Seidel D
Schweiz Med Wochenschr. 1975 Jul 5;105(27):857-62.
Disorders of liver function frequently lead to raised plasma lipid values. The methods for analyzing plasma lipids and lipoproteins developed in recent years have yielded a great deal of data. This information provides new insights into the interrelationships of these disorders and are furthermore important in differential diagnosis of jaundice. An abnormal lipoprotein (LP-X) has been isolated from the plasma of patients with intra- or extrahepatic cholestasis, and a simple and sensitive method of demonstrating this lipoprotein has subsequently been developed. This parameter is today the surest clinico-chemical test for excluding or demonstrating cholestasis, triglyceride-rich lipoproteins accumulate in the plasma due to lack of lipase. This leads to hypertriglyceridemia. The disappearance of pre-beta and alpha-lipoprotein bands in agarose gel electrophoresis, which is a most frequent sign of severe liver damage (irrespective of its origin) is probably caused by a defective lipoprotein A. The capacity of lipoprotein A to bind certain lipid fractions is reduced or abolished. By no means all the mechanisms leading to structural changes in plasma lipoproteins and hyperlipoproteinemia in disorders of liver function are known at present. However, new findings emphasize the central role played by the liver in synthesis and degradation of plasma lipoproteins.
肝功能紊乱常常导致血浆脂质值升高。近年来开发的分析血浆脂质和脂蛋白的方法已经产生了大量数据。这些信息为这些紊乱之间的相互关系提供了新的见解，并且在黄疸的鉴别诊断中也很重要。一种异常脂蛋白（LP-X）已从肝内或肝外胆汁淤积患者的血浆中分离出来，随后开发了一种简单而灵敏的检测这种脂蛋白的方法。如今，这个参数是排除或诊断胆汁淤积最可靠的临床化学检测方法，富含甘油三酯的脂蛋白由于缺乏脂肪酶而在血浆中积聚。这导致高甘油三酯血症。琼脂糖凝胶电泳中前β和α脂蛋白条带的消失，这是严重肝损伤（无论其起源如何）最常见的迹象，可能是由于脂蛋白A缺陷所致。脂蛋白A结合某些脂质成分的能力降低或丧失。目前还远未了解导致肝功能紊乱时血浆脂蛋白结构变化和高脂蛋白血症的所有机制。然而，新的发现强调了肝脏在血浆脂蛋白合成和降解中所起的核心作用。
