【摘要】 目的:研究胆红素血脂综合指数和纤维蛋白原水平与冠状动脉病变程度的关系。方法:共选取324例行冠状动脉造影的患者,按两种分组方法进行分组:(1)按照其冠状动脉造影结果分为冠心病组(n=262)与非冠心病组(n=62);(2)使用Gensini评分系统定量评价所有患者冠状动脉病变程度,按照其结果分为第1四分位组(n=58)、第2四分位组(n=110)、第3四分位组(n=80)、第4四分位组(n=76)。测定全部患者血浆总胆红素(TBIL)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)以及纤维蛋白原水平,计算出胆红素血脂综合指数[TC/(HDL-C+TBIL)、LDL-C/(HDL-C+TBIL)]。结果:(1)冠心病组TC、LDL-C、TC(/HDL-C+TBIL)、LDL-C(/HDL-C+TBIL)以及纤维蛋白原水平较非冠心病组高,差异有统计学意义(P<0.05);总胆红素、间接胆红素冠心病组低于非冠心病组,差异有统计学意义(P<0.05)。(2)以Gensini积分的四分位数的分组中,TBIL、IBIL、LDL-C/(HDL-C+TBIL)、TC/(HDL-C+TBIL)、HDL-C以及纤维蛋白原的差异均有统计学意义(P<0.05)。(3)冠心病危险因素的Logistic回归分析,结果显示在其他危险因素固定的条件下,胆红素血脂综合指数是冠心病的独立的危险因素[TC/(HDL-C+TBIL):优势比(OR)=1.668,95%可信区间(CI):1.065~2.784,P=0.028;LDL-C/(HDL-C+TBIL):OR=1.786,95%CI:1.021~2.879,P=0.030]。(4)相关性分析显示:TC/(HDL-C+TBIL)、LDL-C/(HDL-C+TBIL)均与Gensini评分呈正相关(r=0.423,P<0.01;r=0.417,P<0.01);纤维蛋白原与Gensini积分亦呈正相关(r=0.293,P<0.01)。结论:(1)冠心病组患者胆红素血脂综合指数和纤维蛋白原水平较非冠心病组患者显著升高,TBIL与间接胆红素在冠心病患者显著降低。(2)胆红素血脂综合指数和纤维蛋白原与冠状动脉的病变程度呈正相关。更多还原

【Abstract】 Objective:To investigate the relationship between Bilirubin blood lipid comprehensive index and fibrinogen（FIB） to severity of coronary lesions in patients with coronary artery disease（CAD）.Methods:A total of 324 patients with angiography（CAG） confirmed diagnosis were divided into 2 sets of groups.① By CAG examination,the patients were divided into 2 groups:CAD group,n=262 and Non-CAD group,n=62.② By Gensini scoring system,the patients were divided into 4 quartile groups:1^st quartile group,n=58,2^nd quartile group,n=110,3^rd group,n=80 and 4^th quartile group,n=76.The blood levels of total bilirubin（TBIL）,total cholesterol（TC）,LDL-C,HDL-C,TG and fibrinogen were measured and bilirubin blood lipid comprehensive index,TC/（HDL-C+TBIL） and LDL-C/（HDL-C+TBIL）were calculated respectively.Results:① By CAG examination,compared with Non-CAD group,CAD group had increased TC,LDL-C,ratios of TC/（HDL-C+TBIL）,LDL-C/（HDL-C+TBIL） and FIB,P<0.05;decreased TBIL and indirect bilirubin（IBIL）,P<0.05.② By Gensini scoring system,the level of TBIL,IBIL,ratios of LDL-C/（HDL-C+TBIL）,TC/（HDL-C+TBIL）,HDL-C and FIB were different among 4 groups,P<0.05.③ Logistic regression analysis indicated that with excluded interactional factors,the bilirubin blood lipid comprehensive index was the independent risk factor for CAD[TC/（HDL-C+TBIL）:OR:1.668,95%CI:1.065².784,P=0.028;LDL-C/（HDL-C+TBIL）:OR:1.786,95%CI:1.021².879,P=0.030].④ Correlation analysis presented that TC/（HDL-C+TBIL）,LDL-C/（HDL-C+TBIL） and FIB were positively related to Gensini scoring system（i-0.423,P<0.01）,（r=0.417,P<0.01） and（r=0.293,P<0.01） respectively.Conclusion:Bilirubin blood lipid comprehensive index and fibrinogen were positively related to severity of coronary lesions in CAD patients.更多还原