Clinical Analysis On Correlation Between Serum Bilirubin And Atherosclerosis Cerebral Infarction

Objective : To investigate the incidence and recurrence correlation between serum bilirubin and atherosclerotic cerebral infarction so as to guide the primary and secondary prevention of acute cerebral infarction.Method:select 173 cases of patients with acute atherosclerosis cerebral infarction who were hospitalized 7 days after attack during January 2014-March 2015 in Neurology Department of Chizhou People's Hospital as the cerebral infarction group and 95 cases of healthy person who have passed the physical examination during the same period as the control group.Collect basic information in both groups(age,gender,etc.)and medical history(hypertension,hyperlipidemia,diabetes,drinking and smoking history,etc.)respectively.All subjects were required to take no food at least 12 hours before the phlebotomization with empty stomach.And the blood samples of the cerebral infarction group were collected in the next morning after hospitalization.All biochemical parameters were detected with full-automatic biochemical analyzer,including respective determinations on serum total bilirubin,direct bilirubin and indirect bilirubin levels and other related biochemical indicators as well as the difference comparison between two groups in serum bilirubin levels.The patent who were attached with the disease for the first time were included into the initial cerebral infarction group and those with past atherosclerosis cerebral infarction history were included into the cerebral infarction recurrence group according to various conditions of the patients;then the cerebral infarction recurrence group was divided into two groups according to the length of recurrence(set as one year),namely the recurrence group within one year and recurrence group more than 1 year,so as to compare and analyze the bilirubin level difference between cerebral infarction initial onset group and recurrence group and between the recurrence group within one year and recurrence group more than 1 year.Result:(1)Total bilirubin,direct bilirubin and indirect bilirubin in cerebral infarction group were lower than that in the control group while smoking history and diabetes were higher,The difference was of statistic significance(P<0.05).The significant factors identified in both groups were then included in multivariate logistic regression analysis.Since there was a relatively strong correlation among TBIL,DBIL and IBIL,only IBIL of bilirubin was analyzed in multivariate logistic regression analysis.The result showed that if indirect bilirubin increased,the morbidity of ACI would decrease.Indirect bilirubin was negatively correlated with the morbidity of ACI while smoking history and diabetes were positively correlated with the morbidity of ACI.(2)Total bilirubin,direct bilirubin and indirect bilirubin in cerebral infarction relapse group were greatly lower than that in the first cerebral infarction group while hypertensive disease,diabetes and smoking history were high than that in the first cerebral infarction group.And the difference was statistically significant(P<0.05).The significant factors identified in both groups were then included in multivariate logistic regression analysis.Only indirect bilirubin was analyzed in multivariate logistic regression analysis and the result showed that if serum indirect bilirubin increased,the relapse of ACI would decrease.For those who had diabetes,hypertensive disease and smoking history,the relapse of ACI would increase.Indirect bilirubin was negatively correlated with the morbidity of ACI while smoking history and diabetes and hypertensive disease were positively correlated with that.(3)Comparative difference of total bilirubin,direct bilirubin and indirect bilirubin between relapse group within one year and relapse group more than one year was of no statistic significance(P>0.05).Conclusion:1.Low level of serum bilirubin is closely correlated with the morbidity of atherosclerotic cerebral infarction and low levels of serum indirect bilirubin,smoking history and diabetes are independent risk factors of ACI;2.Low level of serum bilirubin is closely correlated with the relapse of atherosclerotic cerebral infarction but has no significant correlation with the time of relapse,and low level of serum indirect bilirubin,smoking history,diabetes and hypertensive disease are independent risk factors for the relapse of ACI.