中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
7期
2909-2912
,共4页
刘茂%陈剑%刘天民%伍卫%黄丹
劉茂%陳劍%劉天民%伍衛%黃丹
류무%진검%류천민%오위%황단
心绞痛,不稳定型%冠状动脉疾病%胆红素%Gensini积分
心絞痛,不穩定型%冠狀動脈疾病%膽紅素%Gensini積分
심교통,불은정형%관상동맥질병%담홍소%Gensini적분
Angina,unstable%Coronary artery disease%Bilirubin%Gensini score
目的探讨血清胆红素（ TBIL）水平与不稳定型心绞痛患者冠状动脉病变严重程度的关系。方法纳入不稳定型心绞痛患者148例，均行冠状动脉造影（ CAG）检查，记录其TBIL浓度及冠状动脉病变支数及狭窄程度，按Gensini积分（ GS）高低将其分为轻度、中度、重度病变组；纳入58例同期行CAG阴性者为对照组。结果对照组TBIL 水平较中度病变组、重度病变组分别高18.9％（ P＝0.01）、27.6％（ P ＝0.001）；轻度病变组TBIL水平较中度病变组和重度病变组分别高17.1％（ P＝0.028）、26.0％（ P＝0.002）；左前降支（LAD）受累组TBIL低于LAD未受累组[（11.99±4.14）μmol/L vs．（13.28±5.06）μmol/L，P＜0.05]；TBIL与GS呈负相关（ r＝-0.341，P＜0.001）。结论不稳定型心绞痛患者TBIL水平与冠状动脉病变严重程度及受累部位相关，TBIL越低，GS越高，冠状动脉病变越严重；LAD受累者TBIL较LAD未受累者低；TBIL对冠心病的发生及病变严重程度有一定预测价值。
目的探討血清膽紅素（ TBIL）水平與不穩定型心絞痛患者冠狀動脈病變嚴重程度的關繫。方法納入不穩定型心絞痛患者148例，均行冠狀動脈造影（ CAG）檢查，記錄其TBIL濃度及冠狀動脈病變支數及狹窄程度，按Gensini積分（ GS）高低將其分為輕度、中度、重度病變組；納入58例同期行CAG陰性者為對照組。結果對照組TBIL 水平較中度病變組、重度病變組分彆高18.9％（ P＝0.01）、27.6％（ P ＝0.001）；輕度病變組TBIL水平較中度病變組和重度病變組分彆高17.1％（ P＝0.028）、26.0％（ P＝0.002）；左前降支（LAD）受纍組TBIL低于LAD未受纍組[（11.99±4.14）μmol/L vs．（13.28±5.06）μmol/L，P＜0.05]；TBIL與GS呈負相關（ r＝-0.341，P＜0.001）。結論不穩定型心絞痛患者TBIL水平與冠狀動脈病變嚴重程度及受纍部位相關，TBIL越低，GS越高，冠狀動脈病變越嚴重；LAD受纍者TBIL較LAD未受纍者低；TBIL對冠心病的髮生及病變嚴重程度有一定預測價值。
목적탐토혈청담홍소（ TBIL）수평여불은정형심교통환자관상동맥병변엄중정도적관계。방법납입불은정형심교통환자148례，균행관상동맥조영（ CAG）검사，기록기TBIL농도급관상동맥병변지수급협착정도，안Gensini적분（ GS）고저장기분위경도、중도、중도병변조；납입58례동기행CAG음성자위대조조。결과대조조TBIL 수평교중도병변조、중도병변조분별고18.9％（ P＝0.01）、27.6％（ P ＝0.001）；경도병변조TBIL수평교중도병변조화중도병변조분별고17.1％（ P＝0.028）、26.0％（ P＝0.002）；좌전강지（LAD）수루조TBIL저우LAD미수루조[（11.99±4.14）μmol/L vs．（13.28±5.06）μmol/L，P＜0.05]；TBIL여GS정부상관（ r＝-0.341，P＜0.001）。결론불은정형심교통환자TBIL수평여관상동맥병변엄중정도급수루부위상관，TBIL월저，GS월고，관상동맥병변월엄중；LAD수루자TBIL교LAD미수루자저；TBIL대관심병적발생급병변엄중정도유일정예측개치。
Objective To investigate the correlation between serum bilirubin level and the severity of coronary artery lesion .Methods One hundred and forty eight patients diagnosed as unstable angina were divided into three groups based on the Gensini score ,and fifty eight patients with negative CAG outcomes during the same period were admitted as control group .Results Serum bilirubin level in the control group was found higher compared with the moderate lesion group [ ( 13.95 ±5.97 )μmol/L vs.( 11.31 ±3.24 )μmol/L, P =0.01 ] and severe lesion group [ ( 13.95 ±5.97 )μmol/L vs. ( 10.10 ±3.44 )μmol/L, P =0.001 ] .Serum bilirubin concentration in the mild lesion group was higher than the moderate lesion group [ ( 13.64 ±3.99 )μmol/L vs. (11.31 ±3.24)μmol/L,P=0.028]and severe lesion group[ (13.64 ±3.99)μmol/L vs.( 10.10 ±3.44)μmol/L,P=0.002 ] .The serum bilirubin of LAD lesion group was found higher than non-LAD lesion group [ ( 11.99 ± 4.14)μmol/L vs.(13.28 ±5.06)μmol/L,P<0.05].By Spearman rank correlation analysis,Gensini score was correlated with TBIL ( r=-0.341 ,P<0.001 ) .Conclusions Serum bilirubin was inversely correlated with Gensini score indicating the severity of coronary artery lesion .The concentration of serum bilirubin may be a promising predictor of coronary heart disease .
