同型半胱氨酸和总胆红素及高敏C反应蛋白水平与冠心病临床分型相关性研究

目的探讨冠心病患者血清抗氧化因子总胆红素（TBIL）、促氧化因子同型半胱氨酸（Hey）和炎症因子高敏c反应蛋白（hs—CRP）水平变化及其临床意义。方法采用全自动生化分析仪检测20例急性心肌梗死（AMI）组、37例不稳定型心绞痛（UAP）组、85例稳定型心绞痛（SAP）组以及80例健康对照组血清TBIL、Hey以及hs—CRP含量，建立Logistic回归分析冠心病发生的危险因素。结果冠心病患者中AMI组、UAP组和SAP组TBIL含量分别为（12．1±3．0）p,mol／L，（11．5±2．2）μmol／L，（9．0±1．9）μmol／L，均低于正常对照组（13．8±3．6）μmol／L]（P〈0．05）；此3组Hcy含量分别为（21．3±4．6）μmol／L，（19．4±4．1）μmol／L，（14．8±3．9）μmol／L，均高于正常对照组（9．7±3．5）μmol／L]（P〈0．05）；且冠心病各组间TBIL和Hey含量变化密切正相关。但是hs—CRP含量AMI和UAP组分别为（4．82±1．07）mg／L和（1．33±0．33）mg／L，高于SAP组和对照组（0．94±0．23）mg／L和（0．89±0．24）mg／L]，而SAP组和对照组间hs—CRP水平没有差别。结论冠心病患者血清TBIL和Hey水平呈现出一定相关性，对评估冠心病各临床分型鉴别有一定临床价值；hs—CRP在AMI和UAP患者血清中明显升高，可作为它们风险的独立评价指标。

Correlation among the levels of homocysteine, total bilirubin, high-sensitive c-reactive protein and coro-nary heart disease

Objective To evaluate the changes of serum total bilirubin (TBIL), homocysteine (Hcy) and high-sensitive c-reactive protein(hs-CRP) in patients with the coronary heart disease (CHD). Methods Concen-trations of the serum TBIL, Hcy and hs-CRP of control group and CHD group were detected by enzymatic cycling method and turbidimetry. All the CHD patients were individed into three groups: 20 acute myocardial infrcion (AMI), 37 unstable angina pectioris(UAP) and 85 stable angina pectoris(SAP). There were 80 normal controls. Results The levels of TBIL in three CHD groups were all lower than those in control group(P<0.05). Hcy levels were higher than those in control groups (P<0.05). The levels of hs-CRP in AMI and UAP groups were higher than those in SAP and control groups(P<0.05). There was a positive correlation between TSIL and Hcy in all three groups of CHD. Conclusion The changes of TBIL and Hcy help distinguish the types of CHD. Meanwhile the in-crease of hs-CRP level can be used as a risk factor for AMI and UAP patients.