高龄老年患者血清胆红素水平与颈动脉粥样硬化的相关性研究

摘要

目的 探讨高龄老年患者血清胆红素水平与颈动脉粥样硬化的相关性.方法 选择2014年9月～2016年2月从社区收集临床资料完整的高龄老年患者400例,其中男性201例,女性199例,年龄80～～100(85.88±4.05)岁.根据彩色多普勒超声诊断仪测定颈动脉内膜中层厚度,分为硬化组200例和非硬化组200例,所有患者进行相关生化检测,Spearman相关分析和多因素logistic回归分析.结果 非硬化组血清总胆红素、直接胆红素和间接胆红素明显高于硬化组,差异有统计学意义(P＜0.05,P＜0.01).Spearman相关分析显示,血清总胆红素、直接胆红素和间接胆红素与颈动脉内膜中层厚度呈负相关(r=-0.799,r=-0.785,r=-0.781,P=0.000).多因素lo-gistic回归分析显示,血清总胆红素是颈动脉粥样硬化的保护因素(OR=0.48,95％CI:0.29～0.68,P=0.000),而年龄和收缩压是颈动脉粥样硬化的危险因素(OR=1.16,95％CI:1.08～1.31,P=0.002;OR=1.23,95％CI:1.18～1.42,P=0.004).结论 高龄老年患者血清胆红素水平与颈动脉粥样硬化呈负相关,并且是颈动脉粥样硬化的保护因素.%Objective To study the relationship between serum bilirubin level and carotid atherosclerosis in very old patients.Methods The clinical data of 400 community patients (201 males and 199 females) aged 80-100 (85.88±4.05) years were collected from September 2014 to February 2016.The patients were divided into atherosclerosis group (n=200) and atherosclerosis-free group (n=200) according to their carotid IMT.Their biochemical parameters were analyzed by Spearman correlation analysis and multivariate logistic regression analysis respectively.Results The serum levels of total bilirubin,direct bilirubin and indirect bilirubin were significantly higher in atherosclerosis group than in atherosclerosis-free group (P＜0.05,P＜0.01).Spearman correlation analysis showed that the serum levels of total bilirubin,direct bilirubin and indirect bilirubin were negatively related with the carotid IMT (r=-0.799,r=-0.785,r=-0.781,P=0.000).Multivariate logistic regression analysis revealed that the serum total bilirubin level was a protective factor for carotid atherosclerosis while age and SBP were the risk factors for carotid atherosclerosis (OR-0.48,95％CI:0.29-0.68,P=0.000;OR=1.16,95％CI:1.08-1.31,P=0.002;OR =1.23,95 ％ CI:1.18-1.42,P =0.004).Conclusion The serum level of total bilirubin is negatively related with carotid atherosclerosis in very old patients and is its a protective factor.