慢性重型乙型肝炎患者血清游离脂肪酸水平的变化及意义

The significance of serum free fatty acid changes in patient of chronic severe hepatitis B

目的探讨慢性重型乙型肝炎(CSHB)患者血清游离脂肪酸(FFA)水平的变化及其临床意义。方法测定120例CSHB患者、120例慢性乙型肝炎(CHB)患者治疗前后和30名健康对照者的血清FFA水平,并结合血清总胆红素(TBil)、丙氨酸氨基转移酶(ALT)、总胆固醇(TC)水平进行分析。结果治疗前CSHB组和CHB组患者血清FFA水平分别为(1 638.6±96.4)mmol/L和(626.1±37.5)mmol/L,明显高于正常对照组[(223.1±26.4)mmol/L,P<0.01、P<0.05],CSHB组FFA水平高于CHB组(P<0.05);治疗3周后CSHB组和CHB组患者血清FFA水平分别为(548.1±46.3)mmol/L和(228.1±12.4)mmol/L,CSHB组FFA水平高于CHB组,CHB组FFA水平与正常对照组[(220.4±16.4)mmol/L]比较,差异无统计学意义(P>0.05)。结论CSHB、CHB患者FFA水平均显著升高,与病情严重程度相关。治疗后FFA水平下降,提示检测血清FFA水平对CSHB的病情诊断和预后有一定的临床价值。

Objective To investigate the change of serum free fatty acid （ FFA ） in chronic severe hepatitis B （CSHB） and its clinical significance. Methods The levels of serum FFA in 120 CSHB patients, 120 chronic hepatitis B （CHB） patients and 30 healthy controls were determined and compared with the level of serum total billirubin （TBil）, alanine aminotransferase（ALT） and total eholesterol（TC）. Results The levels of serum FFA in patients with CSHB and CHB were （1 638.6±96.4）mmol/L and （626.1 ±37.5 ）mmol/L, which were significantly higher than that in healthy controls [ （ 223.1 ± 26.4 ） retool/L, P 〈 0.01, P 〈 0.05 ]. The FFA levels in CSHB patients were higher than that in CHB patients（ P 〈 0. 05 ）. The levels of serum FFA in patients with CSHB and CHB were （ 548.1 ±46.3 ） mmol/L and （228.1 ±12.4）mmol/L after 3 weeks treatment. The FFA levels in CSHB patients were higher than that in CHB patients. The levels of serum FFA in patients with CHB had no difference compared with control group（P 〉0.05）. Conclusions The levels of serum FFA in CSHB and CHB patients increase significantly and correlate with the severity of disease. The serum FFA level decreases after treatment. Determination of serum FFA has clinical value for the diagnosis and prognosis of CSHB.