急性脑梗死患者血清胆红素、同型半胱氨酸的变化及意义

Changes and clinical significance of serum bilirubin and homocysteine in patients with acute cerebral infarction

目的 探讨血清胆红素、同型半胱氨酸在急性脑梗死发病中的作用.方法 选取住院治疗的脑梗死患者150例为研究对象（脑梗死组）,并选择同期健康体检者110例为对照组,采用全自动生化分析仪测定血清胆红素水平,酶联免疫分析法定量测定血浆同型半胱氨酸水平,并进行统计分析.结果 脑梗死组总胆红素（TBIL）、间接胆红素（IBIL）、直接胆红素（DBIL）分别为（9.74±3.36）μmol/L、（5.82±1.65） μmol/L、（3.80±1.47）μmol/L,均显著低于健康对照组的（14.35±4.27）μmol/L、（8.22±2.53）μmol/L、（6.07±2.03） μmol/L,差异均有统计学意义（t=-2.528、-2.366、-2.256,均P＜0.05）;脑梗死组同型半胱氨酸（Hcy）为（22.56±7.35）μmol/L,显著高于对照组的（6.98±3.35）μmol/L,差异有统计学意义（t=16.973,P＜0.05）.脑梗死组Hcy与TBIL呈负相关（rs=-0.101,P=0.004）,与IBIL呈负相关（rs=-0.153,P=0.037）,而未发现与DBIL存在相关性（rs=-0.067,P=0.231）.结论 Hcy可能为脑梗死的危险因素;胆红素可能参与了脑梗死的发生、发展,并且可能为保护性因素.

Objective To explore the role of serum bilirubin,homocysteine in the pathogenesis of acute cerebral infarction.Methods 150 patients with cerebral infarction were selected as the study group,and at the same time,110 healthy people were selected as the control group.We used automatic biochemical analyzer to determine the serum bilirubin level and enzyme-linked immunoassay was used to quantitatively determine the plasma homocysteine levels.At last,the data were statistically analyzed.Results （1） The concentrations of total bilirubin,indirect bilirubin and direct bilirubin of the study group were （9.74 ± 3.36） μmoL/L,（5.82 ± 1.65） μmol/L （3.80 ± 1.47） rnol/L,respectively,which were obviously lower than those of the control group [（14.35 ± 4.27） μmol/L,（8.22 ± 2.53） μmol/L,（6.07 ± 2.03） μmol/L,t =-2.528,-2.366,-2.256,all P 〈 0.05].The concentration of homocysteine of the study group was （22.56 ± 7.35）pmol/L,which was obviously higher than （6.98 ± 3.35）μmol/L of the control group,the difference was statistically significant （t =16.973,P 〈 0.05）.The concentration of homocysteine was related to both total bilirubin（rs =-0.101,P =0.004） and indirect bilirubin （rs =-0.153,P =0.037）.But there was no correlation between homocysteine and direct bilirubin （rs =-0.067,P =0.231）.Conclusion Homocysteine may be a risk factor for cerebral infarction.Serum bilirubin may be protective factor for cerebral infarction involved in the occurrence and development of cerebral infarction.