血清载脂蛋白A_1和B与慢性乙肝中医证型的关系

目的探讨慢性乙型肝炎患者血清载脂蛋白（ａｐｏ）的变化及其与中医辨证分型的关系。方法慢性乙肝患者６８例，其中慢迁肝４１例，慢活肝２７例；正常对照３２例。６８例慢性乙肝患者按中医辨证分为肝郁脾虚１８例，肝胆湿热１４例，脾肾阳虚１２例，血郁阻络１４例，肝肾阴虚１０例。结果慢性乙肝患者血脂、血清ａｐｏＡ１和ａｐｏＢ的水平均明显低于正常对照组（Ｐ＜０．０１）。慢活肝患者ａｐｏＡ１显著低于慢迁肝（Ｐ＜０．０１）。ａｐｏＡ１和ａｐｏＢ下降幅度最大的是肝肾阴虚型，其次是瘀血阻络型和脾肾阳虚型。ａｐｏＡ１／ａｐｏＢ之比值在慢活肝及肝肾阴虚型患者均明显异常（Ｐ＜０．０５）。结论慢性乙肝患者血清ａｐｏＡ１和ａｐｏＢ降低与病要严重程度相一致，并为本病的中医辨证提供一个可能的量化指标。）

Relationship between the changes of serum apoA_1apoB and Syndrome Differentiation oftraditional Chinese medicinein patients with chronic hepatitis B

Objective To research the relationship between the changes of serum apolipoprotein andthe Syndrome Differentiation of traditional.Chinese medicine in patients with chronic hepatitisB (CHB).Methods Sixty eight patients included inchronic persisting hepatitis (CPH) in 41 casesand chronic active hepatitis (CAH) in 27 cases.Thirty two healthy persons were selected as normal control.In 68 cases of CHB, the stagnation ofthe Liver-qi and deficiency of the spleen were 18patients, dampness and heat in the liver andgalibladder 14 patients, insuficiency of both thespleen and the kidney 12 patients, accumulationof blood stasis 14 patients, by DifferentiationSyndrome of traditional Chinese medicine.Results The levels of serum lipids andapoA1 and apoB were lower in patients CHB thanthat of control group (P<0.01 ). The levels ofapoA1 in CAH were lower obviously than that inCPH (P< 0. 01). The declining range ofapoA1and B were largest in patients with deficincyof liver-yin and kidney-yin, next in patients withinsuficiency of both the spleen and kidney and inpatients with accumulation of blood stasis. A ratioof apoA1to apoB were abnormal obviously in patients with CAH and in patients with dificincy ofliver-yin and kidney-yin (P<0.05).Conclusion The declining degree of serumapoA1and apoB is tallies with severe drgree oflesion, and may provide a quantificating indexfor Syndrome Differentiation of traditionalChinese medicine.