摘要
目的探讨血清胆红素(BIL)与氧化修饰低密度脂蛋白(OX-LDL)水平和冠状动脉粥样硬化性心脏病(CHD)患者冠状动脉病变间的关系及其临床意义。方法160例患者按冠状动脉造影结果分为CHD组和非CHD组,采用Gensini法计算冠状动脉病变积分(CSS)。检测空腹血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)浓度,氧化修饰低密度脂蛋白(OX-LDL)水平。结果CHD组血清TBL明显低于非CHD组[(7.9±2.7)μmol/Lvs(15.5±3.9)μmol/L,P<0.01],而血浆OX-LDL明显高于非CHD组[(98±38)mmol/Lvs(29±11)μmol/L,P<0.01]。相关分析显示血清TBIL与血浆OX-LDL的变化呈负相关(r=-0.65,P<0.01)。双变量分析显示TBIL、DBIL、IBIL与CSS呈负相关(P<0.05或<0.01)结论血清胆红素代谢紊乱参与了CHD的发生和发展,其水平变化与冠状动脉病变的严重性有关。CHD患者血清TBIL抗LDL氧化能力的减弱可能是导致OX-LDL升高的重要原因。
Objective To investigate the clinical significance of the levels of serum bilirubin （BIL） and oxidized low density lipoprotein （OX-LDL） in patients with coronary heart disease （CHD） and to analyze the relationship between their levels and the severity of CHD. Methods 160 patients were divided into CHD group （n = 100）and control group（ n = 60） according to the results of coronary arteriography, and the scores of coronary artery pathological changes were calculated by Gensini method. The levels of TBIL, DBIL, IBIL, TC, TG, HDL-C, LDL-C, OX-LDL were detected. Results Serum levels of total bilirubin （TBL） were significantly lower in patients with CHD than those in control group （ P 〈 0. 01 ）, while plasma levels of OX-LDL were significantly higher in patients with CHD than those in control group. （ P 〈 0.01 ）. Serum levels of TBL were negatively correlated with plasma levels of OX-LDL. （ r = 0.65, P 〈 0.01 ）. At the same time,the levels of TBIL, DBIL, IBIL were significantly lower than those in control group （ P 〈 0. 05 ）. Conclusion The metabolic disturbance of BIL is involved in the pathogenesis and development of CHD, its level changes are related with the severity of coronary artery pathological changes. The decrease of anti-oxidate ability of TBIL in CHD patients may be the main reason to result in the increase of the levels of OX-LDL.
出处
《河北医药》
CAS
2009年第13期1551-1553,共3页
Hebei Medical Journal
