男性乙型肝炎肝硬化患者血清瘦素及血脂水平的研究

目的检测男性乙型肝炎肝硬化患者血清瘦素及血脂水平，探讨其异常变化的临床意义。方法男性乙型肝炎肝硬化患者64例，男性健康受试者28名，用ELISA法检测血清瘦素水平，用全自动生化分析仪检测肝功能和血脂。对血清瘦素、血脂与肝功能的关系进行分析。结果各组乙型肝炎肝硬化Child-Pugh分级患者与对照组比，血清瘦素水平无显著性差异（P〉0．05）；与正常对照组比，乙型肝炎肝硬化患者血CHO和LDL水平显著降低（P〈0．01），按Child分级由A到C级各组CHO和LDL水平逐渐降低，差异有显著性（P〈0．01）。无腹水肝硬化患者血清瘦素水平与BMI及Fat％均呈显著正相关。结论血清瘦素水平不能作为评价男性乙型肝炎肝硬化患者病情严重程度的指标，血清胆固醇、低密度脂蛋白是肝功能减退的指标。瘦素可能参与了男性乙型肝炎肝硬化患者的营养不良。

Serum leptin and blood lipid levels in male patients with hepatitis B-related cirrhosis

Objective To investigate the serum leptin and blood lipids in male patients with hepatitis B-related cirrhosis. Methods Sixty-four male cirrhotic patients with HBV infection and twenty-eight control subjects were included in this study. Serum leptin was determined by ELISA. All data were analyzed by SPSS 10.0 version for Windows. Results Leptin seemed to be increased in patients compared with controls,but there was no statistical significant difference （P〉0.05）. Among the three group patients with liver cirrhosis,the same results could be seen. There was no difference of triglycerides and high density lipoprotein-cholesterol in patients no matter with Child＇s A,B or C class as compared with control group （P〉0.05）. The levels of cholesterol and low-density lipoprotein cholesterol were significantly lower in the three group patients than that in controls （P〈0.01）. The levels of CHO and LDL gradually decreased in patients with cirrhosis from Child＇s class A to B and C （P〈0.01）. A positive correlation between serum lepin levels and body mass index and Fat% were observed in patients with cirrhosis （BMI：r=0.361,P=0.028;Fat%：r=0.425,P=0.01）. A significant positive correlation was also observed in patients without ascites （BMI：r=0.528,P=0.002;Fat%：r=0.538,P=0.002）. Conclusions In male patients with hepatitis B-related cirrhosis,there is no obvious association between serum leptin and Child-Pugh＇s classes. Leptin can＇t serve as an index of evaluating liver function,but it may be a factor resulting in malnutrition in patients. Serum CHO and LDL levels decrease following the impairment of liver function and can be used to monitor the development of the disease as well as to predict the prognosis.