乙型肝炎病毒相关肝病患者血清铁代谢与脂质代谢的关系  

Correlation between iron metabolism and lipid metabolism in patients with HBV-related liver disease

作　　者：程百成 刘梦娜 CHENG Baicheng;LIU Mengna(Clinical Medical College,Guangdong Pharmaceutical University,Guangzhou 511436,China;不详)

机构地区：[1]广东药科大学临床医学院,广州511436 [2]中山大学附属第七医院检验科

出　　处：《山东医药》2023年第26期5-9,共5页Shandong Medical Journal

摘　　要：目的探讨乙型肝炎病毒(HBV)相关性肝病患者血清铁代谢与脂质代谢的关系。方法收集慢性乙型肝炎患者53例(CHB组)、乙型肝炎肝硬化患者37例(LC组)、乙型肝炎肝癌患者50例(HCC组)及健康体检者43例(正常组)。采集受试者空腹静脉血,使用生化分析仪检测血清铁代谢指标[铁(Fe)、铁蛋白(Fer)、转铁蛋白(Tf)]和脂质代谢指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]。比较各组血清铁代谢和脂质代谢指标水平,采用Spearman和Pearson相关分析法分析各组铁代谢指标与脂质代谢指标的相关性。结果与正常组相比,CHB组、LC组各项铁代谢指标差异无统计学意义(P均>0.05),HCC组Fer水平升高、Tf水平降低(P均<0.05);与CHB组相比,LC组各项铁代谢指标比较差异无统计学意义(P均>0.05),HCC组Fer水平升高、Tf水平降低(P均<0.05);HCC组与LC组比较差异均无统计学意义(P均>0.05)。与正常组相比,CHB组、LC组、HCC组各项血清脂质代谢指标差异均无统计学意义(P均>0.05);与CHB组相比,LC组各项血脂指标比较差异无统计学意义(P均>0.05),HCC组TC、HDL、LDL水平降低(P均<0.05);LC组与HCC组比较差异均无统计学意义(P均>0.05)。正常组Fer与TC、TG、LDL水平均呈正相关(r分别为0.396、0.352、0.505,P均<0.05);CHB组Fer与TC、LDL水平均呈正相关(r分别为0.320、0.332,P均<0.05);LC组铁代谢与脂质代谢指标均无明显相关性(P均>0.05);HCC组Fer与HDL水平呈负相关(r=-0.488,P=0.019)。结论在HBV相关肝病进展过程中,肝脏铁代谢与脂质代谢互相影响。在进展到HCC前,CHB、LC患者铁蛋白与胆固醇的变化趋势一致;而进展到HCC阶段后,铁代谢与脂质代谢的相互作用发生变化,此时肝脏出现铁堆积,表现为Fer过载,合成胆固醇和组装脂蛋白的能力降低。Objective To explore the correlation between iron metabolism and lipid metabolism in patients with hepa⁃titis B virus(HBV)-related liver disease.Methods Fifty-three patients with chronic hepatitis B(CHB group),37 pa⁃tients with hepatitis B cirrhosis(LC group),50 patients with hepatic cancer(HCC group)and 43 health examinees(NC group)were selected.The fasting venous blood was collected,and the levels of iron metabolism[(Fe),ferritin(Fer),transferrin(Tf)]and lipid metabolism[total cholesterol(TC),triglyceride(TG),low-density lipoprotein(LDL),and high-density lipoprotein(HDL)]in serum were measured by Abbott C16000 biochemical analyzer.The levels of serum iron metabolism and lipid metabolism in all groups were compared,and the correlation between iron metabolism and lipid metabolism in all groups was analyzed by Spearman and Pearson correlation analysis.Results Compared with the nor⁃mal group,there were no significant differences in iron metabolism indexes in the CHB group and the LC group(all P>0.05),but the Fer level increased and the Tf level decreased in the HCC group(all P<0.05);compared with the CHB group,there were no significant differences in iron metabolism indexes in the LC group(all P>0.05),but the Fer level in⁃creased and the Tf level decreased in the HCC group(all P<0.05);no statistically significant difference was found be⁃tween the HCC group and the LC group(all P>0.05).Compared with the normal group,there were no significant differ⁃ences in all serum lipid metabolism indexes in the CHB,LC,and HCC groups(all P>0.05);compared with the CHB group,there were no significant differences in all lipid indexes in the LC group(all P>0.05),and the levels of TC,HDL,and LDL decreased in the HCC group(all P<0.05);no statistically significant difference was found between the LC and HCC group(P>0.05).Fer was positively correlated with TC,TG,and LDL levels in the normal group(r=0.396,0.352,and 0.505,respectively;all P<0.05);Fer was positively correlated with TC and LDL levels in the CHB group(r=0.320 and

关 键 词：乙型肝炎病毒 慢性乙型肝炎 肝硬化 肝肿瘤 铁代谢 脂质代谢 

分 类 号：R446.11[医药卫生—诊断学]