摘要
目的 探讨血清总胆红素与冠状动脉慢血流（slow coronary flow,SCF）的关系。方法 经冠状动脉造影证实冠状动脉狭窄〈40%的患者298例,根据血清总胆红素水平分为观察组148例[总胆红素14.6（13.0,16.9）μmol/L],对照组150例[总胆红素9.9（8.2,10.7）μmol/L],比较2组临床相关指标水平。结果 观察组男性比例（56.8%）、中性粒细胞计数/淋巴细胞计数比值[2.05（1.56,2.88）]、血红蛋白水平[141.00（130.50,150.00）g/L]高于对照组[42.0%、1.80（1.41,2.43）、136.00（126.00,148.00）g/L],三酰甘油[1.34（0.95,1.90）mmol/L]、血小板计数[201.00（174.00,236.50）×109/L]、血小板压积[0.22（0.19,0.24）%]低于对照组[1.45（1.09,2.32）mmol/L、218.50（188.00,253.00）×109/L、0.23（0.20,0.27）%],差异均有统计学意义（P〈0.05）;2组前降支动脉、回旋支动脉、右冠状动脉TIMI血流帧数及SCF比例比较差异均无统计学意义（P〉0.05）;多因素分析结果显示,血清总胆红素的相关因素为三酰甘油（OR=0.724,95%CI：0.582~0.901,P=0.004）、血红蛋白（OR=1.027,95%CI：1.009~1.046,P=0.003）、血小板压积（OR=0.001,95%CI：0.000~0.300,P=0.017）和中性粒细胞计数/淋巴细胞计数比值（OR=1.251,95%CI：1.001~1.564,P=0.049）。结论 三酰甘油、血红蛋白、血小板压积和中性粒细胞计数/淋巴细胞计数比值是影响血清总胆红素水平的因素。正常偏高水平的血清总胆红素不能减少冠状动脉SCF的发生、发展。
Objective To analyze the correlation between serum bilirubin concentration and slow coronary flow（SCF）. Methods A total of 298 patients with angiographically confirmed stenosis 〈40% were classified into observation group （n=148） （bilirubin： 14.6 （13.0, 16.9） μmol/L） and control group （n=150） （bilirubin： 9.9 （8. 2, 10.7） μmol/L） according to the serum bilirubin concentration. The clinical variables were analyzed between two groups. Results The male proportion, neutrophil to lymphocyte ratio and hemoglobin were higher in observation group （56.8%, 2.05 （1.56, 2.88）, 141.00 （130.50, 150.00） g/L） than those in control group （42.0%, 1.80 （1.41, 2.43）, 136.00 （126.00, 148.00） g/L）, while triacylglycerol, platelet count and plateletcrit levels were lower in observation group （1.34 （0.95, 1.90） retool/L, 201.00 （174.00, 236.50） × 10^9/L, 0.22 （0. 19, 0.24）%） than those in control group （1.45 （1.09, 2.32） mmol/L, 218. 50 （188. 00, 253. 00）× 10^9/L, 0. 23 （0. 20, 0. 27）%） （P〈0.05）. There were no significant differences in the SCF rates and corrected TIMI frame counts of anterior descending branch, circumflex artery and right coronary artery between two groups （P〈0.05）. Multivariate analysis revealed that triacylglycerol （OR = 0. 724, 95% CI： 0. 582 to 0. 901, P=0. 004）, hemoglobin （OR=1. 027, 95% CI： 1. 009 to 1. 046, P=0. 003）, plateletcrit （OR=0. 001, 95%CI： 0.000 to 0.300, P=0.017） and neutrophil to lymphocyte ratio （OR= 1. 251, 95% CI： 1.001 to 1. 564, P= 0. 049） were correlated with the serum bilirubin concentration. Conclusion Triacylglyeerol, hemoglobin, plateletcrit and neutrophil to lymphocyte ratio are the related factors for the serum bilirubin concentration, and serum total bilirubin level in high extremity of the normal range does not reduce the occurrence and development of SCF.
出处
《中华实用诊断与治疗杂志》
2015年第7期654-656,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金(81000130)
首都临床特色应用研究项目(Z131107002213042)
基础临床课题(2012JL58)
