73例肝豆状核变性再入院患者血脂分析

Analysis of Serum Lipid in 73 Re-admission Patients with Wilson's Disease

目的探讨肝豆状核变性(WD)再入院患者血脂代谢的特点及其与肝功能的关系。方法确诊的73例不同临床分型的WD再入院患者作为试验组,40例健康体检者作为正常对照组,采用酶法测定总胆固醇(TC)、甘油三酯(TRIG);采用直接法测定高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);赖氏法检测门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)。结果与对照组比较,WD再入院患者TC、LDL-C均降低(P<0.05);而HDL-C、TRIG较正常对照组改变不明显(P>0.05);其中肝损伤型及神经精神损伤型患者TC、LDL-C较无症状型患者降低(P<0.05);TC、LDL-C下降与肝功能AST及ALT均无明显相关性(P>0.05)。结论WD再入院患者存在血脂异常的并发症,且与临床类型有关。进行血脂检测对病情监测及预防血脂紊乱的发生具有重要的临床意义。

Objective To investigate the characteristics of serum lipid metabolism and its relationship with liver function in re-admission patients with Wilson＇s disease （WD）. Methods 73 re-admission patients with WD and 40 healthy volunteers were subjected to the examinations for serum lipid profile, including cholesterol （TC）, triglycerides （TRIG） ,high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） and aspertate amin- otransferase （AST）, alanine aminotransferase （ALT）. Serum TC and TRIG levels were detected by enzymic method, HDL-C and LDL-C levels were detected by direct measurement, ALT and AST levels were detected by Reitman-Frankel methods. Results Re-admission patients with WD showed lower serum TC and LDL-C levels than those of healthy volunteers （P 〈 0.05） ,while there was no significant difference of HDL-C and TRIG between WD patients and healthy volunteers （P 〉 0. 05 ）. Patients with hepatic and neuropsychiatric symptoms showed lower TC and LDL-C levels than those of asymptomatic patients （P 〈0.05 ）. There was no significant correlation between AST,ALT and the decreasing of TC and LDL-C levels （P 〉 0.05）. Conclusion Dyslipidemia can be found in re-admission patients with WD and associated with the clinical phenotype. To detect the level of serum lipid may play a key role in monitoring illness condition of WD and preventing the complications such as dyslipidemia.