腹腔镜胆囊切除术对血脂的影响

Ali Shuwelif, Haider Mihson, Ayad Maikhan
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引用次数: 0

摘要

背景:胆石病(GSD)是最常见的外科胃肠道疾病之一。胆固醇是胆结石的成分之一。高脂血症和GSD在病理生理上常与胆固醇有关,胆囊切除术与影响脂肪吸收的肝胆循环有关。本研究的目的是评估腹腔镜胆囊切除术(LC)后血脂(LP)的变化。方法:前瞻性队列研究,纳入200例有GSD和基线LP测量的患者,其中一半患者进行LC治疗,并在2周和1个月后进行两次LP随访。比较两组之间的LP,以估计由于LC而发生的差异,之后,将两组随访测量值与基线比较,以估计这些变化随时间的影响。结果:术后1个月患者血清总胆固醇(TC)、甘油三酯(TG)水平较对照组明显降低;两两分析显示,两周和1个月随访时TG水平均低于基线。1个月后高密度脂蛋白(HDL)高于对照组,2周两两分析,与基线无差异,1个月后有显著差异。低密度脂蛋白(LDL)和极低密度脂蛋白(VLDL)与对照组无显著差异。结论:LC与随访1个月后血清TC和TG水平降低以及血清HDL水平升高有关。
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The effect of laparoscopic cholecystectomy on lipid profile
Background: Gallstone disease (GSD) is one of the most common surgical gastrointestinal diseases. Cholesterol is one of the constituents of gallstones. Hyperlipidemia and GSD are often linked to cholesterol in pathophysiology, and cholecystectomy is associated with hepatobiliary circulation affecting fat absorption. The aim of the study is to assess the lipid profile (LP) changes after laparoscopic cholecystectomy (LC). Methods: Prospective cohort study that included 200 patients with documented GSD and baseline measurement of LP, followed by LC for half of them, and two follow-up measurements of LP after 2 weeks and 1 month. Comparison of the LP between the two groups to estimate the difference that occur due to LC, after that, comparison of the two follow-up measurements with baseline to estimate the effect of these changes with time. Results: Total serum cholesterol (TC) and triglyceride level (TG) were significantly lower from control 1 month after surgery; on pairwise analysis, TG level was lower than baseline on both 2-week and 1-month follow-up measurements. High-density lipoprotein (HDL) was higher than the control after 1 month, on pairwise analysis at 2 weeks, no difference from baseline was found, and a significant difference was found after 1 month. Both low-density lipoprotein (LDL) and very LDL (VLDL) were not different from the control. Conclusion: LC is associated with a reduction of the serum level of both TC and TG and an increase serum level of HDL after 1 month of follow-up.
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