摘要
目的探讨血清胆红素、同型半胱氨酸(Hcy)水平与老年冠心病患者颈动脉粥样硬化斑块之间的关系。方法选取我院210例老年冠心病患者,应用颈动脉超声技术检查颈动脉内中膜厚度(IMT),根据IMT值分为斑块组82例和非斑块组128例,记录患者的年龄、性别、高血压史、糖尿病史、吸烟史等一般情况,检测血清总胆红素、直接胆红素、间接胆红素、Hcy、血脂等实验室指标。结果斑块组总胆红素、间接胆红素水平低于非斑块组,血Hcy水平高于非斑块组,差异有统计学意义(P<0.05),总胆红素、间接胆红素水平与颈动脉斑块呈负相关(r=-0.447、-0.482,P<0.05),Hcy水平与颈动脉斑块呈正相关(r=0.376,P<0.05),Logistic逐步回归分析显示,总胆红素、间接胆红素水平降低和Hcy水平升高是颈动脉斑块形成的危险因素。结论干预颈动脉粥样硬化的冠心病患者血清胆红素及Hcy的生成,可以早期预防冠心病患者急性心脑血管事件的发生。
Objective To investigate the relationship between serum bilirubin,homocysteine（Hcy）levels and carotid atherosclerotic plaque in elderly patients with coronary heart disease（CHD）.Methods A sum of 210 cases of elderly patients with coronary heart diseasefrom our hospital were enrolled.The carotid intima-media thickness（IMT）were observed by the carotid artery ultrasound.According to the value of IMT,all cases were divided into two groups：plaque group（n =82）and non plaque group（n =128）,recording the patient＇s age,gender,history of hypertension,history of diabetes,smoking history and other general situation,detection of serum total bilirubin,direct bilirubin,indirect bilirubin,Hcy and lipid laboratory indicators.Results The total bilirubin and indirect bilirubin levels were lower in plaque group than those of non plaque group.However,the plasma Hcy level in plaque group was higher than non plaque group（P〈0.05）.The total bilirubin,indirect bilirubin was negatively correlated with carotid artery plaqu erespectively（r =-0.447,-0.482,P〈0.05）and Hcy level was positively correlated with the carotid plaque（r =0.376,P〈0.05）.The logistic stepwise regression analysis showed that total bilirubin and indirect bilirubin levels decreased and Hcy increased were risk factors in the progression of carotid artery plaque formation.Conclusion The intervention of the formation of serum bilirubin and Hcy in patients with carotid atherosclerosis might prevent the occurrence of acute cardiovascular and cerebrovascular events in CHD patients.
出处
《临床荟萃》
CAS
2016年第11期1202-1205,共4页
Clinical Focus
