血脂、载脂蛋白与慢性病毒性肝炎肝损害关系──附178例报告

Relationship between blood lipid or apolipoprotein and hepatic injury in chronic viral hepatitis.

目的:探讨慢性乙型病毒性肝炎(慢乙肝)各临床分型之间,血脂、载脂蛋白的变化规律,及其与总胆红素和凝血酶原活动度(PTA)之间的相关性,以指导诊断、治疗及判断预后。方法:将178例慢乙肝按轻度慢性肝炎、中度慢性肝炎、重度慢性肝炎、肝炎后肝硬化、慢性重型肝炎分为5个亚组,检测血清总胆固醇、甘油三酯、HDL-C、载脂蛋白A1、载脂蛋白B100、总胆红素、PTA,并与正常对照组作比较。结果:慢乙肝病人随着病情的加重,肝储备能力下降,血脂、载脂蛋白水平相应降低,其中血清总胆固醇、甘油三酯、HDL-C、载脂蛋白A1、载脂蛋白B100与总胆红素、PTA有显著的相关性(均为P<0.01)。结论:慢乙肝病人血脂和载脂蛋白水平的变化可间接表现其肝细胞功能的状态,可作为临床诊断、鉴别诊断及判断预后的参考依据。

Objective:To study the changes of blood lipid and apolipoprotein in different subtypes of viral hepatitis and the relationship between blood lipid or apolipoprotein and total bilirubin or prothrombin activity. Methods:178 viral hepatitis patients were divided into 5 groups as mild,moderate,severe hepatitis,cirrhosis and liver failure. Blood cholesterol,triglyceride,high density lipoprotenin,apolipoprotein A1 (APOA1),apolipoprotein B100 (APOB100),total bilirubin and prothrombin activity were determined. Results:Reduction in reserve liver function in chronic viral hepatitis B was associated with decreased blood lipid and apolipoprotein. There was significant correlation between blood cholesterol,triglyceride,high density lipoprotenin,APOA1 or APOB100 and total bilirubin or prothrombin activity. Conclusion:Change in blood cholesterol and apolipoprotein can indirectly reflect reserve function of the liver and can assist diagnosis,differential diagnosis and predicting prognosis.