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耿学斌,李莉,马燚,赵碧琼,田美蓉.血清胆红素与心绞痛患者冠状动脉病变程度和预后的关系[J].中国动脉硬化杂志,2019,(3):236~240, 253
血清胆红素与心绞痛患者冠状动脉病变程度和预后的关系
Relationship between serum bilirubin and the severity of coronary artery lesion and prognosis in patients with angina
投稿时间:2018-04-11  修订日期:2018-06-05
DOI:
中文关键词:  胆红素  心绞痛  预后  SYNTAX评分
英文关键词:bilirubin  angina  prognosis  SYNTAX score
基金项目:
作者单位E-mail
耿学斌 唐山工人医院心内二科,河北省唐山市 063000 e-mail为xuebingeng@126.com 
李莉 唐山工人医院心内二科,河北省唐山市 063000  
马燚 唐山工人医院心内二科,河北省唐山市 063000  
赵碧琼 唐山工人医院心内二科,河北省唐山市 063000  
田美蓉 唐山工人医院心内二科,河北省唐山市 063000  
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中文摘要:
      目的 探讨血清胆红素与心绞痛患者冠状动脉病变程度和预后的关系。方法 以2013年1月1日至2015年12月31日期间在唐山工人医院诊治并符合条件的连续的486例冠心病患者为研究对象,男性292例,女性194例,平均年龄(61.4±13.2)岁。在出院前一天抽空腹静脉血检测总胆红素。回顾冠状动脉造影,采用SYNTAX评分系统对冠状动脉病变进行评分。本研究进行前瞻性随访,起点事件为经皮冠状动脉介入(PCI),终点事件为主要不良心血管事件(MACE),随访截止日期为2017年12月31日。应用多因素Logistic回归分析血清胆红素与SYNTAX评分之间的关系。生存率估算应用Kaplan-Meier法,两条生存曲线之间的比较采用log-rank检验,应用多变量Cox比例风险回归分析血清总胆红素与MACE之间的关系。结果 多因素Logistic回归分析表明,男性、年龄、2型糖尿病、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)和总胆红素为中高SYNTAX评分的独立影响因素。低胆红素组有38例发生MACE,高胆红素组有25例发生MACE。两组之间无MACE生存曲线存在显著差异(χ2=4.785,P=0.029)。多因素Cox回归分析表明,男性、年龄、总胆红素和SYNTAX评分为影响MACE发生的独立因素。结论 血清胆红素是影响PCI术后心绞痛患者冠状动脉病变程度和预后的重要因素。
英文摘要:
      Aim To explore the relationship between serum bilirubin and the severity of coronary artery lesion, prognosis in patients with angina. Methods This study included 486 continuous angina patients meeting the conditions from January 1,3 to December 1,5. The subjects included 292 males and 194 females, with an average age of (61.4±13.2) years. On the day before discharge, fasting venous blood was drawn to detect total bilirubin. Coronary angiography was retrospectively analyzed and the coronary artery lesions were scored using the SYNTAX scoring system. In this study, prospective follow-up was performed. The initial event was PCI and the end event was major adverse cardiovascular events (MACE). The follow-up deadline was December 1,7. Multivariate logistic regression was used to analyze the relationship between serum bilirubin and SYNTAX scores. The Kaplan-Meier method was used to estimate the survival rate. The log-rank test was used to compare the two survival curves. The relationship between serum total bilirubin and MACE was analyzed by multivariate Cox proportional hazards regression. Results Multivariate logistic regression analysis showed that male, age, type 2 diabetes mellitus, low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC) and bilirubin were independent factors for the moderate-to-high SYNTAX score. MACE occurred in 38 patients of the low bilirubin group and in 25 patients of the hyperbilirubin group. There was significant difference in MACE-free survival curve between the two groups (χ2=4.785, P=0.029). Multivariate Cox regression analysis showed that male, age, bilirubin and SYNTAX scores were independent factors for the occurrence of MACE. Conclusion Serum bilirubin is an important factor affecting the degree of coronary artery lesion and long-term prognosis in PCI patients with angina.
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