关键词: 梗阻性黄疸, 血脂异常, 总胆固醇

Abstract: Objective To analyze the occurrence of dyslipidemia in patients with obstructive jaundice (OJ), and to understand the difference and clinical significance between the distribution characteristics of blood lipids in OJ patients with dyslipidemia and patients with OJ alone.Methods Reviewing the medical records of OJ patients admitted to hospital and followed up in outpatient department from January 2017 to December 2020, 112 cases (65 males and 47 females) were included, with the age of 62 (41, 72) years old. According to the blood lipid level, they were divided into single OJ group and OJ dyslipidemia group. The diagnosis of OJ met the requirements. The diagnosis of dyslipidemia accords with at least one of following items: total cholesterin (TC) ≥ 5.18 mmol/L, triglycerides (TG) ≥ 3.5 mmol/L, high density lipoprotein (HDL) ≤ 1.04 mmol/L or low density lipoprotein (LDL) ≥ 3.37 mmol/L. The laboratory examination results of single OJ group and OJ dyslipidemia group were compared, and the correlation between lipid indexes and liver function indexes of OJ dyslipidemia patients was analyzed by Spearman test.Results Among the 112 patients with OJ, the single OJ group and the OJ dyslipidemia group were 39 cases and 73 cases respectively, and the incidence of dyslipidemia in OJ patients was 65.2%. The causes of OJ include 97 cases of biliary calculi (86.6%), 6 cases of pancreatic cancer (5.3%), 5 cases of biliary stricture caused by biliary surgery (4.5%), 2 cases of congenital biliary stricture (1.8%) and 2 cases of autoimmune liver disease (1.8%). Dyslipidemia accounted for 65.2% of OJ patients, of which 34 cases (46.6%) had elevated TG, 47 cases (64.4%) had elevated TC, 42 cases (57.5%) had elevated LDL and 21 cases (28.8%) had decreased HDL. Comparing the laboratory examination results of single OJ group and OJ dyslipidemia group, the albumin (Alb), alaninetransaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT) and total bilirubin (Tbil) in single OJ group were 40.2 (36.7, 44.7) g/L, 60 (33, 108) U/L, 56 (34, 103) U/L, 212 (120, 352) U/L, 214 (78, 420) U/L and 37.2 (17.8, 78.5) μmol/L, which was significantly higher than those of OJ dyslipidemia group [33.2 (29.6, 36.9) g/L, 92 (57, 202) U/L, 104 (61, 180) U/L, 394 (265, 678) U/L, 355 (167, 730) U/L and 218.0 (141.7, 301.6) μmol/L, Z=-2.084, 3.204, 3.412, 2.824, 2.908 and 7.538, P<0.05]. TG, TC, LDL and HDL in single OJ group were 1.2 (0.9, 1.6) mmol/L, 4.2 (3.6, 5.2) mmol/L, 1.3 (0.7, 2.4) mmol/L and 1.0 (0.8, 1.4) mmol/L, which were significantly different from those in OJ dyslipidemia group [2.2 (1.5, 2.9) mmol/L, 5.0 (3.9, 7.3) mmol/L, 2.4 (1.8, 3.1) mmol/L and 0.2 (0.1, 0.3) mmol/L, Z=2.229, 2.054, 2.224 and -5.418, P<0.05]. Spearman correlation analysis showed that Alb, ALT, ALP and GGT levels in OJ patients with dyslipidemia were well correlated with lipid indexes (r>0.3).Conclusion Hypercholesterolemia is the most common in OJ patients with dyslipidemia, and liver function indexes such as Alb, ALT, ALP and GGT have a good correlation with lipid indexes.    

Key words: Obstructive jaundice, Dyslipidemia, Total cholesterin