosis in patients with cerebral infarction. Methods A total of 100 patients with cerebral infarction who were admitted and treated in our hospital from January 2015 to December 2016 were divided into control group and experimental group. The 50 patients with mild stenosis or without stenosis were were enrolled as control group, and the other 50 patients with moderate, severe stenosis or occlusion were enrolled as experimental group, moreover, according to the degree of intracranial artery stenosis, the 50 patients in experimental group were redivided into two subgroups. The serum levels of bilirubin were detected and compared among different groups. The related risk factors with intracranial arterial stenosis were analyzed by means of Logistic regression analysis. Results The serum levels of TBIL , IBIL and DBIL in experimental group were significantly lower than those in control group （ P 〈 0. 01 or P 〈 0. 05 ） . The serum levels of TBIL, IBIL and DBIL in patients with severe stenosis or occlusion were significantly lower than those in patients with moderate stenosis （P 〈 0. 05 ） . Logistic regression analysis showed that hypertension （ r = 0. 833 ,P=0.789 ） , diabetes mellitus （ r = 0. 076 ,P=0.032 ） were positively correlated to intracranial artery stenosis,however, the TBIL levels were negatively related with intracranial artery stenosis （r = - 0 . 076,P =0.032 ） . Conclusion There is a negative correlation between serum bilirubin and intracranial atherosclerotic stenosis, that is,the lower the serum bilirubin levels,the higher the risk of intracranial artery stenosis.