目的：分析肝功能不全体检人群伴血脂异常患者临床病理特点和实验室检查特征。方法：回顾性分析2019年5月-2022年3月医院收治的135例肝功能不全体检人群的临床资料,根据是否伴有血脂异常分为血脂异常组(n=65)与非血脂异常组(n=70)。所有患者均接受B超检查,对比两组临床资料、临床病理特点、肝功能指标、血脂代谢指标及炎症指标。结果：两组性别、年龄比较差异无统计学意义(P＞0.05),血脂异常组肝腹痛占比、腹水占比及总并发症发生率高于非血脂异常组(P＜0.05)。血脂异常组肝包膜增厚、回声增强、肝密度降低、肝缘毛糙例数占比高于非血脂异常组(P＜0.05)。血脂异常组总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平高于非血脂异常组(P＜0.05)。血脂异常组高密度脂蛋白胆固醇(HDL-C)水平低于非血脂异常组(P＜0.05),三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平高于非血脂异常组(P＜0.05)。血脂异常组血清C反应蛋白(CRP)、白细胞介素-6(IL-6)水平高于非血脂异常组(P＜0.05)。结论：肝功能不全体检人群伴血脂异常患者的临床病理特点主要表现为肝脏功能障碍、血脂代谢紊乱、肝腹水、腹痛、并发症发生率高,肝密度降低、回声增强、肝缘毛糙等表现,且患者炎症反应加重。
Objective: To analyze the clinicopathological features and laboratory characteristics of patients with dyslipidemia and liver dysfunction. Methods: The clinical data of 135 patients with liver dysfunction who underwent physical examination in the hospital from May 2019 to March 2022 were retrospectively analyzed. And they were divided into dyslipidemia group (n=60) and non-dyslipidemia group (n=75) according to whether accompanied by dyslipidemia. All patients underwent B-ultrasound examination, and the clinical data, clinicopathological characteristics, liver function indexes, lipid metabolism indexes and inflammatory indexes of were compared between the two groups. Results: There was no significant difference in gender and age between the two groups (P＞0.05). The proportion of liver and abdominal pain, the proportion of ascites and the incidence of total complications in the dyslipidemia group were higher than those in non-dyslipidemia group (P＜0.05). The proportion of liver capsule thickening, echo enhancement, liver density decrease and liver margin roughness in dyslipidemia group was higher than that in non-dyslipidemia group (P＜0.05). The levels of total bilirubin (TBIL), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in dyslipidemia group were higher than those in non-dyslipidemia group (P＜0.05). The level of high density lipoprotein cholesterol (HDL-C) in dyslipidemia group was lower than that in non-dyslipidemia group (P＜0.05), and the levels of triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in dyslipidemia group were higher than those in non-dyslipidemia group (P＜0.05). The levels of serum C-reactive protein (CRP) and interleukin-6 (IL-6) in dyslipidemia group were higher than those in non-dyslipidemia group (P＜0.05). Conclusion: The clinicopathological features of patients with liver dysfunction and dyslipidemia are mainly characterized by liver dysfunction, dyslipidemia, liver ascites, abdominal pain, high incidence of complications, decreased liver density, enhanced echo, rough liver margin, and increased inflammatory response.
[1] Chew M, Tang ZY, Radcliffe C, et al.Significant Liver Injury During Hospitalization for COVID-19 Is Not Associated With Liver Insufficiency or Death[J].Clin Gastroenterol Hepatol, 2021,19(10):2182-2191.
[2] Zhou EC, Xiang D, Yu B, et al.Ovarian tissue transplantation ameliorates osteoporosis and dyslipidaemia in ovariectomised mice[J].J Ovarian Res, 2022,15(1):139.
[3] Morrow MR, Batchuluun B, Wu JH, et al.Inhibition of ATP-citrate lyase improves NASH, liver fibrosis, and dyslipidemia[J].Cell Metab, 2022,34(6):919-936.
[4] Chen JH, Zhou H, Jin HW, et al.Role of Inflammatory factors in Mediating the Effect of Lipids on Nonalcoholic Fatty Liver Disease: ATwo-Step, Multivariable Mendelian Randomization Study[J].Nutrients, 2022,14(20):4434.
[5] Shin HS, Jun BG, Yi SW.Impact of diabetes, obesity, and dyslipidemia on the risk of hepatocellular carcinoma in patients with chronic liver diseases[J].Clin Mol Hepatol, 2022,28(4):773-789.
[6] Jutric D, Dikic D, Boros A, et al.Effects of naringin and valproate interaction on liver steatosis and dyslipidaemia parameters in male C57BL6 mice[J].Arh Hig Rada Toksikol, 2022,73(1):71-82.
[7] 中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-950.
[8] 中国研究型医院学会肝胆胰外科专业委员会.肝硬化患者肝切除术后肝功能不全的预防与治疗专家共识(2019版)[J].中华消化外科杂志,2019,18(4):297-302.
[9] 崔浩,梁静,向慧玲.新型冠状病毒感染相关肝损伤研究进展[J].临床肝胆病杂志,2022,38(4):931-935.
[10] 樊亚楠,施逸怡,徐京杭,等.274例青少年和成人传染性单核细胞增多症患者肝损伤临床特征分析[J].临床肝胆病杂志,2021,37(3):636-641.
[11] 杨洋,矫宁,陈新国,等.心脏死亡者供肝移植术后受体早期肝功能恢复不良的影响因素分析[J].武警医学,2021,32(9):790-794.
[12] Minamizuka T, Koshizaka M, Shoji M, et al.Low dose red yeast rice with monacolin K lowers LDL cholesterol and blood pressure in Japanese with mild dyslipidemia: a multicenter, randomized trial[J].Asia Pac J Clin Nutr, 2021,30(3):424-435.
[13] 杜婧,邓雁北,高颖,等.瑞舒伐他汀钙与非诺贝特联合治疗血脂异常的疗效及对肝肾功能的影响[J].现代生物医学进展,2021,21(6):1077-1080.
[14] 庄林,胡明芬,庞兴美,等.肝活检与B超诊断脂肪肝的对比研究[J].昆明医科大学学报,2018,39(1):85-91.
[15] 刘爱民,谭邦国,卢福麟,等.钆塞酸二钠增强MRI预测乙型肝炎肝硬化合并肝细胞癌切除术后肝功能不全的研究[J].川北医学院学报,2022,37(2):153-157.
[16] 张洪洪,吴凡,吕晓娟,等.川崎病合并肝功能异常患儿临床分析[J].中国妇幼保健,2023,38(2):251-255.
[17] 储开东,邵志莉,袁伯稳.重组人干扰素 α1b联合更昔洛韦对传染性单核细胞增多症合并肝功能异常患儿炎症免疫和肝功能的影响[J].中国医院用药评价与分析,2023,23(4):443-446,451.
