肝脂酶、脂蛋白脂肪酶在脂肪肝发病中的作用

目的　探讨肝脂酶（ＨＬ）和脂蛋白脂肪酶（ＬＰＬ） 在脂肪肝发病中的作用。方法　３１ 例脂肪肝患者、１０ 例急性肝炎患者、１２ 例慢性肝炎患者、８ 例肝硬化患者及８ 例对照组均测定肝素后血浆中的ＨＬ、ＬＰＬ活性和ＬＰＬ含量，同时测定血脂、肝肾功能、血糖及肝炎病毒标记，其中１３ 例脂肪肝患者和７ 例对照行肝组织ＨＬ、ＬＰＬ活性和ＬＰＬ含量测定。结果　脂肪肝组与正常对照组及其他各组肝病相比，血脂明显升高，主要表现为血甘油三酯升高，肝素后血浆中ＨＬ、ＬＰＬ 活性显著降低，而ＬＰＬ 含量保持不变。脂肪肝组患者肝组织中ＬＰＬ活性亦明显降低。结论　脂肪肝与高脂血症之间关系密切，肝素后血浆中脂蛋白脂肪酶、肝脂酶活性的降低可能在脂肪肝发病中起一定作用。

The role of hepatic lipase and lipoprotein lipase in the pathogenesis of fatty liver

Objective To determine the possible role of hepatic lipase (HL) and lipoprotein lipase (LPL) in the pathogenesis of fatty liver.Methods The activity of HL and LPL and mass of LPL in post heparin plasma were tested in 37 patients with fatty liver, 10 cases of acute hepatitis, 12 cases of chronic hepatitis, 8 cases of liver cirrhosis and 8 normal controls. Blood lipids, hepatic and renal function, glucose and markers for hepatitis virus were also tested. The HL and LPL activity and LPL mass of the hepatic tissue were also tested in 13 patients with fatty liver and 7 normal controls.Results Compared with the normal controls and patients with other hepatic diseases, the fatty liver patients had a significant higher level of blood lipids (es pecially triglyceride) and a significant lower level of HL and LPL activity. The level of LPL mass of post heparin plasma, however, was similar. In addition, the LPL activity of hepatic tissue in the fatty liver group was also decreased.Conclusion Fatty liver is closely related with hyperlipidemia. The lowered level of HL and LPL activity of post heparin plasma may play a role in the pathogenesis of fatty liver.