Schimming W, Schentke K U, Gehrich S, Jaross W, Kobe E
Klinik für Innere Medizin, Medizinischen Akademie Carl Gustav Carus, Dresden.
Gastroenterol J. 1991;51(1):18-21.
40 women, average age 52.5 years, with varying stages of primary biliary cirrhosis, were observed. One third of them suffered from a mild anaemia, mean plasma concentrations of ALAT were increased four times and those of AP six times. Despite the hepatocellular damage products of the liver synthesis such as transport proteins or coagulation factors were found to be normal or enhanced. 60% of the patients had a hypercholesterolaemia. The risk factors low density lipoprotein (LDL)- and very low density lipoprotein (VLDL)-cholesterol showed normal levels, but the protective factor high density lipoprotein (HDL)-cholesterol was clearly increased. Apart from the low blood pressure in most of the patients and the absence of other risk factors these observations explain, why patients with PBC and hypercholesterolaemia don't usually develop arteriosclerotic complications. Only in case of severe cholestasis a lipid constellation comes into being accompanied by high risk for the blood vessels, but in these cases the terminal stage of PBC limits the survival. Positive correlations between markers of cholestasis and lipid parameters let an enhanced production and simultaneous impaired excretion of cholesterol be assumed.
观察了40名平均年龄为52.5岁、处于原发性胆汁性肝硬化不同阶段的女性。其中三分之一患有轻度贫血，谷丙转氨酶（ALAT）的平均血浆浓度升高了四倍，碱性磷酸酶（AP）升高了六倍。尽管存在肝细胞损伤，但肝脏合成的产物如转运蛋白或凝血因子却正常或增加。60%的患者患有高胆固醇血症。危险因素低密度脂蛋白（LDL）和极低密度脂蛋白（VLDL）胆固醇水平正常，但保护因素高密度脂蛋白（HDL）胆固醇明显升高。除了大多数患者血压低以及不存在其他危险因素外，这些观察结果解释了为什么原发性胆汁性肝硬化和高胆固醇血症患者通常不会发生动脉硬化并发症。只有在严重胆汁淤积的情况下，才会出现伴有血管高风险的脂质组合，但在这些情况下，原发性胆汁性肝硬化的终末期限制了生存期。胆汁淤积标志物与脂质参数之间的正相关关系提示胆固醇生成增加同时排泄受损。
