CysC、Lp(a)、胆红素在冠心病患者血清中的表达及意义孟庆书1张言镇2李玉31潍坊医学院(山东潍坊261042)2潍坊市人民医院3潍坊市第二人民医院【摘要】目的探讨血清胱抑素C(cystatinC,CysC)、脂蛋白(a)［lipoprotein(a),Lp(a)］及胆红素(bilirubin)在冠心病(CHD)患者中表达的意义及与冠脉病变程度的关系。方法选择CHD患者180例，按临床类型分为稳定型心绞痛(SAP)组50例、不稳定型心绞痛(UAP)组90例、心肌梗死(AMI)组40例，按冠脉造影结果分为单支病变组74例、双支病变组56例、三支病变组50例，另选60例健康者作为对照组。定量测定所有入选者的血清CysC、LP(a)及胆红素水平。结果血清CysC水平在SAP组、UAP组及AMI组显著低于正常对照组(P<0.05),且随着冠脉病变支数的增加而逐渐下降(P<0.05)；血清LP(a)水平在SAP组、UAP组及AMI组高于对照组(P<0.05),UAP组、AMI组均高于SAP组(P<0.05)；血清LP(a)水平与不同冠脉病变支数间差异有统计学意义，三支病变组、双支病变组和单支病变组均高于正常对照组(P<0.05),>1.三支病变组高于单支病变组(P<0.05)；患者血清总胆红素、间接胆红素水平在SAP组、UAP组及AMI组均低于正常对照组(P<0.05),三支病变组、双支病变组和单支病变组均低于正常对照组(P<0.05)；患者血清直接胆红素水平在各组间无明显差异(P>0.05)。结论冠心病患者血清CysC、胆红素水平下降，Lp⑻水平升高，其浓度水平能够反映冠脉病变的严重程度，可作为临床观察和评定冠状动脉病变发展的指标。【关键词】冠心病CysCLp⑻胆红素动脉粥样硬化［中图分类号］R969［文献标识码］A［文章编号］1810—5734(2011)12-05-03TheexpressionandSignificanceofCysC,Lp(a),bilirubininSerumofPatientswithCoronaryHeartDisease【ABSTRACT】ObjectiveToexplorecystatinC,lipoprotein(a)andbilirubinserumexpressionsignificanceinpatientswithcoronaryatherosclerotic---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---heartdisease(CHD),andtherelationshipwithcoronaryarterystenosis.MethodsThe180CHDpatientsweredividedintostableanginapectoris(SAP)group(50case),unstableanginapectoris(UAP)group(90case)andacutemyocardialinfarction(AMI)group(40case).Thepatientswhounderwentcoronaryradiographyweresubdividedasgroupwithone-vessellesion,groupwithtwo-vessellesion,groupwiththree-vessellesion.Thecontrolgroupwas60healthyindividuals.TheserumlevelsofcystatinC,lipoprotein(a)andbilirubinwerequantitativedetectedforallsubjects.ResultsCysCinCHDpatientswereobviouslylowerthanthatincontrolgroup(P<0.05),andtheCysClevelsdecreasedinfoursubgroups(accordingcontrolgroup,one-vessellesion,two-vessellesion,three-vessellesionorder)(P<0.05).Lp(a)inCHDgroupwasobviouslyhigherthanthatincontrolgroup(P<0.05),UAPgroupandAMIgroupshowedhigherserumleveloftheLp(a)thanSAPgroup(P<0.05);TherewassignificantdifferenceinLp(a)amongonebranch,twobranches,threebranchesofdiseasedvessels.Lp(a)levelwashigherinpatientswiththreebranches,twobranchesandthreebranchesdiseaseofcoronaryarterycomparedwiththatincontrolgroup(P<0.05),andLp(a)ingroupwiththree-vessellesionwashigherthanthatingroupwithone-vessellesion(P<0.05);thelevelsoftotalbilirubin(TBIL),indirectbilirubin(IBIL)inCHDgroupweresignificantlylowerthanthatincontrolgroup(P<0.05),andlevelsofthatwerelowerinpatientswiththreebranches,twobranchesandthreebranchesdiseaseofcoronayarterycomparedwithcontrolgroup(P<0.05);thelevelsofdirectbilirubin(DBIL)werenosignificantdifferencebetweenCHDgroupsandcontrolgroup(P>0.05).ConclusionThedecreasedserumCysCandbilirubin,increasedserumLp(a)inCHDshowedacorrelationwithcoronaryarterystenosis.Thereindicatorscanbeutilizedintheclinicalobservationandassessmentofcoronarylesion.【KEYWORD】Coronarydi...