青海地区藏、汉族肝硬化患者载脂蛋白A1和B100的表达及意义

发布时间：2018-06-26 00:56

本文选题：肝硬化 + 载脂蛋白A1　；参考：《青海大学》2014年硕士论文

【摘要】：目的：通过对青海（高原）地区藏、汉族肝硬化（hepatic cirrhosis）患者体内载脂蛋白A1（apoA1）与B100（apoB100）的对比研究，明确不同民族载脂蛋白在肝硬化患者体内的差异；明确载脂蛋白的表达及意义。为青海地区肝硬化患者治疗提供新的思路。方法：将80例诊断为肝硬化（hepatic cirrhosis）的患者按藏、汉两个民族分成2组。藏族观察组40例，包括25例男性、15例女性，平均（42.20±3.32）岁。汉族观察组40例，男女各20例，平均（42.43±1.11）岁。所有观察对象均为肝炎后肝硬化失代偿期，包括77例乙型肝炎、3例丙型肝炎。所有受检对象均按照《肝硬化临床诊疗指南》诊断标准入选，均为2011年至2013年青海大学附属医院诊断为肝炎后肝硬化的患者。检查前一周停用影响血脂的药物，并确认未服用影响血脂的激素类药物。排除呼吸系统、内分泌系统、消化系统和其他疾病影响结果的因素。另将80例正常人，按藏、汉两个民族分成2族。藏族对照组40例，其中男性23例，女性17例，平均（41.95±1.11）岁。汉族对照组40例，其中男性27例，女性13例，平均年龄（41.40±1.07）岁。均为门诊体检正常者，受检对象均为2011年至2013年青海大学附属医院门诊体检者，检查前一周停用影响血脂的药物，并确认未服用影响血脂的激素类药物。排除呼吸系统、内分泌系统、消化系统和其他疾病影响结果的因素。受检患者均空腹12h后采肘静脉血3ml，3000r/min，离心10min，-30℃存储血清测试，，全自动生化结果分析仪测定载脂蛋白A1和B100，数据以均数±标准差表示，使用spss19统计学软件，进行独立样本t检验得出结论。结果：藏族观察组测得apoA1（0.70±0.05）及apoB100（0.49±0.06）指标明显低于藏族对照组apoA1（1.12±0.13）及apoB100（0.62±0.06），P小于0.05，具有统计学意义。汉族观察组apoA1（1.11±0.06）及apoB100（0.73±0.05）指标明显低于汉族对照组apoA1（1.46±0.07）及apoB100（0.80±0.07），P小于0.05，具有统计学意义。藏族观察组测得apoA1（0.70±0.05）及apoB100（0.49±0.06）指标明显低于汉族观察组apoA1（1.11±0.06）及apoB100（0.73±0.05）指标，P小于0.05具备统计学意义。藏族对照组测得apoA1（1.12±0.13）及apoB100（0.62±0.06）指标明显低于汉族对照组apoA1（1.46±0.07）及apoB100（0.80±0.07），P小于0.05，具备统计学意义。结论：汉族和藏族对照组载脂蛋白含量明显高于汉族和藏族观察组，这与肝硬化有关，因为肝硬化失代偿时期，肝脏长期反复、广泛的肝细胞炎性损伤、变性、坏死和肝细胞的增生、结节，引起肝功能障碍，使肝细胞合成、转化载脂蛋白的分泌能力下降，使血清中载脂蛋白含量减少。藏族观察组体内载脂蛋白水平对比汉族观察组显著降低，因为藏族长期食用牛、羊肉等高蛋白、高脂肪饮食，并且以糌粑为主食。缺少食用新鲜蔬菜及水果，体内维生素、矿物质及其他身体必须的营养成份摄入较少，饮食结构较单一，对肝脏代谢造成负担。藏族一般生活于玉树、果洛等藏区，较汉族生活环境恶劣，高海拔，并长期缺氧。会促使肝脏合成功能减低、代偿性血流增加、肝淤血等症状，使体内血清载脂蛋白含量减低，合并肝硬化失代偿期，使体内载脂蛋白含量进一步减少，致使血清载脂蛋白含量对比汉族减少。藏族对照组体内载脂蛋白含量低于汉族对照组，这可能藏、汉两民族基因表达不同有关，因本实验经费及时间原因，尚未进行基因测定，所以这个结论尚属推断。
[Abstract]:Objective: to clarify the difference of apolipoprotein (apoA1) and B100 (apoB100) in the patients with liver cirrhosis (hepatic cirrhosis) in Qinghai (plateau) area, and to clarify the expression and significance of apolipoprotein in the patients with liver cirrhosis, and provide a new way of thinking for the treatment of liver cirrhosis in Qinghai.
Methods: 80 patients with hepatic cirrhosis were divided into 2 groups according to the Tibetan and Han two nationalities. The Tibetan observation group was 40 cases, including 25 men and 15 women, with an average of (42.20 + 3.32) years old. The Han observation group was 40 cases, 20 men and women, average (42.43 + 1.11) years old. All the subjects were decompensated after hepatitis cirrhosis, including 77 cases B Hepatitis C, 3 cases of hepatitis C. All subjects were selected according to the guidelines for clinical diagnosis and treatment of liver cirrhosis. All the patients were diagnosed as post hepatitis cirrhosis in Affiliated Hospital of Qinghai University from 2011 to 2013. The factors influencing the results of the endocrine system, digestive system and other diseases. Another 80 normal people were divided into 2 ethnic groups according to the Tibetan and Han nationality. The Tibetan control group was divided into 2 ethnic groups. There were 40 cases in the Tibetan control group, including 23 males and 17 women, with an average of 41.95 + 1.11 years old. The Han control group was 40 in 27, 13, and average age (41.40 + 1.07) years. All were normal medical examination. All the subjects were examined in the Affiliated Hospital of Qinghai University from 2011 to 2013. The