肝病病人血脂水平检测及其价值

目的探讨肝病病人血脂水平变化及其临床价值。方法对212例不同类型肝病病人与80例健康人的血脂水平进行检测，包括血清三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL—C）、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB），同时检测肝功能指标，包括总胆红素（TBiL）、谷丙转氨酶（ALT）、清蛋白（ALB）。结果急性肝炎组血清TC、HDL-C、ApoA1水平显著低于正常对照组，慢性肝炎组TC、TG、HDL—C、LDL—C、ApoA1、ApoB水平均显著低于正常对照组，重症肝炎及肝硬化组各血脂检测指标均显著降低，肝癌组TG、HDL—C、ApoA1水平显著降低（F=2．37～53．01，q=5．83～17．58，P〈0．05、0．01）。肝炎病人TC、LDL-C、ApoA1与TBiL水平呈负相关（r=-0．324～-0．387，P〈0．05、0．01）；TG与ALT水平呈负相关（r=-0．426，P〈0．01）；TC、LDL—C、ApoB、HDL-C与ALB呈正相关（r=0．301～0．393，P〈0．05、0．01）。结论血脂检测对判断肝病的程度和预后有重要意义。

DETECTION OF BLOOD LIPID LEVELS IN LIVER DISEASES

Objective To examine the blood lipid levels in patients with hepatic diseases. Methods This study consisted of 212 patients with different liver diseases and 80 healthy subjects, whose blood lipids, including serum triglyceride （TG）, total cholesterol （TC）, high density lipoprotein （HDL-C）, low density lipoprotein （LDL-C）, apolipoprotein Al （ApoAl） and apoli- poprotein B （ApoB） were determined, and total bilirubin （TBiL）, albumin（ALB） and ALT were also detected. Results In acute hepatitis group： the serum TC, HDL-C, and ApoAl were lower than the control; In chronic hepatitis group： TC, TG, HDL-C, LDL-C, ApoAl and ApoB were significantly lower than the control; In severe hepatitis and cirrhosis groups： all of the blood lipid indicators were significantly declined;In liver cancer group： TG, HDL-C, and ApoAl dropped greatly （F = 2. 37 - 53.01; q = 5.83-17.58; P〈0. 05,0. 01）. In hepatitis： a negative correlation was shown in TC, LDL-C, and ApoAl with TBiL （r= -0. 324-0. 387;P〈0.05,0.01）, TG with ALT （r=-0. 426,P〈0.01） and a positive correlation noted in TC, LDL-C, ApoB and HDL-C with ALB （r=0. 301-0. 393;P〈0.05,0.01）. Conclusion Serum lipid detection is of great significance in the estimation of the degree and prognosis of liver diseases.