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目的研究慢性乙型肝炎患者血清中血脂和载脂蛋白水平的变化情况及其与病程进展的相关性。方法收集正常对照组50例,慢性乙型肝炎组259例(乙肝携带组40例,活动性肝炎60例,重症肝炎24例,肝硬化97例,肝癌38例),采用BECKMAN-AU5421全自动生化分析仪检测血清中甘油三脂(TG)、胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A1(Aop A1)及载脂蛋白B(Aop B),比较TG、TC、HDL、LDL、Aop A1及Aop B在慢性乙型肝炎(简称CHB)不同临床阶段的差异性,分析上述指标与CHB预后的相关性。结果 TG、TC、HDL、LDL、Aop A1及Aop B随CHB临床进展,其水平呈降低趋势,但重症肝炎阶段为最低水平。多因素Logistic回归分析显示:TG、TC、HDL、LDL、Aop A1及Aop B减低是CHB病程进展的危险因素。结论血脂和载脂蛋白水平的变化与CHB临床进展情况具有相关性,可作为评估患者病情进展的潜在指标。
Objective To study the changes of serum lipids and apolipoproteins in patients with chronic hepatitis B and its correlation with the course of disease. Methods 50 cases of normal control group, 259 cases of chronic hepatitis B group (40 cases of hepatitis B carriers, 60 cases of active hepatitis, 24 cases of severe hepatitis, cirrhosis, 97 cases, liver cancer 38 cases), BECKMAN-AU5421 automatic biochemical The analyzer detected serum TG, TC, HDL, LDL, Aop A1 and Aop B, . The differences of TG, TC, HDL, LDL, Aop A1 and Aop B in different clinical stages of chronic hepatitis B (CHB) were compared. The correlation between these indexes and the prognosis of CHB was analyzed. Results The levels of TG, TC, HDL, LDL, Aop A1 and Aop B decreased with the clinical progress of CHB, but the stage of severe hepatitis was the lowest. Multivariate logistic regression analysis showed that the decrease of TG, TC, HDL, LDL, Aop A1 and Aop B were the risk factors for the progression of CHB. Conclusion The changes of blood lipids and apolipoprotein levels are correlated with the clinical progress of CHB, which may be used as a potential indicator to evaluate the progression of the disease.