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脑梗死患者血清胆红素及尿酸浓度的临床研究

张莹,王世民,李效兰   

  1. 天津市环湖医院
  • 收稿日期:2011-11-09 修回日期:2012-03-16 出版日期:2012-10-15 发布日期:2012-10-15
  • 通讯作者: 张莹

Clinical study of serum bilirubin and uric acid in patients with cerebral infarction

  • Received:2011-11-09 Revised:2012-03-16 Published:2012-10-15 Online:2012-10-15

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摘要： 目的：通过对脑梗死患者血清胆红素和尿酸浓度的研究，探讨其在脑梗死发生、发展中所起的作用。方法：233例脑梗死患者测定血清总胆红素、直接胆红素、间接胆红素、尿酸浓度，与对照组进行比较。结果：脑梗死患者与对照组比较，血清总胆红素、直接胆红素浓度均明显增高（P值分别为0.031、0.000）。中重型脑梗死组与轻型脑梗死组比较，血清胆红素浓度均明显升高（P<0.05）。急性脑梗死组血清胆红素浓度均高于亚急性组和对照组（P<0.05）；亚急性脑梗死组与对照组比较血清胆红素浓度差异无统计学意义（P>0.05）。脑梗死患者血清尿酸浓度高于对照组（P=0.007）。中重型脑梗死组与轻型脑梗死组比较，血清尿酸浓度明显降低（P=0.021）。急性和亚急性脑梗死组血尿酸浓度均高于对照组（P<0.05），而急性与亚急性脑梗死组之间比较差异无统计学意义（P>0.05）。结论：血清胆红素作为抗氧化剂，在脑梗死急性期的升高为机体的应激反应，且病情越重，升高越明显。在脑梗死后血清尿酸浓度升高不是机体应激反应，而可能是反应的患者动脉粥样硬化的情况。中重型脑梗死患者血清尿酸浓度低的可能机制是尿酸作为抗氧化剂在脑梗死后被消耗所致。

关键词: 脑梗死, 胆红素, 尿酸

Abstract: Objective: To investigate the role they play in occurring and developing of cerebral infarction, this study focuses on the concentration of serum bilirubin and uric acid in patients with cerebral infarction. Method: All the 233 patients with cerebral infarction were taken fasting blood sample to detect serum total bilirubin, direct bilirubin, indirect bilirubin, uric acid. Control group includes 187 healthy employees of our hospital. Result: The concentration of serum total bilirubin and direct bilirubin in patients with cerebral infarction is statistically higher versus controls（P=0.031，0.000）. Moderate and sever group has higher serum bilirubin concentration compare with mild group（P<0.05）. A statistically significant rise in serum bilirubin was found in patients with acute cerebral infarction compare with sub-acute group and controls（P<0.05）, but the sub-acute group doesn’t have significant difference with controls. The concentration of serum uric acid in patients with cerebral infarction is statistically higher versus controls（P=0.007）. Moderate and sever group has lower serum uric acid concentration compare with mild group（P=0.021）. A statistically significant rise in serum uric acid was found in patients with acute and sub-acute cerebral infarction patients compare with controls（P<0.05）, but no significant difference was found between acute group and sub-acute group. Conclusion: Serum bilirubin, as an anti-oxidant, elevates during acute period and decreases during sub-acute period. The more severe the neurological dysfunction is, the higher serum bilirubin appears. The increase of serum uric acid is not just at acute period after cerebral infarction. After acute period, the serum uric acid is still high due to atherosclerosis. The moderate and severe group has lower serum uric acid maybe because consumption of uric acid as anti-oxidant.

Key words: Cerebral infarction, Serum bilirubin, Serum uric acid