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目的:探讨急性冠状动脉综合征(ACS)患者血清总胆红素、尿酸(UA)水平的变化。方法:将238例ACS患者分为ST段抬高急性心肌梗死(STEMI)组,非ST段抬高急性心肌梗死(NSTEMI)组,不稳定型心绞痛(UAP)组,检测血清总胆红素、UA、血糖、血脂等生化指标,部分ACS患者行冠状动脉造影检查。109例冠状动脉造影检查未见冠状动脉明显狭窄者作为对照组。结果:ACS各组患者血清总胆红素、UA、血糖显著高于对照组,差异有统计学意义(P<0.01或P<0.05)。STEMI组总胆红素、血糖显著高于NSTEMI组和UAP组患者,差异有统计学意义(P<0.01)。1周后复查,ACS各组患者血清总胆红素明显回降,与对照组比较差异无统计学意义(P>0.05)。结论:ACS患者血糖、UA升高,提示机体氧化应激加重;同时血清总胆红素升高,显示机体代偿性抗氧化程度加强。随病情逐渐稳定,胆红素回降。UA和胆红素可间接反映ACS机体氧化、抗氧化情况。胆红素对评估病情进程亦有一定帮助。
Objective: To investigate the changes of serum total bilirubin and uric acid (UA) in patients with acute coronary syndrome (ACS). Methods: 238 patients with ACS were divided into STEMI group, NSTEMI group and UAP group. Serum total bilirubin, UA, blood glucose, blood lipids and other biochemical indicators, some ACS patients underwent coronary angiography. 109 cases of coronary angiography showed no significant coronary stenosis as a control group. Results: Serum total bilirubin, UA and blood glucose in ACS patients were significantly higher than those in control group (P <0.01 or P <0.05). Total bilirubin and blood glucose in STEMI group were significantly higher than those in NSTEMI and UAP groups (P <0.01). One week later, the total serum bilirubin in ACS patients decreased significantly compared with the control group (P> 0.05). Conclusion: The blood glucose and UA in patients with ACS are increased, suggesting that the body’s oxidative stress is aggravated. At the same time, serum total bilirubin is elevated, which indicates that the degree of compensatory anti-oxidation is enhanced. With the gradual stability of the disease, bilirubin drop back. UA and bilirubin indirectly reflect the oxidation and oxidation of ACS. Bilirubin also has some help in assessing the course of the disease.