急性上消化道出血患者胆固醇水平及其代谢的临床观察

Clinical observation of cholesterol metabolism in acute upper gastrointestinal bleeding patients

目的:观察急性上消化道出血患者胆固醇代谢情况,探讨急性上消化道患者是否有胆固醇代谢紊乱。方法:观察组选取我科24例急性上消化道出血患者观察时间为自出血发生起的6 d之内,对照组选择102例献血自愿者的血浆,将TC、LDL、HDL以及麦固醇、烯胆烷醇、菜油甾醇、鲨烯等非胆固醇甾醇作为观察测量参数,后4个观察指标评价胆固醇的合成和吸收程度。结果:上消化道出血患者血浆TC(P<0.001)和LDL(P<0.05)的含量要明显低于对照组;而两组血浆HDL含量则差异无显著性;此外,上消化道出血患者血浆中麦固醇、烯胆烷醇、菜油甾醇以及鲨烯等这些合成和促进CH吸收的固醇的含量也明显低于对照组(P<0.05)。结论:急性上消化道出血患者不仅胆固醇含量降低,而且非胆固醇甾醇含量也明显降低。这种胆固醇代合成和吸收代谢紊乱可能是急性消化道患者低胆固醇血症的一个重要原因,当然需要更进一步的临床研究去证明。

Objective To explore cholesterol metabolism situation in acute upper gastrointestinal bleeding patients, examine the serum CH profile during acute gastrointestinal bleeding which is a life-threatening condition. Method 24 patients with acute upper gastrointestinal bleeding were enrolled, within 6-day period after bleeding. 100 healthy blood donors were as control. Total CH, LDL, HDL and serum non-CH sterols （lathosterol,squalene, sitosterol and campesterol） concentrations were measured. （P 〈 0.05）. Results Plasma levels of total CH （P 〈 0.001） and LDL CH （P 〈 0.05） in patients with UGIB were lower than control group. Plasma levels of HDL CH were not statistically different brtween two groups. In addition, patients had signifcantly lower plasma levels of lathosterol, squalene, eampesterol and sitosterol （P 〈 0.05）. Conclusion Abnormalities not only in CH plasma profle, but also in non-CH sterols plasma concentrations oceured in acute upper gastrointestinal bleeding patients. Tese fndings of alterations in both the CH synthesis and absorption process could be a contributory cause of hypocholesterolemia during acute gastrointestinal bleeding.