肝病病人血清脂蛋白的变化及其机制探讨

A study on the change of serum lipoproteins and its mechanism in patients with liver diseases

肝脏在脂蛋白的合成、降解及贮存中起枢纽作用。已有许多证据表明很多原因引起的肝损伤都伴有脂蛋白合成及代谢的异常,且这种异常可在血浆脂蛋白系统中得以反映。本文通过对多种肝病病人血清脂蛋白及有关指标的测定分析,了解其脂蛋白代谢的紊乱情况及可能发生的机理,并探讨它们在肝病诊断及预后判定中的意义。

The levels of serum lipoproteins,total cholesterol and other parametersfor liver dysfunction were determined in 206 patients with acute or chronicliver diseases,including acute or chronic hepatitis 129 cases,liver cirrhosis43 cases,primary hepatoma 26 cases and obstructive jaundice 8 cases,and60 normal controls.The results showed that the regularity of changes ofserum TC and LDL-C was not very marked,but the change of HDL-C wasvery significant.HDL-C decreased strikingly in all the patients as comparedwith normal controls.There were remarkable changes among various groups.The range of HDL-C reduction correlated to degree of illness.The changesof HDL subfraction cholesterols were different in different groups of diseases.HDL_3-C was decreased significantly in all the groups of disease except conv-alescent stage of acute hepatitis,but HDL_2-C was only decreased in patientswith acute hepatitis,chronic active hepatitis,decompensated cirrhosis andprimary hepatoma with cirrhosis groups.HDL_2-C/HDL_3-C ratio showed HDL_2-Cwas mainly decreased in acute liver diseases,while in chronic liver diseases,a preferential decrease in HDL_3-C.