慢性丙型肝炎患者脂类代谢与丙型肝炎病毒复制以及肝脏病理的关系  

Correlation of plasma lipid levels with serum hepatitis C virus RNA load and liver histopathological changes in patients with chronic hepatitis C

作　　者：李蕴铷[1] 凌伟[1] 陈凤欣[1] 范小玲[1] 

机构地区：[1]北京地坛医院,北京市100015

出　　处：《世界华人消化杂志》2010年第17期1820-1823,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨慢性丙型肝炎患者脂类代谢与病毒复制状态以及肝脏病理损伤程度的关系.方法:以75例慢性丙型肝炎(CHC)患者为研究对象,应用FQ-PCR方法检查患者血清HCV RNA载量;应用全自动生物化学分析仪检测患者外周血三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)水平;肝脏病理行HE染色,对炎症、纤维化和脂肪变进行分级.分析脂类代谢指标和HCV RNA载量、肝功能指标以及肝脏病理分级的关系.结果:不同HCV复制状态的CHC患者之间的血浆TG、CHO、HDL、ApoA水平的差异无显著性,但血浆LDL、ApoB水平在三组间比较差异有显著性(P=0.037和0.027),表现为HCV RNA载量越高,LDL和ApoB水平越低;相关分析显示HCV RNA载量和LDL、ApoB之间呈负相关(r=-0.305,-0.417,P=0.011,0.001);67.7%CHC患者有不同程度的肝脂肪变性,不同程度肝脂肪变的CHC患者之间只有HCV RNA载量有显著性差异,肝脂肪变越高,HCV RNA载量越高,其他指标在各组间差异无显著性.结论:外周血LDL、ApoB水平和肝脂肪变程度与HCV复制密切相关,但未发现与肝脏损伤程度和肝纤维程度相关性.AIM：To investigate the relationship among plasma lipid levels,serum hepatitis C virus （HCV） RNA load,and liver histopathological changes in patients with chronic hepatitis C （CHC）.METHODS：Seventy-five CHC patients were included in the study.Serum HCV RNA levels were measured by fluorescent quantitative polymerase chain.The levels of plasma TG,CHO,LDL,HDL,ApoA,and ApoB were measured using a biochemical autoanalyzer.A liver biopsy was performed in 62 patients,and liver histopathological changes in these patients were evaluated by HE staining under a light microscope and scored according to the grade of hepatic necroinflammatory activity and the stage of liver fibrosis and liver steatosis.RESULTS：Significant differences were notedin the levels of LDL and ApoB among the three groups （HCV RNA： 105 copies/mL,105-107 copies/mL,and 107 copies/mL）.The levels of plasma LDL and ApoB were negatively correlated with HCV RNA load （r=-0.305,-0.417;P= 0.011,0.001）.Approximately 67.7% of CHC patients had liver steatosis.There were signifi cant differences in HCV RNA load among the three groups.HCV RNA load was positively correlated with the degree of liver steatosis.CONCLUSION：The levels of plasma LDL and ApoB are associated with HCV load but not with the degree of liver injury and fi brosis in patients with chronic hepatitis C.

关 键 词：丙型肝炎病毒 慢性丙型肝炎 脂类 代谢 组织病理学 

分 类 号：R512.63[医药卫生—内科学]