阻塞性黄疸患者总胆汁酸与血脂水平分析

摘要

Objective To investigate the changes of total bile acid (TBA) and blood lipid level in patients with obstructive jaundice, and to analyze the correlation between TBA and blood lipid level. Methods One hundred and four patients with obstructive jaundice from August 2012 to December 2013 in our hospital were selected as case group, which were then divided into low level group and high level group according to the level of total bile acids. Eighty healthy individuals in the same period in the Outpatient Department were selected as control group. The level of blood lipid and TBA were compared between the three groups. Results Total cholesterol (TC), triglyceride (TG), TBA, total bilirubin (T-Bil) and direct bilirubin (D-Bil) in the case group were all significantly higher than those in the control group (P<0.05), while high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), Apolipoprotein A1 (apoA1), Lipoprotein (α) [Lp(α)] were all significantly lower than those in the control group (P<0.05). TC, TG, T-Bil, D-Bil in high level group were significantly higher than those in the low level group (P<0.05), while HDL-C, apoA1, LDL-C, Lp(α) were significantly lower (P<0.05). Correlation analysis results showed that TAB was positively associated with TC, TG, T-Bil, D-Bil (r>0, P<0.05), and negatively correlated with HDL-C, apoA1, LDL-C, Lp(α) (r<0, P<0.05). Conclusion Patients with obstructive jaundice have different degrees of disor-der in lipid metabolism, and total bile acids may play an important role in promoting the disorder.%目的：探讨阻塞性黄疸患者总胆汁酸(TBA)与血脂水平变化情况，分析TBA与血脂水平的相关性。方法选择2012年8月至2013年12月我院收治的104例阻塞性黄疸患者作为病例组，根据TBA不同水平分为低水平组和高水平组，选择同时期门诊健康体检者80例作为对照组，比较各组对象的TBA及血脂水平。结果病例组总胆固醇(TC)、三酰甘油(TG)、TBA、总胆红素(T-Bil)、直接胆红素(D-Bil)均高于对照组，高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、载脂蛋白A1(apo A1)、脂蛋白(α)[Lp(α)]均低于对照组，差异均有统计学意义(P<0.05)；高水平组TC、TG、T-Bil、D-Bil均高于低水平组，HDL-C、apo A1、LDL-C、Lp(α)均低于低水平组，差异均有统计学意义(P<0.05)；相关性分析结果显示，TBA与TC、TG、T-Bil、D-Bil呈显著正相关(r>0，P<0.05)，与LDL-C、HDL-C、apo A1、Lp(α)呈显著负相关(r<0，P<0.05)。结论阻塞性黄疸患者伴有程度不同的脂代谢紊乱，总胆汁酸可能起着重要促进作用。