血清总胆红素水平检测在脑梗死突发事件中的应用
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摘要
目的观察分析血清总胆红素水平检测在脑梗死突发事件中的相关应用.方法选取2013年9月至2015年7月德宏州人民医院收治的脑梗死患者(发病≤2周)62例作为观察组,另选取同期体检正常者62例作为对照组.观察比较2组受试者入院72 h内的血清总胆红素、血脂、血糖等生化指标水平.结果观察组患者的三酰甘油、总胆固醇、高密度脂蛋白胆固醇、舒张压、收缩压、空腹血糖均显著高于对照组[(1.85±0.36)mmol/L vs(1.36±0.21)mmol/L,(4.9±1.5)mmol/L vs(4.5±1.1)mmol/L,(1.56±0.39)mmol/L vs(1.43±0.28)mmol/L,(83.1±11.5)mm Hg vs(75.2±10.3)mm Hg,(132.5±22.4)mm Hg vs(117.3±19.8)mm Hg,(5.9±0.3)mmol/L vs(5.3±0.9)mmol/L],低密度脂蛋白胆固醇低于对照组[(2.01±0.29)mmol/L vs(2.41±0.37)mmol/L].观察组患者的血清总胆红素、直接胆红素、间接胆红素显著均高于对照组[(15.1±3.8)μmol/L vs(12.1±3.5)μmol/L,(4.6±1.1)μmol/L vs(3.9±1.3)μmol/L,(10.5±2.1)μmol/L vs(8.1±1.4)μmol/L](P<0.05).不同程度神经功能缺损患者总胆红素、直接胆红素、间接胆红素比较差异无统计学意义(P>0.05).预后良好组患者总胆红素、直接胆红素、间接胆红素水平均显著高于预后不良组[(16.1±3.7)μmol/L比(11.9±2.9)μmol/L、(4.9±1.1)μmol/L比(3.6±1.1)μmol/L、(11.2±2.1)μmol/L比(8.2±2.3)μmol/L](P<0.05).结论对血清总胆红素水平检测,能够了解患者胆红素水平,有利于对脑梗死患者的早期诊断和治疗,同时判断患者预后.
Objective To observate and analyze the significance of serum total bilirubin level detected in cerebral emergencies.Methods A total of 62 patients with cerebral infarction(incidence ≤2 weeks) in the People's Hospital of Dehong from September 2013 to July 2015 were selected as the observation group,another 62 cases of examination of patients were selected as a control group.Then we compared the biochemical indexes including serum total bilirubin,blood lipids and blood sugar within 72 h after admission between two groups of patients.Results For patients in the observation group,serum levels o f triglyceride,total cholesterol,high density lipoprotein cholesterol,diastolic blood pressure,systolic blood pressure,fasting blood glucose were significantly higher than the control group [(1.85±0.36) mmol/L vs(1.36 ±0.21) mmol/L,(4.9 ±1.5)mmol/L vs(4.5±1.1) mmol/L,(1.56±0.39) mmol/L vs(1.43±0.28) mmol/L,(83.1±11.5) mm Hg vs(75.2±10.3) mm Hg,(132.5±22.4) mm Hg vs(117.3±19.8) mm Hg,(5.9±0.3) mmol/L vs(5.3±0.9) mmol/L,Low density lipoprotein cholesterol was lower than the control group [(2.01±0.29) mmol/L vs(2.41 ±0.37) mmol/L].Serum total bilirubin,direct bilirubin,indirect bilirubin of observation group was significantly higher than the control group [(15.1±3.8) μmol/L vs(12.1±3.5) μmol/L,(4.6±1.1) μmol/L vs(3.9±1.3) μmol/L,(10.5±2.1) μmol/L vs(8.1±1.4) μmol/L],the difference was statistically significant(P<0.05).Varying degrees of neurological impairment with total bilirubin,directbilirubin,indirect bilirubin had no significant difference(P>0.05).Good prognosis group total bilirubin,directbilirubin,indirect bilirubin levels were significantly higher than the poor prognosis group [(16.1±3.7) μmol/L vs(11.9±2.9) μmol/L,(4.9±1.1) μmol/L vs(3.6±1.1) μmol/L,(11.2±2.1) μmol/L vs(8.2±2.3) μmol/L],the difference was statistically significant(P<0.05).Conclusion Serum levels of total bilirubin in patients is beneficial for the early diagnosis and treatment of patients with cerebral infarction,and determine the prognosis.
