CAJ | 학술논문

目的观察胸导管夹闭术后高血脂患者血脂水平的变化及对肝肾功能和血糖的影响,探讨胸导管夹闭术能否作为降低高脂血症的方法.方法采用前瞻性随机对照研究,65例临床病理分期Ⅰ期的肺癌合并高血脂患者,随机数字表分为夹闭组34例和未夹闭组31例.分析患者入院时、术后1周、1个月、3个月、6个月和12个月的血总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),肝肾功能、血糖和腹部B超检查的结果.结果术后1年,夹闭组血中TC和LDL-C量明显低于未夹闭组,差异有统计学意义(P＜0.05);夹闭组TG和HDL-C量低于未夹闭组,但差异无统计学意义(P＞0.05);夹闭组肝肾功能部分指标、血糖和脂肪肝阳性率较未夹闭组略有上升,但术后1年时差异均无统计学意义(P＞0.05).结论电视胸腔镜胸导管夹闭术可降低血TC、LDL-C水平,部分降低TG、HDL-C水平,对肝肾功能、血糖和脂肪肝无明显影响.
목적 관찰흉도관협폐술후고혈지환자혈지수평적변화급대간신공능화혈당적영향,탐토흉도관협폐술능부작위강저고지혈증적방법.방법 채용전첨성수궤대조연구,65례림상병리분기Ⅰ기적폐암합병고혈지환자,수궤수자표분위협폐조34례화미협폐조31례.분석환자입원시、술후1주、1개월、3개월、6개월화12개월적혈총담고순(TC)、삼선감유(TG)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C),간신공능、혈당화복부B초검사적결과.결과 술후1년,협폐조혈중TC화LDL-C량명현저우미협폐조,차이유통계학의의(P＜0.05);협폐조TG화HDL-C량저우미협폐조,단차이무통계학의의(P＞0.05);협폐조간신공능부분지표、혈당화지방간양성솔교미협폐조략유상승,단술후1년시차이균무통계학의의(P＞0.05).결론 전시흉강경흉도관협폐술가강저혈TC、LDL-C수평,부분강저TG、HDL-C수평,대간신공능、혈당화지방간무명현영향.
Objective To explore the influence of ligation of thoracic duct (TDL) on patients' lipid metabolism,liver and renal function and fasting blood glucose(FBG),and provide an alternative therapeutic method for lung cancer patients concomitant with hyperlipidemia.Methods 65 patients of lung cancer concomitant with hyperlipidemia were randomly allocated:34 patients received thoracic duct ligation and 31 patients had thoracic duct preserved.Blood specimens of patients were collected at the admissiondata,and the 7th day,1st month,3rd months,6th month,1st year after surgery,respectively.Total cholesterol(TC),triglyceride (TG),high-density lipoprotein-cholesterol (HDL-C),low-density lipoprotein-cholesterol (LDL-C),liver and renal function,and fasting blood glucose(FBG) were detected,abdominal B ultrasonography was also assessed.Results The level of TC,LDL-C in thoracic duct ligation group decreased significantly at the 1 st year after surgery compared with thoracic duct preserved group(P ＜0.05),but this significant difference did not translate into thelevel of TG and HDL-C between two groups(P ＞ 0.05).However,the incidence of liver and renal function disorder,FBG rising and fatty liver at the 1st year after surgery in thoracic duct ligation group seemed increased compared with thoracic duct preserved group,but there were no significantly differences(P ＞0.05).Conclusion Video-assisted thoracic duct ligation can decrease the plasma levels of TC and LDL-C in patients of lung cancer concomitantwith hyperlipidemia,and partially decrease the leavel of TG and HDL-C.It does not negatively affect the liver and renal function,as well as FBG and the incidence of fatty liver.