摘要
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。
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, 1 st month, 3rd months, 6th month, 1 st year after surgery, respectively. Total cholesterol （ TC ）, triglyeeride （ TG ）, high-density lipoprotein-eholesterol （ 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 1 st 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.
出处
《中华胸心血管外科杂志》
CSCD
2015年第9期541-544,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
基金
广东省科技厅立项课题（粤科规划字[2012]145号-6）
关键词
高脂血症
胸导管夹闭术
总胆固醇
三酰甘油
高密度脂蛋白胆固醇
低密度脂蛋白胆固醇
Hyperlipidemia Thoracic duct ligation Total cholesterol Triglyeeride High density lipoprotein-cholesterol Low density lipoprotein-cholesterol
