肝移植术后患者脂蛋白(a)水平变化及与肝功能指标的关系

The changes of lipoprotein(a) in liver transplantation patients and its correlation with hepatic function index

[目的]探讨肝移植术后患者血清脂蛋白(a)[LP(a)]水平及肝功能指标变化及与预后的关系。[方法]选取2011-01—2014-05期间在我院收治的97例肝移植术后患者为研究对象(肝移植组),随机抽取同期健康体检患者40例为对照组,应用胶乳凝集比浊法测定观察血清LP(a)变化,同时检测谷丙转氨酶、谷草转氨酶、转肽酶、总胆红素、结合胆红素、胆碱酯酶血清水平。[结果](1)与对照组相比,肝移植组LP(a)水平明显降低,经分析差异有统计学意义(P<0.05);与此同时,肝移植组血清谷丙转氨酶、谷草转氨酶、转肽酶、总胆红素水平升高,胆碱酯酶水平降低,差异具有统计学意义(P<0.05);肝移植组结合胆红素水平与对照组比较差异无统计学意义(P>0.05)。(2)相关分析显示,肝移植术后患者LP(a)与谷丙转氨酶、谷草转氨酶、转肽酶、总胆红素呈负相关,与胆碱酯酶呈正相关(r分别为-0.258、-0.233、-0.193,-0.225,0.195,均P<0.05)。[结论]肝移植术后患者血清LP(a)水平明显降低,可作为肝移植术后的病情监测的新的生物学标记物。

[Objective]To investigate the changes of lipoprotein（a）[LP（a）]and hepatic function index in liver transplantation patients and its relationship with prognosis of liver transplantation. [Methods]Total of 97 hospitalized patients with liver transplantation during January 2010 and May 2014 were enrolled in study. At the same time,40 healthy cases were randomly recruited as control. The levels of serum LP（a） were measured by latex agglutination turbidimetric method. The levels of alanine aminotransferase, asparrate aminotransferase,transpeptidase,total bilirubin, conjugated bilirubin and cholinesterase were detected simultaneously. [Results]（1）Compared with control, the level of LP（a）was significantly decreased in liver transplantion group（P〈0.05）. The level of alanine aminotransferase, aspartate aminotransferase, transpeptidase and total bilirubin were significantly higher, and serum cholinesterase was lower in transplantation patients than that of controls（P〈0. 05）. Compared with control group,serum conjugated bilirubin had no significantly difference. （2）Correlated analysis showed that the concentration of LP（a）had negative correlation with alanine aminotransferase, aspartate aminotransferase, transpeptidase and total bilirubin, and had positive correlation with eholinesterase（correlation coefficient was- 0. 258, - 0. 233, - 0. 193, - 0. 225, 0. 195 respeetively,P〈0.05）. [Conelusion]The level of LP（a）in patients with liver transplantation is obviously decrease. Serum LP（a）maybe a useful biomarker for monitoring in clinical practice.