梗阻性黄疸患者血脂的变化及临床意义

Changes and clinical significance of lipids in patients with obstructive jaundice

目的探讨梗阻性黄疸患者血清脂蛋白的变化及意义。方法选择梗阻性黄疸、胆石症及健康对照组3组为研究对象,分别测定其甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(a)[LP(a)]、载脂蛋白A(ApoA1)、及载脂蛋白B(ApoB)。结果梗阻性黄疸组的HDL-C、LP(a)及ApoA1显著低于另2组(P<0.01),TG显著高于另2组(P<0.01),TC(P<0.05)、ApoB显著高于对照组(P<0.01);胆石症组LDL-C显著高于对照组(P<0.01),其余指标组间差异无显著性(P>0.05)。结论由梗阻性黄疸引发的革兰阴性细菌感染或内毒素血症患者血中脂蛋白,尤其是HDL因过多消耗而降低,原因为HDL能与脂多糖(LPS)结合,从而对抗LPS对机体的毒性作用。

Objective To investigate the alteration and clinical significance of lipids in patients with obstructive jaundice. Methods Selecting two groups of patients with obstructive jaundice or cholelithiasis and one group of healthy subjects（control group）. Serum TG, TC, HDL-C, LDL-C, Lp（a）, ApoA1 and ApoB in patients of three groups were detectedrespectively. Results HDL-C, Lp（a）, ApoA1 of obstructive jaundice group were significant lower than those in the other two groups （ P 〈 0.001）, TG of obstructive jaundice group was significant higher than that in the other 2 groups （ P 〈0.01）, TC （ P 〈0.05） and ApoB （ P 〈0.01） in obstructive jaundice group were significant higher than those in control group, LDL-C of cholelithiasis group was significant higher than that control group （ P 〈 0.01）. There were no significant differences in aforesaid indexes among groups （ P 〉 0.05）. Conclusion Serum lipoproteins in patients with gram-negative bacterial infection or endotoxemia induced by obstructive jaundice may be decreased by consuming more HDL. Because HDL could combine with LPS to resist toxic effect of LPS on body.