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目的检测慢性乙肝患者血清总胆固醇(TC)、甘油三酯(TG)、载脂蛋白A(apoA)、载脂蛋白B(apoB)水平变化,并探讨其临床意义。方法采用全自动生化分析仪检测患者血清TC、TG、apoA和apoB,同时检测凝血酶原时间(PT),并与正常对照组比较分析。结果TC、apoB在乙肝轻度组、中度组有所上升(P<0.05),但在重度组和乙肝肝硬化组则明显下降(P<0.01)。TG在轻度组、中度组、重度组有所上升(P<0.05),在乙肝肝硬化组却明显下降(P<0.01)。慢性乙肝各组血清apoA与正常对照组相比较均有不同程度的下降(P<0.05),以乙肝肝硬化组下降最为明显(P<0.01)。乙肝肝硬化组血清apoA与PT呈明显负相关(r=-0.99,P<0.01)。结论血清血脂及载脂蛋白的水平可反映肝细胞功能状态,可作为提示慢性乙肝病情严重程度的指标。
Objective To investigate the changes of serum total cholesterol (TC), triglyceride (TG), apolipoprotein A (apoA) and apolipoprotein B (apoB) levels in patients with chronic hepatitis B and to investigate their clinical significance. Methods The levels of serum TC, TG, apoA and apoB in patients were detected by automatic biochemical analyzer. The prothrombin time (PT) was also measured and compared with the normal control group. Results The levels of TC and apoB in mild and moderate hepatitis B group increased (P <0.05), but decreased significantly in severe and hepatitis B cirrhosis group (P <0.01). TG was increased in mild group, moderate group and severe group (P <0.05), but decreased significantly in cirrhosis group (P <0.01). Chronic hepatitis B serum apoA levels compared with the normal control group were decreased to varying degrees (P <0.05), the most obvious decline in hepatitis B cirrhosis group (P <0.01). Serum apoA and PT in hepatitis B cirrhosis group were significantly negative correlation (r = -0.99, P <0.01). Conclusion Serum lipids and apolipoprotein levels can reflect the functional status of hepatocytes, which can be used as an indicator of the severity of chronic hepatitis B.