基于诊断分期研究肝炎肝硬化患者的血脂水平及其与血瘀证型的相关性
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摘要
目的观察代偿期、失代偿期肝炎肝硬化并血脂异常患者的血脂水平,以及两期患者血瘀证型判定组与非判定组的血脂水平,探讨不同病情阶段肝炎肝硬化患者的血脂水平及其与血瘀证型的相关性。方法采用流行病学横断面调查方法,收集肝炎肝硬化患者的相关临床信息,运用SPSS统计软件分析患者代偿期与失代偿期血脂水平的差异,以及血瘀证型与血脂水平的相关性。结果肝炎肝硬化失代偿期患者四项血脂指标总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)的检测值均低于代偿期(P<0.05)。肝炎肝硬化代偿期患者,血瘀证判定组TC、HDL、LDL水平低于非判定组(P<0.05,P<0.01);失代偿期患者,血瘀证判定组LDL水平高于非判定组(P<0.05)。血瘀证判定组HDL水平低于非判定组(P<0.05)。结论肝炎肝硬化并血脂异常患者的病情进展可能引起患者血脂水平的变化。血瘀证型判定组与非判定组间血脂水平有差异,提示中医病性辨证与血脂指标可能存在一定相关性。
Objective To observe the blood lipid level in the patients of hepatitis hepatocirrhosis at the compensated stage and the decompensated stage as well as with dyslipidemia,and the blood lipid level in determination group and non- determination group of blood stagnation pattern/syndrome at the two stages and explore the blood lipid level and the correlation with blood stagnation in the patients of hepatitis hepatocirrhosis at different stages. Methods The cross- sectional study of epidemiology was adopted. The relevant clinical information was collected in the patients. SPSS software was used to analyze the difference in blood lipid level at the compensated stage and the decompensated stage,as well as the correlation between blood stagnation and blood lipid. Results The values of TC,TG,HDL and LDL in the decompensated stage were all lower than those in the compensated stage( P < 0. 05). For the patients at the compensated stage,the levels of TC,HDL and LDL in blood stagnation determination group were all lower than those in the non- determination group( P < 0. 05,P < 0. 01). For the patients at the decompensated stage,LDL level in the determination group was higher than that in the non- determination group( P < 0. 05). HDL level in the determination group was lower than that in the non- determination group( P < 0. 05). Conclusion The progression of hepatitis hepatocirrhosis and dyslipidemia may induce the change in blood lipid. The blood lipid is difference between the group of blood stagnation determination and that without determination. It is suggested that a certain of correlation presents between TCM differentiation and blood lipid indicators.
Objective To observe the blood lipid level in the patients of hepatitis hepatocirrhosis at the compensated stage and the decompensated stage as well as with dyslipidemia,and the blood lipid level in determination group and non- determination group of blood stagnation pattern/syndrome at the two stages and explore the blood lipid level and the correlation with blood stagnation in the patients of hepatitis hepatocirrhosis at different stages. Methods The cross- sectional study of epidemiology was adopted. The relevant clinical information was collected in the patients. SPSS software was used to analyze the difference in blood lipid level at the compensated stage and the decompensated stage,as well as the correlation between blood stagnation and blood lipid. Results The values of TC,TG,HDL and LDL in the decompensated stage were all lower than those in the compensated stage( P < 0. 05). For the patients at the compensated stage,the levels of TC,HDL and LDL in blood stagnation determination group were all lower than those in the non- determination group( P < 0. 05,P < 0. 01). For the patients at the decompensated stage,LDL level in the determination group was higher than that in the non- determination group( P < 0. 05). HDL level in the determination group was lower than that in the non- determination group( P < 0. 05). Conclusion The progression of hepatitis hepatocirrhosis and dyslipidemia may induce the change in blood lipid. The blood lipid is difference between the group of blood stagnation determination and that without determination. It is suggested that a certain of correlation presents between TCM differentiation and blood lipid indicators.
引文
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[20]薛晓琳,王天芳,李昕,等.从“肝藏血主疏泄”功能失调角度探讨肝硬化的发生机理[J].世界中医药,2013,8(2):121-124.
[21]姚魁武,王阶,朱翠玲,等.血瘀证患者实验室指标诊断贡献度比较研究[J].世界中西医结合杂志,2010,5(1):42-44.
[2]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:419-421.
[3]卢小容.90例肝硬化患者血脂变化的临床意义探讨[J].齐齐哈尔医学院学报,2011,32(3):362-363.
[4]赵丽红,王天芳,薛晓琳,等.801例肝炎肝硬化患者常见病性类证候要素在代偿期及失代偿期的分布特点[J].北京中医药大学学报,2015,38(4):260-265.
[5]张琳,吴秀艳,薛晓琳,等.基于现代文献的肝硬化中医证候及证候要素分布特点的研究[J].北京中医药大学学报,2012,35(11):747-751.
[6]中华医学会传染病与寄生虫病学分会,中华医学会肝病学分会.病毒性肝炎防治方案[J].传染病信息,2000,13(4):141-150.
[7]贾继东,李兰娟.慢性乙型肝炎防治指南(2010年版)[J].临床肝胆病杂志,2011,27(1):113-128.
[8]许海燕,顼志敏,陆宗良.中国成人血脂异常防治指南(2007)概要与解读[J].中华老年心脑血管病杂志,2008,10(3):238-240.
[9]王为,王方岩,陈维亚,等.病理生理学[M].杭州:浙江大学出版社,2015:160-162.
[10]金宝艳,刘兆江.肝硬化与血脂关系的临床分析[J].天津医药,2007,35(6):472-473.
[11]赵水平.临床血脂学[M].北京:人民卫生出版社,2006:5-14.
[12]曹济生,王慕琪.268例肝病患者血清甘油三酯测定及临床分析[J].临床医学,1999,19(1):62-63.
[13]陈黎红,杨海燕.血脂、载脂蛋白与慢性病毒性肝炎肝损害关系的临床研究[J].中国医刊,2010,45(6):43-44.
[14]张卫良,童乐.高密度脂蛋白与载脂蛋白A1、低密度脂蛋白与载脂蛋白B的相关性分析[J].中国当代医药,2012,19(24):93-94.
[15]萧焕明,施梅姐,池晓玲.373例乙肝肝硬化失代偿期患者证候与客观指标的相关性研究[J].辽宁中医杂志,2012,39(10):1909-1912.
[16]袁继丽,张华,王磊,等.乙型肝炎后肝硬化患者中医证候要素的生物化学特征[J].中西医结合学报,2011,9(4):374-381.
[17]丁蕊,马红,贾继东.肝硬化的分期、无创诊断、预后模型及治疗进展[J].传染病信息,2012,25(4):193-195.
[18]屈雪莹,车琳.高密度脂蛋白在心血管代谢风险中的研究[J].国际心血管病杂志,2010,37(2):81-84.
[19]王杰,刘夏曦.肝藏血主疏泄理论及应用[J].云南中医中药杂志,2012,33(12):20-21.
[20]薛晓琳,王天芳,李昕,等.从“肝藏血主疏泄”功能失调角度探讨肝硬化的发生机理[J].世界中医药,2013,8(2):121-124.
[21]姚魁武,王阶,朱翠玲,等.血瘀证患者实验室指标诊断贡献度比较研究[J].世界中西医结合杂志,2010,5(1):42-44.