Objective To observate and analyze the significance of serum total bilirubin level detected in cerebral emergencies.Methods A total of 62 patients with cerebral infarction(incidence ≤2 weeks) in the People's Hospital of Dehong from September 2013 to July 2015 were selected as the observation group,another 62 cases of examination of patients were selected as a control group.Then we compared the biochemical indexes including serum total bilirubin,blood lipids and blood sugar within 72 h after admission between two groups of patients.Results For patients in the observation group,serum levels o f triglyceride,total cholesterol,high density lipoprotein cholesterol,diastolic blood pressure,systolic blood pressure,fasting blood glucose were significantly higher than the control group [(1.85±0.36) mmol/L vs(1.36 ±0.21) mmol/L,(4.9 ±1.5)mmol/L vs(4.5±1.1) mmol/L,(1.56±0.39) mmol/L vs(1.43±0.28) mmol/L,(83.1±11.5) mm Hg vs(75.2±10.3) mm Hg,(132.5±22.4) mm Hg vs(117.3±19.8) mm Hg,(5.9±0.3) mmol/L vs(5.3±0.9) mmol/L,Low density lipoprotein cholesterol was lower than the control group [(2.01±0.29) mmol/L vs(2.41 ±0.37) mmol/L].Serum total bilirubin,direct bilirubin,indirect bilirubin of observation group was significantly higher than the control group [(15.1±3.8) μmol/L vs(12.1±3.5) μmol/L,(4.6±1.1) μmol/L vs(3.9±1.3) μmol/L,(10.5±2.1) μmol/L vs(8.1±1.4) μmol/L],the difference was statistically significant(P<0.05).Varying degrees of neurological impairment with total bilirubin,directbilirubin,indirect bilirubin had no significant difference(P>0.05).Good prognosis group total bilirubin,directbilirubin,indirect bilirubin levels were significantly higher than the poor prognosis group [(16.1±3.7) μmol/L vs(11.9±2.9) μmol/L,(4.9±1.1) μmol/L vs(3.6±1.1) μmol/L,(11.2±2.1) μmol/L vs(8.2±2.3) μmol/L],the difference was statistically significant(P<0.05).Conclusion Serum levels of total bilirubin in patients is beneficial for the early diagnosis and treatment of patients with cerebral infarction,and determine the prognosis.
引文
[1]汤建武,周强,王新元,等.老年血清胆红素水平与冠心病、脑梗死关系的研究[J].天津医药,2011,39(7):654-655.
[2]刘梅娟,张素媛,贾昭华.老年血清胆红素水平在冠心病、脑梗死诊断中价值[J].中国民康医学,2014,27(6):39-40.
[3]刘军,王昌富.胆红素的检测方法及其与临床疾病的关系[J].中国康复理论与实践,2007,13(3):273-274.
[4]王云,马业民.血清胆红素水平与冠心病的关系探讨及检测血清胆红素的意义[J].中国医学创新,2012,5(32):96-97.
[5]黄文盛,庄伟端.血清胆红素水平与缺血性脑卒中的关系[J].医学综述,2014,20(1):25-27.
[6]张元晓,张琳.血清胆红素水平与急性缺血性脑卒中关系的临床研究[J].陕西医学杂志,2015,44(4):453-454.
[7]巫嘉陵,王纪佐,王世民,等.脑卒中患者临床神经功能缺损程度评分的信度与效度[J].中华神经科杂志,2009,42(2):75-78.
[8]PREEDYVR,WATSON RR.NIHSS-National Institute of Health Stroke Scale[M].New York:Springer,2010:4270-4270.
[9]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,43(2):146-153.
[10]李婷,苗玲.血清胆红素与脑梗死急性期患者的关系[J].中国脑血管病杂志,2011,8(10):513-517.
[11]刘广琴,曹成波,刘广峰,等.血清胆红素与脑梗死患者年龄及分型的关系探讨[J].中国实用神经疾病杂志,2013,16(7):7-9.
[12]田婷,石正洪.胆红素抗氧化系统与缺血性脑卒中的关系[J].中国康复理论与实践,2015,21(10):1178-1181.
