Relationship Between Serum Bilirubin,Beta2-microglobulin With Coronary Heart Disease And Extent Of The Coronary Artery Lesions

Objective:This paper proposes to explore the relationship between serum bilirubin?BIL?and beta2-microglobulin??2-MG?levels with the occurrence of coronary heart disease?CHD?and the extent of coronary artery lesions.And to evaluate the diagnostic efficacy of the two indexes for CHD,so as to determine whether they can be the reference indexes for the early prediction of CHD and the extent of coronary artery lesions.Methods:In this study,patients who suspected of chest distress and chest pain as CHD and admitted to the second Department of Cardiology of Lu'an people's Hospital for coronary angiography?CAG?from January 2017 to March 2019 were studied.The general data of these patients were collected,including age,gender,smoking history and history of previous chronic diseases,and the levels of total bilirubin?TBIL?,direct bilirubin?DBIL?,indirect bilirubin?IBIL?,beta2-microglobulin??2-MG?,creatinine?Cr?,total cholesterol?TC?,triglyceride?TG?,high-density lipoprotein cholesterol?HDL-C?and low-density lipoprotein cholesterol?LDL-C?of the blood test at the day after admission were further collected and recorded.At the same time,according to the CAG results of each study object,we can judge their disease situation,and then further count the cumulative number of coronary lesions and Gensini score of each study object.Finally,SPSS24.0 software was used to deal with the collected data,to analyze the relationship between the levels of BIL,?2-MG and the occurrence of CHD and the extent of coronary arterylesions,and diagnostic efficacy of serum TBIL and?2-MG for CHD.Results:1.There were significant differences in gender,age,smoking history,HDL,TBIL,DBIL,IBIL,?2-MG,Cr between CHD group and normal control group?P<0.05?.In CHD group,there were more men patients with smoking history than in the control group,and the average age was also higher;the comparison of related biochemical indexes found that the levels of HDL-C,TBIL,DBIL and IBIL in CHD group were significantly lower than that in the control group,while the levels of?2-MG and Cr were significantly higher.2.Multivariate Logistic regression analysis showed that age?P=0.041,OR=1.083,95%CI:1.003-1.170?and?2-MG?P=0.016,OR=23.720,95%CI:1.802-312.316?are independent risk factors for CHD,while DBIL?P=0.003,OR=0.338,95%CI:0.166-0.691?and IBIL?P=0.001,OR=0.330,95%CI:0.176-0.619?are independent protective factors for CHD.3.There were significant differences in serum TBIL,DBIL,IBIL and?2-MG in serum between the SVD group,DVD group and TVD group of the CHD patients?P<0.05?,and the levels of BIL in SVD and DVD group were higher than those in TVD group?P<0.05?;But the level of?2-MG in serum is the opposite,its level in SVD and DVD group was significantly lower than that of TVD group?P<0.05?.4.There were also significant statistical differences in serum TBIL,DBIL,IBIL,and?2-MG among the three groups of CHD patients with normal Gensini scores,low and high groups?P<0.05?.The serum BIL levels of patients in the high group were significantly lower than those in the low group and the normal group?P<0.05?,and the levels of the low group were also lower than those in the normal group?P<0.05?;while serum?2-MG was the opposite.The level of the indicator in the high group is significantly higher than that in the low group and the normal group?P<0.05?,and the level of the indicator in the low group is also higher than the normal group?P<0.05?.5.The levels of BIL and?2-MG in serum had a strong correlation with the Gensini score of coronary artery?|r|>0.6,P<0.05?.There was a significant negative linear correlation between the levels of TBIL,DBIL and IBIL in serum and the Gensini score(r_TB=-0.754;r_DB=-0.651;r_IB=-0.734,P<0.05),but there was a significant positive linear correlation between the levels of serum?2-MG and the Gensini score?r=0.704,P<0.05?.6.TBIL and?2-MG in serum are both very effective in the diagnosis of CHD.The ROC curve of subjects shows that:The area under the serum TBIL index curve was0.950?P<0.05,95%CI:0.915-0.985?,and the diagnostic index was the highest?0.744?when the sensitivity was 89.6%and the specificity was 87.8%.At this time,the diagnostic efficiency was higher,so as the best diagnostic threshold,and the corresponding serum TBIL concentration was 12.55?mol/L;However,the area under the curve of serum?2-MG was 0.905?P<0.05,95%CI:0.862-0.948?,and the diagnostic index was the highest?0.681?when the sensitivity was 84.4%and the specificity was83.7%.Therefore,as the best diagnostic threshold,and the corresponding serum?2-MG concentration was 1.95mg/L.Conclusion:1)The levels of BIL and?2-MG in serum are related to the occurrence and development of CHD.DBIL and IBIL are independent protective factors for CHD,while?2-MG is an independent risk factor for CHD.2)The levels of TBIL,DBIL,IBIL and?2-MG in serum are all highly correlated with the extent of coronary artery lesions.These four indexes may have extremely important value in evaluating the extent of coronary artery lesions in CHD patients.3)The level of serum TBIL and?2-MG can effectively predict the diagnosis of CHD,and the diagnostic efficacy of TBIL in serum is slightly higher than that of?2-MG in serum.