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目的探讨老年血吸虫肝病患者血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)及载脂蛋白(APOAⅠ和APOB)的临床意义。方法对上海交通大学附属第六人民医院南院收治的280例老年血吸虫肝病患者(慢性肝纤维化198例、肝硬化82例)的临床资料进行回顾性分析,并分别对肝纤维化、肝硬化患者及肝功能Child-pugh分级为A、B、C级者的血脂水平进行比较。结果肝纤维化组198例患者中仅69例表现为HDL-C、LDL-C、APOAⅠ轻度异常,占34.8%(69/198);肝硬化组82例(100%)患者血脂水平均明显降低,两组血脂水平异常率差异有统计学意义(χ2=5.74,P<0.05);肝硬化组患者TC、HDL-C、LDL-C、APOAⅠ水平均显著低于肝纤维化组(P均<0.05)。肝功能A级者TC、TG、HDL-C、APOAⅠ及APOB水平均显著高于C级者,肝功能B级患者TC、TG、HDL-C水平亦显著高于C级者,差异均有统计学意义(P均<0.05)。结论老年血吸虫肝病患者肝硬化后血脂水平降低明显,其与肝硬化患者肝功能损害程度密切相关。检测患者血脂及载脂蛋白水平对判断病情、评估预后有一定参考价值。
Objective To investigate the clinical value of serum total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) and apolipoprotein (APOAⅠ and APOB) significance. Methods The clinical data of 280 elderly schistosomiasis patients with chronic liver fibrosis (198 cases of chronic liver fibrosis and 82 cases of cirrhosis) admitted to the Southern Hospital of Shanghai Jiaotong University Affiliated Sixth People’s Hospital were retrospectively analyzed. The clinical data of liver fibrosis, cirrhosis Patients and liver function Child-pugh grade A, B, C level of blood lipids were compared. Results Only 69 cases of HDL-C, LDL-C and APOAⅠ were found in 198 cases of liver fibrosis, accounting for 34.8% (69/198); in the liver cirrhosis group, 82 cases (100%) had obvious blood lipid levels (Χ2 = 5.74, P <0.05). The levels of TC, HDL-C, LDL-C and APOAⅠ in patients with cirrhosis were significantly lower than those in patients with liver fibrosis <0.05). The levels of TC, TG, HDL-C, APOAⅠ and APOB in A grade were significantly higher than those in C grade, and the levels of TC, TG and HDL-C in B grade were also significantly higher than those in C grade Significance (P <0.05). Conclusion The blood lipid level of cirrhotic patients with schistosomiasis is obviously decreased after liver cirrhosis, which is closely related to the degree of liver dysfunction in patients with cirrhosis. Detection of serum lipids and apolipoprotein levels to judge the condition, the prognosis of a certain reference value.