高脂血症患者腹腔镜胆囊切除术后ALT和AST水平的变化及意义

刘洋; 张洪义; 赵刚

doi:10.3969/j.issn.1001-5256.2016.03.027

高脂血症患者腹腔镜胆囊切除术后ALT和AST水平的变化及意义

DOI: 10.3969/j.issn.1001-5256.2016.03.027

1. 安徽医科大学空军临床学院
2. 中国人民解放军空军总医院肝胆外科

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中图分类号: R589.2;R657.4
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出版历程
- 出版日期: 2016-03-20

Effect of laparoscopic cholecystectomy on aminotransferase levels in patients with hyperlipidemia

The Air force Clinical College of Anhui Medical University

摘要

摘要:
目的研究经腹腔镜胆囊切除术（LC）对合并不同类型高脂血症（HLP）患者术后转氨酶ALT和AST水平的影响。方法回顾性分析2012年1月-2014年12月于空军总医院肝胆外科行LC的HLP患者213例,根据患者血清总胆固醇（TC）、甘油三酯（TG）和高密度脂蛋白（HDL）胆固醇水平分为高TC组（n=63）、高TG组（n=53）、混合组（n=48）、低HDL组（n=49）,并选取同期血脂正常行LC的患者为非HLP组（n=204）。检测各组术前及术后第1、3、7天ALT和AST水平;计量资料多组间比较采用方差分析,进一步两两比较采用q检验,计数资料组间比较采用χ2检验。结果各HLP组术前转氨酶水平均高于正常对照组,且高TC组ALT、AST水平较其他HLP组升高更明显,差异均有统计学意义（P值均<0.05）;各组患者LC术后第1、3天ALT和AST增高值较对照组均有不同程度的升高,且高TC组ALT和AST水平较其他HLP组更明显,差异均有统计学意义（P值均<0.05）;各组术后1周转氨酶均恢复至正常水平,无严重肝功能异常情况发生。结论实施LC对HLP患者的肝功能影响较小,可临床观察...
- 高脂血症 /
- 胆囊切除术,腹腔镜 /
- 转氨酶类
Abstract:
Objective To investigate the effect of laparoscopic cholecystectomy( LC) on postoperative levels of alanine aminotransferase( ALT) and aspartate aminotransferase( AST) in patients with different types of hyperlipidemia( HLP). Methods A total of 213 HLP patients who underwent LC in Department of Hepatobiliary Surgery in Air Force General Hospital,PLA from January 2012 to December 2014 were analyzed retrospectively,and according to the serum levels of total cholesterol( TC),triglyceride( TG),and high- density lipoprotein cholesterol( HDL),they were divided into high TC group( n = 63),high TG group( n = 53),and mixed group( n = 48),low HDL group( n = 49). The patients with normal blood lipid who underwent LC during the same period of time were enrolled as non- HLP group( n =204). Enzyme- linked immunosorbent assay was performed before surgery and on days 1,3,and 7 after surgery to measure the levels of ALT and AST. Analysis of variance was used for comparison of continuous data between several groups,and q- test was used for comparison of such data between each two groups; the chi- square test was applied for comparison of categorical data between groups. Results All the HLP groups had significantly higher levels of aminotransferases before surgery than the normal control group( all P < 0. 05),and the high TC group had significantly greater increases in ALT and AST levels compared with the other HLP groups( all P < 0. 05). Compared with the control group,all the HLP groups had varying degrees of increase in ALT and AST levels on days 1 and 3 after LC,and the high TC group had significantly greater increases in ALT and AST levels compared with the other HLP groups( all P < 0. 05). In all the groups,the levels of aminotransferases on day 7 after surgery returned to normal,with no occurrence of severe abnormal liver function. Conclusion LC has a little influence on the liver in HLP patients. Clinical observation should be performed,and the treatment to protect the liver and reduce the levels of aminotransferases should be given when necessary.
- hyperlipidemia /
- cholecystectomy,laparoscopic /
- transaminases

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参考文献(14)

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