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目的 通过研究肾功能及胆红素与急性心肌梗死(acute myocardial infarction, AMI)患者冠脉Gensini评分和冠脉病变血管支数的关系,探讨以上因素在AMI冠脉动脉粥样硬化进展中的作用及关系.方法 ①将207 例急诊介入治疗的AMI患者依据Gensini评分分为3组:A组:Gensini评分≤60 分,共107 例;B组:60 分＜Gensini评分≤120 分,共69 例;C组:Gensini评分＞120 分,共31 例.②AMI患者介入治疗前和治疗后24 h内均留取静脉血,测定BUN、Scr、eGFR、UA、胆红素及血脂等观察指标.③观察比较每组患者冠脉Gensini评分和肾功能、胆红素的关系.④按照冠脉血管病变支数分为3组:单支病变组,双支病变组,三支病变组.比较各组BUN、Scr、UA及胆红素等观察指标及其相关性.结果 ①A、B、C三组Gensini评分依次增高,组间差异均有统计学意义(P＜0.05).②A、B、C三组随着Gensini评分的增高,术前和术后24 h BUN、Scr、UA水平均逐渐增高,组间差异均有统计学意义(P＜0.05);术前eGFR、术后24 h eGFR水平A、B、C三组逐渐降低,组间差异均有统计学意义(P＜0.05).③B组、C组与A组比较,TBIL、DBIL、IDBIL均明显增高,差异有统计学意义(P＜0.05);C组与B组相比有增高趋势,但差异无统计学意义(P＞0.05).④对Gensini评分和差异有统计学意义的观察指标进行Pearson相关分析,显示Gensini评分与肾功能和胆红素均具有一定的相关性(P＜0.05).⑤AMI患者冠脉血管病变支数与肾功能、胆红素均具有一定的相关性(P＜0.05).结论 肾功能、胆红素水平与AMI患者冠脉Gensini评分和冠脉血管病变支数均密切相关,对于冠脉血管病变严重程度的判断具有一定的指导意义.“,”Objective To study the relationship between renal function, bilirubin and coronary Gensini score and the number of coronary artery lesion branches in patients with acute myocardial infarction (AMI), and to explore the role and relationship of the above factors in the progression of coronary atherosclerosis in patients with AMI. Methods (1)207 patients with AMI undergoing emergency interventional therapy were divided into three groups according to Gensini score: group A (Gensini score ≤ 60, n＝107), group B (60 ＜ Gensini score ≤ 120, n＝69), group C (Gensini score＞120,n＝31). (2)Venous blood was collected from patients with AMI before and within 24 hours after interventional therapy, and BUN, Scr, eGFR, UA, bilirubin and blood lipid were measured. (3)The relationship between coronary Gensini score, renal function and bilirubin were compared in each group. (4)According to the number of coronary artery lesion branches, the patients were divided into three groups:single vessel disease group, double vessel disease group, and three vessel disease group. BUN, Scr, UA, bilirubin and their correlation were compared in each group. Results (1)Gensini scores of group A, B and C increased in turn, and the differences between groups were statistically significant (P＜0.05). (2)With the increase of Gensini score, BUN, Scr and UA levels in group A, B and C increased gradually before and 24 hours after surgery, and the differences between groups were statistically significant (P＜0.05). The levels of eGFR before surgery and 24 hours after surgery decreased gradually in groups A, B and C. The differences between groups were statistically significant (P＜0.05). (3)Compared with group A, TBIL, DBIL and IDBIL increased significantly in group B and C, and the differences were statistically significant (P＜0.05); There was an increasing trend in group C compared with group B, but the difference was not statistically significant ( P＞0.05). (4) Pearson correlation analysis of Gensini score and observation indexes with statistical significance showed that Gensini score was correlated with renal function and bilirubin (P＜0.05). (5)The number of coronary artery lesion branches in patients with AMI is correlated with renal function and bilirubin (P＜0.05). Conclusion Renal function and bilirubin levels are closely related to coronary Gensini score and the number of coronary artery lesion branches in patients with AMI, which has certain guiding significance for judging the severity of coronary artery lesion.