Abstract: Objective Objective To explore the clinical significance of lipid levels including total cholesterol（TC），triglyceride （TG），high?density lipoprotein（HDL?C），low density lipoprotein（LDL?C），and apolipoprotein（APOAⅠ and APOB）of elder? ly patients with hepatic schistosomiasis. Methods Methods A total of 280 hospitalized elderly patients with hepatic schistosomiasis （198 cases of chronic liver fibrosis and 82 cases of hepatocirrhosis）were chosen as study objects，and their clinical data were collected and analyzed retrospectively. Meanwhile，the lipid levels between the patients with liver fibrosis and hepatocirrhosis， and those among the patients with A，B，C degrees of Child?pugh grading of liver function were compared. Results Results Among the 280 patients，the abnormality rates of the lipid levels were 34.8% （69/198） and 100%（82/82）in the liver fibrosis group and he? patocirrhosis group respectively，and the difference between them were statistically significant（χ2 = 5.74， P＜0.05） . The levels of TC，HDL?C，LDL?C，APOAⅠ of the patients in the latter group were significantly lower than those in the former group（all P ＜0.05） . The levels of TC，TG，HDL?C，APOAⅠ，APOB of the patients with C degree liver function were significantly lower than those of the patients with A degree liver function，and the levels of TC，TG，HDL?C of the former were also lower than those of the patients with B degree liver function（all P ＜0.05） . Conclusions Conclusions The lipid levels of the elderly patients with he? patic schistosomiasis reduce obviously in the course of hepatocirrhosis，and it is correlated with the damage level of the liver. Lipid and apolipoprotein detections have certain values on the illness judgment and prognosis assessment.

Key words: Hepatic schistosomiasis； Liver fibrosis； Hepatocirrhosis； Blood lipid； Elderly patient

摘要： 目的 目的 探讨老年血吸虫肝病患者血清总胆固醇 （TC）、 甘油三酯 （TG）、 高密度脂蛋白 （HDL?C）、 低密度脂蛋白 （LDL?C） 及载脂蛋白 （APOAⅠ和APOB） 的临床意义。方法 方法 对上海交通大学附属第六人民医院南院收治的280例老年血吸 虫肝病患者 （慢性肝纤维化198例、 肝硬化82例） 的临床资料进行回顾性分析， 并分别对肝纤维化、 肝硬化患者及肝功能 Child?pugh分级为A、 B、 C级者的血脂水平进行比较。结果 结果 肝纤维化组198例患者中仅69例表现为HDL?C、 LDL?C、 APOAⅠ轻度异常， 占34.8% （69/198）； 肝硬化组82例 （100%） 患者血脂水平均明显降低， 两组血脂水平异常率差异有统 计学意义 （χ2 = 5.74， P＜0.05）； 肝硬化组患者TC、 HDL?C、 LDL?C、 APOAⅠ水平均显著低于肝纤维化组 （P均＜0.05）。肝 功能A级者TC、 TG、 HDL?C、 APOAⅠ及APOB水平均显著高于C级者， 肝功能B级患者TC、 TG、 HDL?C水平亦显著高于C 级者， 差异均有统计学意义 （P均＜0.05）。结论 结论 老年血吸虫肝病患者肝硬化后血脂水平降低明显， 其与肝硬化患者肝 功能损害程度密切相关。检测患者血脂及载脂蛋白水平对判断病情、 评估预后有一定参考价值。

关键词: 血吸虫肝病； 肝纤维化； 肝硬化； 血脂； 老年患者