Objective:To analyze the relationship of serum total bilirubin, Fibrinogen, the ratio of fibrinogen to total bilirubin (FIB/TBIL) and Gensini scores by measuring them in patients with coronary heart disease(CHD) and non- coronary heart disease (NCHD)who were diagnosed by coronary angiography, and to appraise the diagnostic evaluation of CHD by measuring Fib/TBIL.Methods: We studied 186 people, who underwent coronary angiography (CAG) in The Fourth Hospital of HeBei Medical University from January 2007 to January 2009, without infection、liverd and kindet disease、congestive heartfailure、disorder of blood clotting、peripheric blood vessel disease、tumour、operation . According to the results of CAG , all the cases were classified as CHD group(the severity of coronary artery≥50% at least one ramus , including 100 men and 31 women, average age 59.81±10.866 years) and non-CHD group(the severity of coronary artery 0.05); the level of LPa in CHD group was higher than it in NCHD group(P<0.01). 3 The numerus of TBIL/Fib in the CHD group and the NCHD group were 0.384615 and 0.196644 respectively, whereas there was statistically significant(P<0.01). To analyze Fib/TBIL by ROC, the area under the ROC curve was 0.88(P<0.01)and the sensitivity and specificity of diagnosing CHD were 90.1%and 80.0 % when Fib/TBIL was 0.257027.4 Linear correlation reveal that Gensini scores were positively correlation with both Fib and Fib/TBIL(r=0.25, P < 0.01; r=0.362, P < 0.01) and negatively correlated with TBIL(r=-0.293,P<0.01).Putting Fib and TBIL into Multiple linear stepwise regression analysis again showed Fib、TBIL、LPa、age entered regression equation.The regression equation is: Gensini scores =-4.743 2.842Fib-1.83TBIL  0.045LPa  0.377 age (R=0.655, R~2=0.429, R_(adj)~2=0.411);and Putting Fib/TBIL into Multiple linear stepwise regression analysis showed Fib/TBIL、LPa、age entered regression equation.The regression equation is: Gensini scores= -22.902  28.239Fib/TBIL   0.045 LPa 0.363age(R=0.674,R~2=0.454, R_(adj)~2=0.441).5 Putting Fib、TBIL、Fib/TBIL、TC、TG、HDL、LDL、VLDL、LPa、age、sex、smoking、hypertension ,diabetes into Multiple logistic regression analysis showed age、sex、Fib、TBIL、Fib/TBIL、LPa entered regression equation, partial regression coefficient were -2.077、0.733、1.888、-2.043、1.677、1.544 respectively, constant were -2.712. Considering age、sex、Fib、TBIL、Fib/TBIL、LPa were independent Risk factor in my investigation, the OR were 0.125、2.081、6.608、0.13、5.349、4.683 respectively.Conclusion: Fib、TBIL、Fib/TBIL are independent Risk factor of coronary artery disease. The severity of coronary artery is positively correlation with both Fib and Fib/TBIL, and negatively correlated with TBIL. To CHD, Fib/TBIL has certain diagnostic evaluation.Both lower bilirubin and higher fibrinogen promote coronary heart disease.