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目的探讨慢性乙型肝炎患者血清瘦素水平与血脂、肝纤维化的关系,为临床有效防治慢性肝炎提供新的思路。方法对男性慢性乙型肝炎轻、中、重度患者各30例及20例正常对照者的血清瘦素、胆固醇(CHO)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(ⅣC)进行检测。结果慢性乙型肝炎轻、中、重度瘦素水平较正常对照组显著升高(P值分别为0.004、0.001、0.001);慢性肝炎重度HA、PCⅢ、ⅣC较正常对照组显著升高(P<0.01);慢性肝炎重度组CHO显著下降(P<0.001),HDL-C、LDL-C均明显下降(P<0.05),各组间无相关性。结论提示瘦素参与了慢性肝炎的病理过程,在慢性肝炎早期同时开始抗纤维化治疗,可降低肝纤维化水平,缩短病程,达事半功倍之功效;对于脂代谢紊乱的重症肝炎同时施以调脂药物在内的均衡营养成分的辅助治疗无疑对促进肝病的恢复有重要作用。
Objective To explore the relationship between serum leptin level and serum lipids and liver fibrosis in patients with chronic hepatitis B and to provide new ideas for the effective prevention and treatment of chronic hepatitis. Methods Serum leptin, cholesterol (CHO), triglyceride (TG), high density lipoprotein (HDL-C) and low density lipoprotein (HDL-C) were measured in 30 patients with mild, moderate, and severe chronic hepatitis B and 20 normal controls LDL-C, HA, LN, PCⅢ, ⅣC were detected. Results The levels of mild, moderate and severe leptin in chronic hepatitis B were significantly higher than those in normal control group (P = 0.004, 0.001 and 0.001 respectively); the levels of severe HA, PCⅢ and ⅣC in chronic hepatitis were significantly higher than those in normal control group (P < 0.01). The levels of CHO in severe chronic hepatitis group were significantly decreased (P <0.001), while the levels of HDL-C and LDL-C in serum were significantly decreased (P <0.05). The results suggest that leptin participates in the pathological process of chronic hepatitis and start anti-fibrosis treatment in the early stage of chronic hepatitis, which can reduce the level of liver fibrosis, shorten the course of disease and achieve the goal of reducing the disease multiplier. For severe hepatitis with lipid metabolism disorder, Adjuvant therapy of balanced nutrition, including drugs, undoubtedly plays an important role in promoting the recovery of liver disease.