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目的探讨冠心病患者血清总胆红素(TBil)、血尿酸(SUA)和C-反应蛋白(CRP)与冠脉病变程度及斑块稳定性的关系。方法根据冠脉造影(CAG)结果将178例老年患者分为2组,冠心病组116例和非冠心病组(对照组)62例,其中冠心病组又分为3个亚组:单支病变组(SV组,37例)、双支病变组(DV组,41例)、多支病变组(MV组,38例),分别测定血清TBil、SUA和CRP水平,并分析它们与冠脉病变程度及斑块稳定性的关系。结果冠心病组SUA和CRP水平均明显高于对照组,而冠心病组血清TBil水平均明显低于对照组,差异均具有显著性(P<0.05);冠心病各亚组之间比较显示,SUA和CRP水平越高,冠脉病变越严重,而血清TBil水平越低,冠脉病变越严重(P<0.05);SUA和CRP均随冠状动脉病变程度的加重而增高,与之呈正相关;TBil水平随冠状动脉病变程度的加重而降低,与之呈负相关(P<0.05);与病变稳定组比较,病变不稳定组CRP明显升高,TBil明显降低(P<0.05),而SUA无差异性(P>0.05)。结论SUA和CRP水平的升高及TBil含量的降低与冠心病的发生和冠脉病变严重程度密切相关,高SUA、CRP及低TBil可能是冠脉病变严重的独立危险因素。
Objective To investigate the relationship between serum total bilirubin (TBil), serum uric acid (SUA) and C-reactive protein (CRP) and coronary artery disease and plaque stability in patients with coronary heart disease. Methods According to the results of coronary angiography (CAG), 178 elderly patients were divided into two groups: coronary heart disease group (116 cases) and non-coronary heart disease group (control group), 62 cases. The coronary heart disease group was divided into three subgroups: Serum levels of TBil, SUA and CRP were measured in patients with lesion (SV group, 37 cases), double-vessel lesion group (DV group, 41 cases) and multivessel disease group (MV group, 38 cases) Relationship between lesion and plaque stability. Results The levels of SUA and CRP in CHD group were significantly higher than those in control group, while the serum levels of TBil in CHD group were significantly lower than those in control group (P <0.05) The higher the level of SUA and CRP, the more severe the coronary artery disease. The lower the level of serum TBil, the more severe the coronary artery disease (P <0.05). Both SUA and CRP increased with the severity of coronary artery disease. The level of TBil decreased with the severity of coronary artery disease (P <0.05), while the level of TBil in unstable group was significantly lower than that in stable group (P <0.05) Difference (P> 0.05). Conclusions The increase of SUA and CRP level and the decrease of TBil level are closely related to the occurrence of coronary heart disease and the severity of coronary artery disease. High SUA, CRP and low TBil may be the independent risk factors of coronary artery disease.