CAJ | 학술논문

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。
목적：탐토노년혈흡충간병환자혈청총담고순（TC）、감유삼지（TG）、고밀도지단백（HDL?C）、저밀도지단백（LDL?C）급재지단백（APOAⅠ화APOB）적림상의의。방법대상해교통대학부속제륙인민의원남원수치적280례노년혈흡충간병환자（만성간섬유화198례、간경화82례）적림상자료진행회고성분석，병분별대간섬유화、간경화환자급간공능Child?pugh분급위A、B、C급자적혈지수평진행비교。결과간섬유화조198례환자중부69례표현위HDL?C、LDL?C、APOAⅠ경도이상，점34.8%（69/198）；간경화조82례（100%）환자혈지수평균명현강저，량조혈지수평이상솔차이유통계학의의（χ2=5.74，P＜0.05）；간경화조환자TC、HDL?C、LDL?C、APOAⅠ수평균현저저우간섬유화조（P균＜0.05）。간공능A급자TC、TG、HDL?C、APOAⅠ급APOB수평균현저고우C급자，간공능B급환자TC、TG、HDL?C수평역현저고우C급자，차이균유통계학의의（P균＜0.05）。결론노년혈흡충간병환자간경화후혈지수평강저명현，기여간경화환자간공능손해정도밀절상관。검측환자혈지급재지단백수평대판단병정、평고예후유일정삼고개치。
Objective To explore the clinical significance of lipid levels including total cholesterol TC triglyceride TG high?density lipoprotein HDL?C low density lipoprotein LDL?C and apolipoprotein APOAⅠand APOB of elder?ly patients with hepatic schistosomiasis. Methods A total of 280 hospitalized elderly patients with hepatic schistosomiasis 198 cases of chronic liver fibrosis and 82 cases of hepatocirrhosis were chosen as study objects and their clinical data were collected and analyzed retrospectively. Meanwhile the lipid levels between the patients with liver fibrosis and hepatocirrhosis and those among the patients with ABC degrees of Child?pugh grading of liver function were compared. Results Among the 280 patients the abnormality rates of the lipid levels were 34.8% 69/198 and 100% 82/82 in the liver fibrosis group and he?patocirrhosis group respectively and the difference between them were statistically significant χ2=5.74 P 0.05 . The levels of TC HDL?C LDL?C APOAⅠof the patients in the latter group were significantly lower than those in the former group all P 0.05 . The levels of TC TG HDL?C APOAⅠ APOB of the patients with C degree liver function were significantly lower than those of the patients with A degree liver function and the levels of TC TG HDL?C of the former were also lower than those of the patients with B degree liver function all P 0.05 . Conclusions The lipid levels of the elderly patients with he?patic schistosomiasis reduce obviously in the course of hepatocirrhosis and it is correlated with the damage level of the liver. Lipid and apolipoprotein detections have certain values on the illness judgment and prognosis assessment.