肝病患者血脂水平的变化

目的探讨肝病患者血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）的变化情况及其临床意义。方法测定235例肝病患者（其中急性肝炎55例、慢性肝炎59例、肝硬化50例、重型肝炎71例）血清TC、TG、HDL-C、LDL-C水平，并与75名健康人进行比较，同时测定血清总胆红素（TBil）、白蛋白（Alb）、血浆凝血酶原活动度（PTA）。对重型肝炎患者血清TC、TG、HDL-C、LDL-C浓度与其TBil、Alb、PTA进行相关性分析。结果各型肝病患者血清TC、TG、HDL-C、LDL-C水平和对照组比较均有所降低，其中肝硬化和重型肝炎患者以上指标与对照组比较明显下降（P〈0．01或P〈0．05）。重型肝炎组血清TC、TG、HDL-C、LDL-C与TBil呈负相关P〈0．01]，与Alb呈正相关（P〈0．01），与PTA呈正相关（P〈0．01或P〈0．05）；血清TC与LDL-C呈正相关（P〈0．05）。重型肝炎组中39例死亡患者与32例存活患者的血清TC、TG、HDL-C、LDL—C水平差异均具有统计学意义（P〈0．05）。结论对肝病患者进行定期的血脂水平测定能及时反映体内的脂类代谢状况，对了解肝病患者的肝脏损伤程度、病程进展情况以及重型肝炎的预后判断都有重要价值。

Variation of serum lipid level in patients with liver diseases

Objective To investigate the clinical significance of serum total cholesterol （TC）, triglyceride （TG）, high-density lipoprotein cholesterol（ HDL-C ） and low-density lipoprotein cholesterol （LDL-C） in patients with liver disease. Methods The levels of serum TC, TG, HDL-C, LDL-C in 235 patients with liver disease and 75 heahhy people were measured and serum total bilirubin （TBil） , albumin （Alb） and plasma prothrombin activity （PTA） were simultaneously detected. The correlation analysis of the results of severe hepatitis was made. Results Compared with the control group, the levels of serum TC, TG, HDL-C, LDL-C of various types of liver disease group were decreased, more significantly in severe hepatitis and cirrhosis patients （P〈0.05 or P〈0.01）. The levels of serum lipid of fulminant hepatitis were negatively correlated with TBil （P〈0.01） and positively correlated with Alb and PTA （P〈0.05 or P〈0.01）. The TC was positively correlated with LDL-C （P〈0.05）. The levels of serum TC, TG, HDL-C, LDL-C had significant difference between the fatal group （39 cases） and the survival group （32 cases） in the patients with severe hepatitis （P〈0.05）. Conclusions Detecting the the levels of serum lipid of patients with liver disease regularly can timely reflect the metabolism of lipids and have significant value of right understanding of the degree of liver injury, disease progression as well as the prognosis of severe hepatitis patients.