Olinescu R, Kummerow F A, Greabu M, Crocnan D O, Voiculescu B
The Burnsides Research Laboratory, University of Illinois, Urbana, IL 61801, USA.
Rom J Intern Med. 1999 Jul-Sep;37(3):239-49.
In agreement with previous reports, we found that the bilirubin level is significantly lower in the blood of patients with coronary heart disease (CHD) than in age and sex matched controls. However, we found that the level of bilirubin in the blood seemed to be an age-dependent phenomenon and closely related to the activation of leukocytes. In 1,000 cardiac catheterized patients from Urbana. USA suffering from CHD, the level of blood bilirubin was found to be lower than in age and sex-matched controls. The same results were obtained on 300 patients with acute ischemia from three hospitals from Bucharest, Romania. The activation of polymorphonuclear leukocytes increased in the catheterized patients, as well in Romanian patients. An activation of leukocytes triggered by a chronic inflammatory process may increase the lysis of erythrocytes. The erythrocytes of patients with 100% stenosis exhibited a higher rate of in vitro lysis in the presence of activated leukocytes and homocysteine. The increased hemolysis may trigger the activation and removal of the resulting bilirubin from blood. Such a mechanism may depend on the liver clearing function. This function had decreased in catheterized patients over 60 years of age, but had accelerated in younger patients. An individual variation in liver function may explain the widespread bilirubin levels in the blood of patients suffering from CHD.
与先前的报道一致，我们发现冠心病（CHD）患者血液中的胆红素水平显著低于年龄和性别匹配的对照组。然而，我们发现血液中胆红素水平似乎是一种年龄依赖性现象，并且与白细胞的激活密切相关。在美国厄巴纳的1000例接受心脏导管插入术的冠心病患者中，发现血液胆红素水平低于年龄和性别匹配的对照组。罗马尼亚布加勒斯特三家医院的300例急性缺血患者也得到了相同的结果。接受导管插入术的患者以及罗马尼亚患者中多形核白细胞的激活均增加。由慢性炎症过程触发的白细胞激活可能会增加红细胞的溶解。在存在激活的白细胞和同型半胱氨酸的情况下，100%狭窄患者的红细胞在体外表现出更高的溶解率。溶血增加可能会触发胆红素从血液中的激活和清除。这种机制可能取决于肝脏的清除功能。60岁以上接受导管插入术的患者这种功能下降，但年轻患者中则加快。肝功能的个体差异可能解释了冠心病患者血液中胆红素水平的广泛差异。
