摘要
为确立胆囊结石易患人群高危因素与防石因素的血清学指标，作者对比研究了胆囊结石患者（结石组）与非胆囊结石患者（对照组）血脂与载脂蛋白水平；胆囊结石不同类型的血脂特点；血脂、载脂蛋白（Ａｐｏ）水平与胆汁中类脂水平及胆固醇饱和指数的关系。结果：结石组（Ａｐｏ）Ａ１、Ｃ２、Ｅ显著升高；而总胆固醇（ＴＣ），甘油三酯（ＴＧ），低密度脂蛋白－胆固醇（ＬＤＬ－Ｃ），高密度脂蛋白－胆固醇（ＨＤＬ－Ｃ），ＨＤＬ－Ｃ／ＴＣ，ＬＤＬ－Ｃ／ＨＤＬ－Ｃ，ＡｐｏＡ２、Ｂ、Ｃ３水平，结石组与对照组比较差异均无显著意义，表明Ａｐｏ是较血脂更敏感的指标。胆固醇结石组以ＬＤＬ－Ｃ、ＬＤＬ－Ｃ／ＨＤＬ－Ｃ，ＡｐｏＢ水平升高为特点，而胆色素结石组以ＴＧ，ＡｐｏＣ２升高为特点。血清中ＴＣ、ＬＤＬ－Ｃ、ＡｐｏＢ、Ｃ２、Ｃ３与胆囊胆汁胆固醇含量和（或）胆固醇饱和指数呈正相关，ＡｐｏＥ与总胆管胆汁卵磷脂含量呈负相关，均系成石的高危因素。ＨＤＬ－Ｃ与胆囊、总胆管胆汁中卵磷脂，总胆管胆汁中胆盐含量呈正相关，系防石因素。
To pick up serum high risk lithogenic factors predisposing one to gallstone formation and protective factors against gallstone formation in gallbladder.We compared serum lipid and apolipoprotein level of patients with gallbladder stone(stone group)with that of patients without gallbladder stone(control group).The correlation between serum lipid, apolipoprotein level and bile lipid level,cholesterol saturated index(CSI),characteristics of lipidemia in different kinds of gallblader stones were studied.The results showed that the increase of serum Apo Al,C2 and E level in the stonegroup was more significant than in the control group.But there was no statistical significance in TC,TG,LDL-C,HDL-C,Apo A2,B,C3 level between the stone and control groups.These results suggested that serum apolipoproteins perhaps are more sensitive parameters than serum lipids in distinguishing patients withstones from those without stones.There were different profiles of serum lipid and apolipoproteins in different chemical types of gallbladder stones.Increased level in serum LDL-C,Apo B and ratio of LDL-C/HDL-C were characterized by an index for cholesterol stone,otherwise that in serum TG and Apo C2 an index for pigment stones.There was a positive correlation between serum total cholesterol(TC) or Apo B,C2,C3 and cholesterol amount or CSI in gallbladder bile.Therefore,TC,Apo B,C2,C3 could be considered as high risk lithogenic factors.A positive correlation existed between serum HDL-C and lecithin in gallbladder or common bile duct(CBD) bile as well as between HDL-C and bile acids in CBD bile.Thus,HDL-C might be a protective factor against gallstone formation in gallbladder.
出处
《中华医学杂志》
CAS
CSCD
北大核心
1995年第11期657-659,共3页
National Medical Journal of China
关键词
血脂过多
脂蛋白
高密度
低密度
胆汁
胆结石
Hyperlipemia cholelithiasis Lipoproteins,HDL Lipoproteins LDL Bile