drugs that affected blood lipids were stopped for the week before the examination, and the hormone drugs that were not used to affect blood lipids were confirmed. The factors affecting the respiratory system, the endocrine system, the digestive system and other diseases were excluded. The patients received the 3M of the elbow vein after 12h. L, 3000r/min, centrifuge 10min, -30 C were stored in serum test. The apolipoprotein A1 and B100 were measured by automatic biochemical analyzer. The data were expressed with mean standard deviation. The spss19 statistics software was used to get the conclusion of independent sample t test.
Results: the index of apoA1 (0.70 + 0.05) and apoB100 (0.49 + 0.06) in the Tibetan observation group was significantly lower than that of the Tibetan control group (1.12 + 0.13) and apoB100 (0.62 + 0.06), and P was less than 0.05. The Han observation group was significantly lower than the Han control group (1.11 + 0.06) and apoB100 (0.73 + 0.05) indexes, which were significantly lower than those of the Han control group. 07), P was less than 0.05, with statistical significance. The indexes of apoA1 (0.70 + 0.05) and apoB100 (0.49 + 0.06) of the Tibetan observation group were significantly lower than those of the Han observation group (1.11 + 0.06) and apoB100 (0.73 + 0.05), and P less than 0.05 were statistically significant. The indexes of apoA1 (1.12 + 0.13) and apoB100 (0.62 + 0.06) in the Tibetan control group were significantly lower than those of the Han nationality. Group apoA1 (1.46 + 0.07) and apoB100 (0.80 + 0.07) and P less than 0.05 were statistically significant.
Conclusion: the content of apolipoprotein in the Han and Tibetan control groups is significantly higher than that of the Han and Tibetan observation groups, which is related to liver cirrhosis, because the liver cirrhosis is decompensated, the liver is repeated for a long time, extensive hepatic inflammatory injury, degeneration, necrosis and proliferation of liver cells, nodules, liver dysfunction, liver cell synthesis and the transformation of apolipoprotein. The level of serum apolipoprotein decreased. The level of apolipoprotein in the Tibetan observation group was significantly lower than that in the Han observation group, because the Tibetans had long eaten cattle, mutton and other high protein, high fat diet, and were staple food. Lack of fresh vegetables and fruits, vitamins, minerals and other bodies in the body must be found. The nutrition composition is less, the diet structure is relatively simple, and the liver metabolism is burden. The Tibetans generally live in the Tibetan areas such as Yushu and Lau, and the Han people live in bad environment, high altitude, and long-term hypoxia. It will cause the liver function reduction, compensatory blood flow increase, liver stasis and so on, reduce the content of serum apolipoprotein in the body, combine the liver with the liver The content of apolipoprotein in the serum was lower than that of the Han nationality. The content of apolipoprotein in the Tibetan control group was lower than that of the Han control group. This may be hidden and the gene expression of the Han two nationalities is different. It is still inferring.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.2

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