血清总胆汁酸水平与老年人冠心病的相关性

2016-10-12王观华胡增敏向海霞

贵州医科大学学报 2016年8期

关键词：血脂冠心病血清

王观华，胡增敏，向海霞，方　鹏

(柞水县人民医院内一科，陕西柞水　711400)

血清总胆汁酸水平与老年人冠心病的相关性

王观华，胡增敏，向海霞，方鹏

(柞水县人民医院内一科，陕西柞水711400)

目的：检测血清总胆汁酸(TBA)水平与老年人冠心病(CHD)的相关性。方法： 40例(稳定性心绞痛)老年CHD患者作为观察组(用Gensini评分评价CHD的严重程度)，42例同期老年健康体检者作为对照组，取观察组入院时或对照组体检当日的血清，采用全自动生化仪检测总胆固醇(TC)、高密度脂蛋白(HDL-c)、低密度脂蛋白(LDL-c)及甘油三脂(TG)等血脂指标，白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)等炎症因子及TBA的表达，比较2组受检者血清血脂指标、炎症因子和TBA水平；采用Spearman法分析冠心病患者TBA与血脂指标、炎症因子及Gensini评分的相关性。结果：与对照组比较，观察组除TC、TNF-α及TBA水平显著升高，差异有统计学意义(P<0.05)；Spearman法分析结果显示，老年CHD患者血清TBA水平与TC、TNF-α及Gensini评分均呈现显著正相关(r=0.787、0.924、0.837，P<0.01)。结论：老年CHD患者TBA水平显著升高，且与疾病严重程度密切相关。

冠状动脉硬化；心脏病；老年人；总胆汁酸；炎症趋化因子类；血脂

[Abstract]Objective: To analyze the correlation between serum total bile acid level(TBA) and coronary heart disease of aged patients. Methods: 40 cases of patients with (stable angina) CHD were collected as observation group (with the Gensini score evaluating the severity of coronary heart disease) and 42 cases of healthy old people in the same period as control group. Serum was collected from observation group at admission and control group at examination day. The automatic biochemical analyzer was adopted to detect blood lipid indexes including serum total cholesterol(TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG), and inflammatory factors including interleukin-6 (IL-6), tumor necrosis factor alpha (TNF alpha) and other inflammatory cytokines and TBA, all of which were compared between observation group and control group.Spearmanmethod was used to analyze the correlation between TBA and serum lipid, inflammatory factors and Gensini score in patients with CHD. Results: The patients in observation group had higher levels of TBA, TC and TNF-α than those of control group, and the difference were statistically significant (P<0.05). The result ofSpearmananalysis showed that in observation group, the levels of TBA was significantly positive correlated with TC and TNF-α and Gensini score(r=0.787、0.924、0.837，P<0.01). Conclusion: TBA level was significantly elevated in elderly patients with coronary heart disease, and is closely related to the severity of the disease.

[Key words]coronary artery sclerosis; heart disease；the aged; total bile acid; chemokines; blood lipid

冠状动脉粥样硬化性心脏病(coronary heart disease，CHD)是我国最为常见的心血管系统疾病之一，目前认为血脂代谢紊乱与血管内皮细胞受损的交互作用在该病的发生和发展中起着重要作用[1-4]。高脂血症是公认的CHD危险因素，新近的研究显示血清总胆汁酸(total bile acid，TBA)水平升高与CHD的发生发展有关[5]。本研究以老年CHD患者作为研究对象，观察其外周血清TBA水平的改变。