急性胰腺炎血脂、脂蛋白及载脂蛋白的变化及临床意义  

Changes and clinical significance of blood lipids,lipoproteins and apolipoproteins in acute pancreatitis

作　　者：刘子君[1] 时开网[1] 卞建民[1] 井清源[1] 

机构地区：[1]南京医科大学附属南京第一医院普外科,南京市210006

出　　处：《中华肝胆外科杂志》2005年第5期304-306,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的分析急性胰腺炎血脂、脂蛋白及载脂蛋白的变化并探讨其临床意义。方法总结我院2001年6月至2003年6月112例急性胰腺炎病人(轻症96例,重症16例,其中死亡4例)血脂、脂蛋白及载脂蛋白的变化。结果轻症胰腺炎时28.1%HDL-C和33.3%apoA1的起始值轻度降低。重症胰腺炎时这两项指标起始值分别有81.3%和75%降低,随后检查全部病例均降低。轻症胰腺炎和重症胰腺炎HDL-C和apoA1起始值比有显著差异(P<0.01)。apoB在轻症胰腺炎中31.3%异常,其中27.1%轻度升高。重症胰腺炎中有25%升高。T-CHO在轻症胰腺炎时变化不明显,在重症胰腺炎12.5%明显升高,56.3%明显降低,18.8%开始正常随后明显降低。Trig在轻症胰腺炎有6.3%轻度升高,在重症胰腺炎18.1%明显升高(>6 mmol/L)。LDL-C和Lp(a)在轻症胰腺炎和重症胰腺炎无明显变化。结论HDL-C和apoA1的起始值和(或)随后明显减少提示胰腺炎病情严重。T-CHO的显著变化与胰腺炎严重程度密切相关。Trig显著升高的胰腺炎可能为重症。LDL-C、Lp(a)及apoB对判别急性胰腺炎的严重程度无明显意义。Objective To investigate the changes in blood lipids, lipoproteins and apolipoproteins in acute pancreatitis(AP) and explore their clinical significance.Methods The changes in blood lipids,lipoproteins and apolipoproteins in 112 patients with AP treated in our hospital from June 2001 to June 2003 were reviewed.Of these 112 patients,96 were with mild AP and 16 with severe AP(4 of them died).Results The values of 28.1% high density liproprotein(HDL-C) and 33.3% apolipoprotein A(apoA1) were slightly reduced in patients with mild AP.However,they were much lower or rapidly reduced in the patients with severe AP.There were significant differences in the values of the 2 indexes between the 2 groups of patients(P<0.01).For mild AP,the value of apolipoprotein B(aproB) was abnormal in 31.3% and slightly increased in 27.1% of the patients.For severe AP,the value of aproB was slightly higher in 25% of the patients.Few of the patients with mild AP had abnormal value of total cholesterol(T-CHO).However,the value was significantly increased in 12.5%,markedly decreased in 56.5% and was normal at first and then decreased in 18.8% of the patients with severe AP.The value of triglyceride was slightly high in the patients with mild AP but remarkably increased in 18.1% of the patients with severe AP.The values of low density lipoprotein(LDL-C) and lipoprotein a(Lp(a)) were abnormal in all the patients.Conclusions The far lower values or rapidly reduced values of HDL-C and apoA1 indicate that the AP is severe.Too much abnormal changes in T-CHO value is related to the severity of AP.High value of triglyceride is a signal of severity.The values of LDL-C and Lp(a) are not correlated to severity of AP.

关 键 词：急性胰腺炎 载脂蛋白 临床意义 血脂 白及 重症胰腺炎 APOA1 HDL-C 2003年6月 Lp(a) APOB Trig 严重程度 2001年 LDL-C 轻症 升高 起始 轻度 CHO 

分 类 号：R657.51[医药卫生—外科学]