酒精性肝病与血脂代谢相关性分析

Relationship between alcoholic liver disease and blood lipid metabolism

目的探讨不同时期酒精性肝病(alcoholic liver disease,ALD)患者血脂代谢的变化。方法比较2008年1月-2013年10月中国医科大学附属第一医院健康体检者及酒精性脂肪肝(alcoholic fatty liver,AFL)、酒精性肝硬化(alcoholic liver cirrhosis,ALC)、慢性病毒性肝炎肝硬化(viral liver cirrhosis,VLC)、ALC合并酒精性肝炎(alcoholic hepatitis,AH)、ALC不合并AH患者的血脂变化。结果与健康体检者相比,AFL患者的TG、TC、LDLC显著升高(P<0.05),HDLC显著降低(P<0.05)。与AFL患者相比,ALC患者的TG、TC、HDLC、LDLC均显著降低(P<0.05)。与VLC患者相比,ALC患者的TG、TC、LDLC显著升高(P<0.05),HDLC差异无统计学意义(P>0.05)。与不合并AH的ALC患者相比,ALC合并AH患者的HDLC显著降低(P<0.05),TG、TC、LDLC差异无统计学意义(P>0.05)。结论随着ALD的发生、发展,血脂在AFL中水平明显上升,当发展为ALC时,血脂明显下降;与ALC相比,VLC的血脂下降更明显;合并AH的ALC患者HDLC明显低于不合并AH的ALC患者。

Objective To investigate the variations of blood lipid metabolism in patients with alcoholic liver diseases （ALD） at different periods. Methods The variations of blood lipid were compared between healthy controls and pa- tients with alcoholic fatty liver （AFL） , patients with alcoholic liver cirrhosis （ALC） , patients with viral liver cirrhosis （VLC）, patients with ALC combined with alcoholic hepatitis （AH） and patients with ALC without AH respectively ac- cording to the medical examination of the First Affiliated Hospital of China Medical University from Jan. 2008 to Oct. 2013. Results Compared with healthy controls, the TG, TC and LDLC were significantly increased, HDLC was de- creased in patients with AFL （P 〈 0.05）. Compared with AFL, the TG, TC, HDLC, LDLC were significantly de- creased in patients with ALC （P 〈 0.05）. Compared with VLC patients, the TG, TC, LDLC were significantly in- creased in patients with ALC （P 〈 0.05）. Meanwhile, there was no statistically significant difference in the HDLC be- tween VLC and ALC patients （P 〉 0.05）. Compared with ALC without AH patients, the HDLC was significant de- creased in patients with ALC combined with AH （P 〈 0.05） , but there were no statistically significant differences in TG, TC, LDLC between two groups （P 〉 0.05）. Conclusion With the occurrence and development of ALD, the blood lipid experienced a marked upward trend in AFL. When developing into ALC, the blood lipid significantly de- creased, the decrease of blood lipid in VLC is more considerable compared with ALC; compared with the ALC patients without AH, the HDLC significant decreases in ALC patients combined with AH.