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目的探讨病毒性肝炎肝硬化与胆汁性肝硬化之间的血脂、载脂蛋白变化及其临床意义。方法检测35例慢性乙型病毒性肝炎肝硬化、21例胆汁性肝硬化病人的血浆胆固醇(CHOL)、甘油三脂(TRIG)、高密度脂蛋白(HDL)、载脂蛋白A1(APOA1)、载脂蛋白B100(APOB100)、总胆红素(TBIL)、凝血酶原活动度(PTA),并与正常人相比较。结果胆汁性肝硬化病人的CHOL、TRIG和APOB100明显升高,而肝炎后肝硬化病人却反有明显下降,统计学差异显著(P<0.01);两组病人的HDL、APOA1都有轻度下降,两者的下降幅度相差不明显;所有病人TBIL均明显升高,以胆汁性肝硬化病人尤为明显,统计学差异显著;两肝硬化组病人的PTA比对照组明显降低,以肝炎后肝硬化组尤甚,统计学差异显著。结论肝炎后肝硬化与胆汁性肝硬化血脂、载脂蛋白的变化有一定差异,可作为临床诊断、鉴别诊断的参考依据。
Objective To investigate the changes of blood lipids and apolipoproteins between cirrhosis and biliary cirrhosis of viral hepatitis and its clinical significance. Methods Cholesterol (CHOL), triglyceride (TRIG), high density lipoprotein (HDL), apolipoprotein A1 (APOA1) in 35 patients with chronic hepatitis B cirrhosis and 21 patients with biliary cirrhosis were measured. Apolipoprotein B100 (APOB100), total bilirubin (TBIL), prothrombin activity (PTA), and compared with normal people. Results CHOL, TRIG and APOB100 in patients with biliary cirrhosis were significantly higher than those in patients with posthepatitic cirrhosis, but the difference was statistically significant (P <0.01). The HDL and APOA1 in both groups were slightly decreased , The difference between the two decreases is not obvious; all patients TBIL were significantly increased, particularly in patients with biliary cirrhosis, statistical significant differences; two patients with cirrhosis of the PTA was significantly lower than the control group, with hepatitis cirrhosis In particular, the difference was statistically significant. Conclusions There is a certain difference between posthepatitic cirrhosis and biliary cirrhosis of blood lipids and apolipoprotein, which may serve as reference for clinical diagnosis and differential diagnosis.