慢性乙型肝炎患者血脂和载脂蛋白水平与肝组织炎症关系的研究  

Relationship between blood lipid and apolipoprotein levels and hepatitis grade in patients with chronic hepatitis B

作　　者：郑春梅[1] 冯冰[1] 龙尧[1] 

机构地区：[1]广东医学院附属医院,广东湛江524001

出　　处：《宁夏医学杂志》2008年第2期114-116,共3页Ningxia Medical Journal

摘　　要：目的探讨慢性乙型肝炎患者血脂和载脂蛋白水平与肝组织炎症病理分级(G)的关系。方法采用RI-1000TM全自动生化分析仪检测96例经病理证实的慢性乙型肝炎患者和32例正常人血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)、脂蛋白(Lp-a)、载脂蛋白A-I(APOA-I)、载脂蛋白B(APOB)水平,并分析与肝组织病理炎症分级(G0-G4)的关系。结果各项血脂水平随着肝组织炎症活动度的增高而降低,G4级降至最低。在肝组织炎症病理分级为G4级患者,其血清TC、TG、HDL、LDL、VLDL、Lp-a、APOA-I水平均比正常对照组明显降低,差别有高度显著性(P<0.01)。降低比较敏感的是HDL和APOA-I,在G2级开始下降,与对照组比较均有高度显著性(P<0.05或<0.01)。结论血清HDL和APOA-I水平能很好地反映肝脏病理炎症活动度,能可靠地反映肝细胞损害的程度,比TC、TG更敏感。Objective To investigate the relationship between blood lipid and apolipoprotein levels and hepatitis grade （G） in patients with chronic hepatitis B. Methods The serum levels of total cholesterol （TC） , triglyceride （TG） , high density lipoprotein （HDL） , low density lipoprotein （LDL） , very low density lipoprotein （VLDL） , lipoprotein （ Lp - a） , apolipoprotein A - I （ APOA - I） and apolipoprotein B （APOB） in 96 patients with chronic hepatitis B and graded histopathologically with the needle biopsy were enrolled in this study and 32 normal subjects were determined with RI - 1000TM whole auto - chemical analyzer. Results In patients with the liver organization inflammation pathology graduation G4 level, blood serum TC, TG, HDL, LDL, VLDL, Lp - a, APOA - I and APOB levels were obviously reduced than those in control group （ P 〈 0. 01 ）. The changes of HDL, APOA - I levels were most sensitive. The HDL, APOA - I levels in G2 was lower than those in control group （ P 〈0. 01 ）. Following the exacerbation of hepatic inflam- mation, the HDL, APOA - I levels were decreased gradually and it was the lowest in G4 （ P 〈 0. 01 ）. Conclusion The blood serum HDL, APOA - I levels are better to reflect the exacerbation of hepatic inflammation ; it could reliably reflect the severity of hepatic injury better than TC, TG.

关 键 词：乙型肝炎 血脂 载脂蛋白 肝脏 病理学 

分 类 号：R512.62[医药卫生—内科学]