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目的:探讨血清总胆红素(TBIL)水平与急性冠脉综合征(ACS)的关系。方法:选择经冠状动脉造影术证实的冠状动脉疾病(CAD)患者486例,按冠状动脉病变情况分为冠状动脉硬化症组和ACS组,后者再分为急性心肌梗死(AMI)组和不稳定性心绞痛(UAP)组;另按冠状动脉狭窄程度分为单支、双支和三支组;同时选择健康体检者223例作为正常对照组,进行血清TBIL水平测定,将各组的血清TBIL进行比较分析。结果:UAP组及其单支、双支和三支组TBIL水平均显著低于正常对照组、冠脉硬化症组和AMI组(P均<0.05),且三支组明显低于单支组(P<0.05);AMI组及其单支、双支和三支TBIL水平均明显高于正常对照组和冠脉硬化症组(P均<0.05),且单支、双支、三支组之间均无明显差异(P>0.05);冠脉硬化症组与正常对照组无差异(P>0.05)。结论:TBIL可能参与了ACS的发病过程,对ACS的判断和病变程度有重要临床价值。
Objective: To investigate the relationship between serum total bilirubin (TBIL) and acute coronary syndrome (ACS). Methods: A total of 486 patients with coronary artery disease (CAD) who were confirmed by coronary angiography were divided into two groups: coronary arteriosclerosis group and ACS group. The latter group was divided into acute myocardial infarction (AMI) group and non-AMI group (UAP group) .According to the extent of coronary artery stenosis, the patients were divided into single branch, double branch and triple branch group. Meanwhile, 223 healthy subjects were selected as normal control group, serum TBIL levels were measured, and the serum TBIL For comparative analysis. Results: The levels of TBIL in UAP group, single branch, double branch and triple branch group were significantly lower than those in normal control group, coronary artery disease group and AMI group (all P <0.05), and the three groups were significantly lower than those in single branch group (P <0.05). The level of TBIL in AMI group, single vessel, double vessel and triple vessel were significantly higher than those in normal control group and coronary artery disease group (all P <0.05), and single vessel, double vessel, (P> 0.05). There was no difference between the group of coronary sclerosis and the control group (P> 0.05). Conclusion: TBIL may be involved in the pathogenesis of ACS, which has important clinical value for the judgment and severity of ACS.