CAJ | 학술논문

目的：探讨总TBIL(total bilirubin，TBIL)水平对绝经后女性冠心病(coronary heart disease，CHD)风险及其病变程度的关系。方法：回顾性分析2004年1月-2013年12月疑诊CHD并初次行诊断性冠状动脉造影的绝经后女性患者467例的临床资料。根据血 TBIL 水平将患者分为 TBIL 正常组(＞4μmol/L)和 TBIL 降低组(＜4μmol/L)。根据 Syntax评分将患者按照病变严重程度分为低危组和高危组(Syntax评分≤22分计为低危，＞22分计为高危)。结果：血TBIL降低组的CHD发生率、病变支数以及Syntax评分均显著高于血TBIL正常组(P均＜0.05)。以冠脉造影诊断是否CHD作为二分类变量进行 Logistic 回归分析，结果显示，血 TBIL 是绝经后女性 CHD 发病的保护因素(OR=0.75，95%CI 0.61～0.91，P=0.044)，TBIL每增加1mmol/L，CHD发病的相对危险度就会下降25%。以Syntax评分分级评价的冠脉病变程度作为二分类变量进行 Logistic 回归分析结果显示，TBIL 是绝经后女性冠脉病变程度的独立保护因素(OR=0.88，95%CI 0.81～0.97，P=0.014)，TBIL每增加1mmol/L，冠脉病变严重程度就会相对降低12%。结论：在绝经后女性人群中，血TBIL是CHD的保护因素；血TBIL水平越低，冠脉病变越严重。
목적：탐토총TBIL(total bilirubin，TBIL)수평대절경후녀성관심병(coronary heart disease，CHD)풍험급기병변정도적관계。방법：회고성분석2004년1월-2013년12월의진CHD병초차행진단성관상동맥조영적절경후녀성환자467례적림상자료。근거혈 TBIL 수평장환자분위 TBIL 정상조(＞4μmol/L)화 TBIL 강저조(＜4μmol/L)。근거 Syntax평분장환자안조병변엄중정도분위저위조화고위조(Syntax평분≤22분계위저위，＞22분계위고위)。결과：혈TBIL강저조적CHD발생솔、병변지수이급Syntax평분균현저고우혈TBIL정상조(P균＜0.05)。이관맥조영진단시부CHD작위이분류변량진행 Logistic 회귀분석，결과현시，혈 TBIL 시절경후녀성 CHD 발병적보호인소(OR=0.75，95%CI 0.61～0.91，P=0.044)，TBIL매증가1mmol/L，CHD발병적상대위험도취회하강25%。이Syntax평분분급평개적관맥병변정도작위이분류변량진행 Logistic 회귀분석결과현시，TBIL 시절경후녀성관맥병변정도적독립보호인소(OR=0.88，95%CI 0.81～0.97，P=0.014)，TBIL매증가1mmol/L，관맥병변엄중정도취회상대강저12%。결론：재절경후녀성인군중，혈TBIL시CHD적보호인소；혈TBIL수평월저，관맥병변월엄중。
Objective: To study the relationship between general TBIL(total bilirubin,TBIL)level and coronary heart disease (coronary heart disease,CHD)risk and severity in the postmenopausal women.Methods:Retrospective analyze the clinical data of 467 suspected CHD and initial diagnostic coronary angiography patients in postmenopausal women from January 2004 to December 2013.According to the blood levels of TBIL,cases were divided into the normal TBIL group(>4μmol/L)and TBIL low group(<4μmol/L).According to Syntax score ,cases were divided into low risk group and high risk group(Syntax score≤22 as low risk,22 points for high risk).The incidence rate of CHD,LesionSyntax score of TBIL low group were significantly higher than normal TBIL group(P<0.05).In coronary angiography in the diagnosis of CHD as the two categorical variables were analyzed by using Logistic regression analysis,the results showed:blood TBIL were the protective factors in the pathogenesis of CHD in postmenopausal women(OR=0.75,95% CI:0.61~0.91,P=0.044),for each additional TBIL 1mmol/L,the relative risk of the CHD incidence will fall 25%.The severity of coronary artery disease classification evaluated with Syntax scoring as the two categorical variables were analyzed using Logistic regression analysis,the results showed:TBIL is an independent protective factors of degree of coronary artery disease in women after menopause(OR=0.88,95%CI:0.81~0.97,P=0.014),for each additional TBIL 1mmol/L, the severity of coronary artery disease will be relatively reduced 12% .Conclusion:In postmenopausal women,serum TBIL is a protective factor for CHD.The lower Blood TBIL level is,the more severe coronary lesions are.