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目的 探讨老年人冠脉病变的严重程度与血清胆红素及尿酸 (UA)水平的关系。方法 符合条件并经冠状动脉造影的老年人 192名 ,根据其冠脉狭窄的程度分为 5组 (A～E) ,A组 :无狭窄 ;B组 :狭窄 <5 0 % ;C组 :狭窄在 5 0 %～ 79% ;D组 :狭窄在80 %～ 99% ;E组 :完全闭塞。再将D +E组病人分为 3组 :单支病变组、双支病变组和三支病变组 ,均测定其血清胆红素 ,尿酸及血脂水平并计算TC/(HDL -C +胆红素 ) ,LDL -C/(HDL -C +胆红素 )的比率进行比较。结果 B～E组病人的总胆红素水平逐渐下降 ,并与A组比较有显著性差异 (P <0 0 1) ,B～E组的TC/(HDL +TBIL)和LDL/(HDL +TBIL)均明显高于A组 (P <0 0 1) ;B～E组的尿酸水平逐渐上升 ,且与A组比较有显著性差异 (B组 P <0 0 5 ,C～E组 P <0 0 1)。与单支病变组比较 ,双支和三支病变组的总胆红素明显下降 (P <0 0 1) ,三支病变组的TC/(HDL +TBIL)和LDL/(HDL +TBIL)明显高于单支与双支病变组 (P <0 0 1)。结论胆红素与尿酸的水平与冠脉病变的严重程度有一定的关系 ,可通过胆红素 ,血脂及尿酸等生化指标的综合测定 ,来间接的评估患者冠脉病变严重程度。
Objective To investigate the relationship between the severity of coronary artery disease and serum bilirubin and uric acid (UA) in the elderly. Methods A total of 192 elder eligible coronary arteries were divided into 5 groups according to their degree of coronary artery stenosis: group A: no stenosis; group B: stenosis <50%; group C: stenosis In 5 0% ~ 79%; D group: stenosis in 80% ~ 99%; E group: completely occluded. The patients in D + E group were divided into 3 groups: single-vessel lesion group, double-vessel lesion group and three-vessel lesion group. Serum bilirubin, uric acid and lipids were measured and TC / (HDL- ), LDL-C / (HDL-C + bilirubin). Results The levels of total bilirubin in patients in groups B to E decreased gradually and were significantly different from those in group A (P <0.01). TC / (HDL + TBIL) and LDL / (HDL + TBIL) were significantly higher than those in group A (P <0.01). The level of uric acid in group B ~ E increased gradually, and there was significant difference compared with group A (P <0 05 in group B, P < 0 0 1). The levels of total bilirubin in double and triple lesion group were significantly lower than those in single lesion group (P <0.01). TC / (HDL + TBIL) and LDL / (HDL + TBIL) in three lesion group were significantly Higher than the single-vessel and double-vessel lesions (P <0.01). Conclusions The level of bilirubin and uric acid has a certain relationship with the severity of coronary artery disease. The severity of coronary artery disease can be assessed indirectly by the comprehensive determination of biochemical indexes such as bilirubin, blood lipid and uric acid.