慢性病毒性乙肝合并精神分裂症患者肝功能、脂代谢及肝脏超声的改变

Changes of liver function,lipid metabolism and liver ultrasound in patients with chronic viral hepatitis B complicated with schizophrenia

目的探讨慢性病毒性乙肝合并精神分裂症患者肝功能、脂代谢及肝脏超声的改变。方法以2015年2月~2017年1月我院收治的36例慢性病毒性乙肝合并精神分裂症患者(设为研究组)、同期于我院治疗的30例单纯慢性病毒性乙肝患者(设为对照组)为对象,2组对象入院后均行常规生化及超声检查,比较2组肝功能[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBi L)]、脂代谢[甘油三酯(TG)、血清总胆固醇(TC)、低密度脂蛋白(LDLC)、高密度脂蛋白(HDLC)]及肝脏超声变化。结果研究组ALT、AST、TBi L水平较对照组明显高,差异有统计学意义(均P<0.05);且研究组TG、TC、LDLC水平较对照组明显高,而HDLC较对照组明显低,差异具有统计学意义(均P<0.05);此外肝脏超声变化结果显示研究组肝脏边缘钝化、肝脏实质回声不均匀、肝右叶最大斜径增大的概率较对照组明显高,差异具有统计学意义(均P<0.05)。结论慢性病毒性乙肝合并精神分裂症患者存在明显的肝功能下降、脂代谢紊乱以及肝脏超声变化,可能是因为精神分裂症可加剧慢性病毒性乙肝病情进展及恶化。

Objective To investigate the changes of liver function,lipid metabolism and liver ultrasound in patients with chronic viral hepatitis B complicated with schizophrenia. Methods 36 cases of patients with chronic viral hepatitis B complicated with schizophrenia treated in our hospital during February 2015 to January 2017 were as the study group and 30 cases of patients with chronic viral hepatitis B only who were admitted to our hospital over the same period were as the control group in the study. Routine biochemical and ultrasonic examinations were performed in the two groups after admission. The liver function [alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,total bilirubin（TBi L）],indexes of lipid metabolism [triglyceride（TG）,serum total cholesterol（TC）,low-density lipoprotein（LDLC）,high-density lipoprotein（HDLC）] and changes of liver ultrasound were compared between the two groups. Results The levels of ALT,AST and TBi L in the study group were significantly higher than those in the control group（P〈0.05）. The levels of TG,TC and LDLC were significantly higher,while HDLC level was significantly lower in the study group than those in the control group（P〈0.05）. The changes of liver ultrasound showed that the probabilities of liver edge passivation,liver parenchyma with inhomogeneous echo and the largest oblique diameter of right liver lobe increasing in the study group were significantly higher than those in the control group（P〈0.05）. ConclusionPatients with chronic viral hepatitis B complicated with schizophrenia have significant hepatic dysfunction,lipid metabolism disorders and liver ultrasound changes,and schizophrenia may exacerbate the progression of chronic viral hepatitis B.