丙型肝炎病毒感染者血脂分析及临床意义

目的探讨血脂分析对丙型肝炎病毒（HCV）感染者的临床意义。方法收集HCV感染者107例,分成HCV携带者、轻度和中度慢性丙型肝炎患者三组,分析血脂水平。结果 HCV感染者血清总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）均较正常对照组低（P〈0.05）,且随肝功能损害加重,降低程度增大。HCV携带者血清甘油三酯（TG）与对照组比较差异无统计学意义（P〉0.05）,但中度和轻度慢性丙型肝炎患者TG含量高于对照组（P〈0.01）。HCV携带者和轻度慢性丙型肝炎患者血清载脂蛋白AI（ApoAI）含量与对照组差异无统计学意义（P〉0.05）,但中度慢性丙型肝炎患者ApoAI含量较对照组低（P〈0.01）。HCV感染者血清载脂蛋白B100和脂蛋白（a）含量与对照组比较差异无统计学意义（P〉0.05）。结论 HCV感染者血清TC降低可能是肝脏储备功能下降所致,TG升高可能与HCV核心蛋白抑制微粒体TG转运蛋白相关。

Serum lipids in HCV-infected subjects and their significance

Objective To analyze serum lipid levels in HCV-infected subjects,and to explore clinical significance of serum lipids for these subjects.Methods Peripheral blood samples were obtained from 107 HCV-infected subjects,and these subjects were divided into three groups as HCV carriers,patients with mild and moderate chronic hepatitis C.Serum lipids were measured with clinical chemical analyzer.Results Serum total cholesterol,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol levels were significantly lower in HCV-infected subjects than healthy controls（P0.05）.The decrease in these lipids was associated with an increase in liver damage.Serum triglyceride levels were significantly higher in patients with moderate and mild chronic hepatitis C than healthy controls（P0.01）,while there was no difference between HCV carriers and healthy controls.There were not significant differences in serum apoliprotein AI among healthy controls,HCV carriers,and patients with mild chronic hepatitis C.However,apoliprotein AI levels were significantly lower in patients with moderate chronic hepatitis C than healthy controls（P0.01）.There were not significant differences in serum apoliprotein B100 and lipoprotein（a） between HCV-infected subjects and healthy controls（P0.05）.Conclusion The low levels in serum cholesterol may be caused by decrease in hepatic functional reserve.The high levels in triglyceride may be associated with hepatitis C virus core protein inhibiting microsomal triglyceride transfer protein activity.