[13]秦娜,赵世刚,丁姝月,等.胆红素与脑梗死关系的研究进展[J].四川生理科学杂志,2015,37(1):40-42.
[14]张莹,王世民,李效兰.脑梗死患者血清胆红素水平的变化[J].中风与神经疾病,2009,26(1):110-111.
[15]李婷,苗玲.胆红素及血红素氧化酶与缺血性卒中的关系[J].中国脑血管病杂志,2010,7(12):664-667.
[16]徐玉龙,刘兆阳,丁琪.血尿酸水平与氧化应激在急性脑梗死发生中的关系探讨[J].卒中与神经疾病,2010,17(1):9-11.
[17]卜令同,吴桥,江荣炎.冠状动脉病变程度与血清尿酸、胆红素及血脂水平的相关性[J].心血管康复医学杂志,2010,19(3):257-259.
[18]贾宁人,王钢.血清总抗氧化水平测定用于重症患者临床监护的意义初探[J].中国中西医结合急救杂志,2002,9(1):19-20.
[19]邹晓辉,王咏龙,党利华.动脉粥样硬化性血栓性脑梗死的临床治疗分析[J].中国医药导报,2011,08(3):50-51.
[20]颜帅.血清胆红素与动脉粥样硬化性血栓性脑梗死的相关性临床研究[D].长春:吉林大学(博士论文),2015.
[2]刘梅娟,张素媛,贾昭华.老年血清胆红素水平在冠心病、脑梗死诊断中价值[J].中国民康医学,2014,27(6):39-40.
[3]刘军,王昌富.胆红素的检测方法及其与临床疾病的关系[J].中国康复理论与实践,2007,13(3):273-274.
[4]王云,马业民.血清胆红素水平与冠心病的关系探讨及检测血清胆红素的意义[J].中国医学创新,2012,5(32):96-97.
[5]黄文盛,庄伟端.血清胆红素水平与缺血性脑卒中的关系[J].医学综述,2014,20(1):25-27.
[6]张元晓,张琳.血清胆红素水平与急性缺血性脑卒中关系的临床研究[J].陕西医学杂志,2015,44(4):453-454.
[7]巫嘉陵,王纪佐,王世民,等.脑卒中患者临床神经功能缺损程度评分的信度与效度[J].中华神经科杂志,2009,42(2):75-78.
[8]PREEDYVR,WATSON RR.NIHSS-National Institute of Health Stroke Scale[M].New York:Springer,2010:4270-4270.
[9]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,43(2):146-153.
[10]李婷,苗玲.血清胆红素与脑梗死急性期患者的关系[J].中国脑血管病杂志,2011,8(10):513-517.
[11]刘广琴,曹成波,刘广峰,等.血清胆红素与脑梗死患者年龄及分型的关系探讨[J].中国实用神经疾病杂志,2013,16(7):7-9.
[12]田婷,石正洪.胆红素抗氧化系统与缺血性脑卒中的关系[J].中国康复理论与实践,2015,21(10):1178-1181.
[13]秦娜,赵世刚,丁姝月,等.胆红素与脑梗死关系的研究进展[J].四川生理科学杂志,2015,37(1):40-42.
[14]张莹,王世民,李效兰.脑梗死患者血清胆红素水平的变化[J].中风与神经疾病,2009,26(1):110-111.
[15]李婷,苗玲.胆红素及血红素氧化酶与缺血性卒中的关系[J].中国脑血管病杂志,2010,7(12):664-667.
[16]徐玉龙,刘兆阳,丁琪.血尿酸水平与氧化应激在急性脑梗死发生中的关系探讨[J].卒中与神经疾病,2010,17(1):9-11.
[17]卜令同,吴桥,江荣炎.冠状动脉病变程度与血清尿酸、胆红素及血脂水平的相关性[J].心血管康复医学杂志,2010,19(3):257-259.
[18]贾宁人,王钢.血清总抗氧化水平测定用于重症患者临床监护的意义初探[J].中国中西医结合急救杂志,2002,9(1):19-20.
[19]邹晓辉,王咏龙,党利华.动脉粥样硬化性血栓性脑梗死的临床治疗分析[J].中国医药导报,2011,08(3):50-51.
[20]颜帅.血清胆红素与动脉粥样硬化性血栓性脑梗死的相关性临床研究[D].长春:吉林大学(博士论文),2015.