本文選題：肝硬化 + 載脂蛋白A1�。� 參考：《青海大學(xué)》2014年碩士論文

【摘要】：目的：通過對(duì)青海（高原）地區(qū)藏、漢族肝硬化（hepatic cirrhosis）患者體內(nèi)載脂蛋白A1（apoA1）與B100（apoB100）的對(duì)比研究，明確不同民族載脂蛋白在肝硬化患者體內(nèi)的差異；明確載脂蛋白的表達(dá)及意義。為青海地區(qū)肝硬化患者治療提供新的思路。 方法：將80例診斷為肝硬化（hepatic cirrhosis）的患者按藏、漢兩個(gè)民族分成2組。藏族觀察組40例，包括25例男性、15例女性，平均（42.20±3.32）歲。漢族觀察組40例，男女各20例，平均（42.43±1.11）歲。所有觀察對(duì)象均為肝炎后肝硬化失代償期，包括77例乙型肝炎、3例丙型肝炎。所有受檢對(duì)象均按照《肝硬化臨床診療指南》診斷標(biāo)準(zhǔn)入選，均為2011年至2013年青海大學(xué)附屬醫(yī)院診斷為肝炎后肝硬化的患者。檢查前一周停用影響血脂的藥物，并確認(rèn)未服用影響血脂的激素類藥物。排除呼吸系統(tǒng)、內(nèi)分泌系統(tǒng)、消化系統(tǒng)和其他疾病影響結(jié)果的因素。另將80例正常人，按藏、漢兩個(gè)民族分成2族。藏族對(duì)照組40例，其中男性23例，女性17例，平均（41.95±1.11）歲。漢族對(duì)照組40例，其中男性27例，女性13例，平均年齡（41.40±1.07）歲。均為門診體檢正常者，受檢對(duì)象均為2011年至2013年青海大學(xué)附屬醫(yī)院門診體檢者，檢查前一周停用影響血脂的藥物，并確認(rèn)未服用影響血脂的激素類藥物。排除呼吸系統(tǒng)、內(nèi)分泌系統(tǒng)、消化系統(tǒng)和其他疾病影響結(jié)果的因素。受檢患者均空腹12h后采肘靜脈血3ml，3000r/min，離心10min，-30℃存儲(chǔ)血清測(cè)試，，全自動(dòng)生化結(jié)果分析儀測(cè)定載脂蛋白A1和B100，數(shù)據(jù)以均數(shù)±標(biāo)準(zhǔn)差表示，使用spss19統(tǒng)計(jì)學(xué)軟件，進(jìn)行獨(dú)立樣本t檢驗(yàn)得出結(jié)論。 結(jié)果：藏族觀察組測(cè)得apoA1（0.70±0.05）及apoB100（0.49±0.06）指標(biāo)明顯低于藏族對(duì)照組apoA1（1.12±0.13）及apoB100（0.62±0.06），P小于0.05，具有統(tǒng)計(jì)學(xué)意義。漢族觀察組apoA1（1.11±0.06）及apoB100（0.73±0.05）指標(biāo)明顯低于漢族對(duì)照組apoA1（1.46±0.07）及apoB100（0.80±0.07），P小于0.05，具有統(tǒng)計(jì)學(xué)意義。藏族觀察組測(cè)得apoA1（0.70±0.05）及apoB100（0.49±0.06）指標(biāo)明顯低于漢族觀察組apoA1（1.11±0.06）及apoB100（0.73±0.05）指標(biāo)，P小于0.05具備統(tǒng)計(jì)學(xué)意義。藏族對(duì)照組測(cè)得apoA1（1.12±0.13）及apoB100（0.62±0.06）指標(biāo)明顯低于漢族對(duì)照組apoA1（1.46±0.07）及apoB100（0.80±0.07），P小于0.05，具備統(tǒng)計(jì)學(xué)意義。 結(jié)論：漢族和藏族對(duì)照組載脂蛋白含量明顯高于漢族和藏族觀察組，這與肝硬化有關(guān)，因?yàn)楦斡不Т鷥敃r(shí)期，肝臟長(zhǎng)期反復(fù)、廣泛的肝細(xì)胞炎性損傷、變性、壞死和肝細(xì)胞的增生、結(jié)節(jié)，引起肝功能障礙，使肝細(xì)胞合成、轉(zhuǎn)化載脂蛋白的分泌能力下降，使血清中載脂蛋白含量減少。藏族觀察組體內(nèi)載脂蛋白水平對(duì)比漢族觀察組顯著降低，因?yàn)椴刈彘L(zhǎng)期食用牛、羊肉等高蛋白、高脂肪飲食，并且以糌粑為主食。缺少食用新鮮蔬菜及水果，體內(nèi)維生素、礦物質(zhì)及其他身體必須的營(yíng)養(yǎng)成份攝入較少，飲食結(jié)構(gòu)較單一，對(duì)肝臟代謝造成負(fù)擔(dān)。藏族一般生活于玉樹、果洛等藏區(qū)，較漢族生活環(huán)境惡劣，高海拔，并長(zhǎng)期缺氧。會(huì)促使肝臟合成功能減低、代償性血流增加、肝淤血等癥狀，使體內(nèi)血清載脂蛋白含量減低，合并肝硬化失代償期，使體內(nèi)載脂蛋白含量進(jìn)一步減少，致使血清載脂蛋白含量對(duì)比漢族減少。藏族對(duì)照組體內(nèi)載脂蛋白含量低于漢族對(duì)照組，這可能藏、漢兩民族基因表達(dá)不同有關(guān)，因本實(shí)驗(yàn)經(jīng)費(fèi)及時(shí)間原因，尚未進(jìn)行基因測(cè)定，所以這個(gè)結(jié)論尚屬推斷。
[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.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R575.2

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