胆红素与冠心病及炎性标记物hs-CRP相关性分析

发布时间：2018-11-06 08:47

【摘要】：目的分析总胆红素水平(TBil)是否为冠心病的保护性因素及对其的预测价值,同时通过分析与hs-CRP的相关关系,探讨其可能的冠心病保护机制。方法选取2014年10月-2016年10月期间本院心血管心内科住院疑诊冠心病心绞痛并接受冠状动脉造影检查且临床资料完整的患者180例作为研究对象,根据造影结果分为冠心病组(n=90)与非冠心病组(n=90),分别收集其年龄、性别、体重指数(BMI)、有无高血压病、有无糖尿病、有无吸烟史、高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(low density lipoprotein,LDL)、总胆红素(total bilirubin,TBil)、超敏C反应蛋白(high-sensitivity C-reaction protein,hs-CRP)、谷丙转氨酶(alanine transaminase,ALT)等临床资料,采用logistic回归分析探讨TBil与冠心病的相关性;双变量Pearson法分析TBil与hs-CRP的关系;通过绘制受试者工作特征曲线(receiver operating characteristic curve,ROC曲线),探讨TBil对冠心病的诊断价值。结果(1)与非冠心病组相比,冠心病组TBil水平较低(P0.05),经二元Logistic回归分析,显示TBil为冠心病的独立保护性因素(P=0.001,95%CI:0.738~0.922);(2)双变量Pearson线性分析显示TBil与hs-CRP水平存在负相关关系(r=-0.367,P0.001);(3)经绘制ROC曲线,TBil正确预测冠心病的界点值为10.35umol/L,最大ROC曲线下面积0.739(P0.01,95%CI:0.668~0.811),对应的敏感度为0.633,特异度为0.700。结论TBil为冠心病的独立保护性因素,低水平TBil可以作为冠心病的预测因子;TBil与hs-CRP显著负相关,提示其抗炎作用可能是其对冠心病的保护机制之一;TBil10.35umol/L可以为作为诊断冠心病的界定指标。
[Abstract]:Objective to analyze whether total bilirubin level (TBil) is the protective factor of coronary heart disease (CHD) and its predictive value, and to explore the possible protective mechanism of coronary heart disease (CHD) by analyzing the relationship between total bilirubin and hs-CRP. Methods from October 2014 to October 2016, 180 patients with suspected angina pectoris of coronary heart disease and complete clinical data were selected. Age, sex, body mass index (BMI), hypertension, diabetes mellitus, smoking history, high density lipoprotein (high density lipoprotein,HDL) were collected. Low density lipoprotein (low density lipoprotein,LDL), total bilirubin (total bilirubin,TBil), hypersensitive C-reactive protein (high-sensitivity C-reaction protein,hs-CRP), alanine aminotransferase (alanine transaminase,ALT) and so on. Logistic regression analysis was used to investigate the correlation between TBil and coronary heart disease. The relationship between TBil and hs-CRP was analyzed by bivariate Pearson method, and the diagnostic value of TBil in coronary heart disease was discussed by drawing the (receiver operating characteristic curve,ROC curve of operating characteristic curve of subjects. Results (1) compared with the non-CHD group, the level of TBil in the CHD group was lower (P0.05). The results of binary Logistic regression analysis showed that TBil was an independent protective factor for coronary heart disease (P0. 001% 95 CI: 0.7380.922). (2) the linear analysis of bivariate Pearson showed that there was a negative correlation between TBil and hs-CRP level (r-0.367, P0.001); (3) by drawing the ROC curve, TBil correctly predicted that the threshold value of coronary heart disease was 10.35 umol / L, and the area under the maximum ROC curve was 0.739 (P0.01 ~ 95CI: 0.668 / 0.811). The sensitivity and specificity of TBil were 0.633 and 0.700 respectively. Conclusion TBil is an independent protective factor for coronary heart disease, low level TBil can be used as a predictor of coronary heart disease, TBil is negatively correlated with hs-CRP, suggesting that its anti-inflammatory effect may be one of its protective mechanisms for coronary heart disease. TBil10.35umol/L can be used as a defining indicator for the diagnosis of coronary heart disease.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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