LIPID SPECTRUM OF BLOOD SERUM AND ITS SIGNIFICANCE IN PATHOGENESIS OF CHOLELITHIASIS.

V.B. LIFSHITS, N.V. SUSHKOVA, V.G. SUBBOTINA, T.A. KOLOPKOVA, E.A. SIMONOVA

Saratov State Medical University after V.I. Razumovsky, Saratov, RUSSIA

The purpose of the study: definition of lipid spectrum in blood serum in chronic cholecystitis (CC) and cholelithiasis (CL), is revealing the correlation of biochemical parameters and of their role in the pathogenesis of cholelithiasis.

Materials and methods: Were examined 98 patients (48 males and 50 females) in the average age 50,0 ± 6,2 years. Patients were divided into 3 groups: the1st - with exacerbation of chronic cholecystitis (ECC), the 2-d- with remission of chronic cholecystitis (RCC), the 3rd - with cholelithiasis (CL). Were analyzed the content of alkaline phosphatase (ALP) in blood serum by Haussament T.U. method (1977), the concentration of lipids: total cholesterol (LDL) - by PAP method, HDL cholesterol by Burstein M. et al. method (19), triglycerides (TG) by Young D. et al.method (1975) with mathematical calculation of LDL cholesterol and atherogenic coefficient (AC). Mathematical processing of the results was carried out by a «STATISTICA» program. Depending on the types of data and tasks both parametric and nonparametric tests were used.

Results: In patients with CL, AC increased significantly as compared with RCC and increased slightly as compared with ACC (3,65 ± 0,9 mmol / l; 3,1 ± 0,7 mmol / l; 2,4 ± 0,6 mmol / l respectively). In RCC in comparison with CK HDL cholesterol increased in1.5-times (p <0, 05) (1,8 ± 0,5 mmol / l and 1,2 ± 0,3 mmol / l, respectively). In examined patients with ACC VLDL cholesterol decreased in 1,8 times in comparison with patients with ECC and in 1.5 times in comparison with patients with CL (1,8 ± 0,5 mmol / l and 1,2± 0,3 mmol / l respectively, p <0, 05). In patients with CL cholesterol / HDL-C ratio was raised in 1,5 times compared with patients with RCC( 4,73 ± 1,1 mmol / l; 4,06 ± 1,3 respectively) and this criterion was not significantly different in patients with ACC (3,41 ± 1,1 mmol / l). This ratio is a widely recognized marker of redistribution of blood plasma cholesterol in the direction of LDL.

Conclusions: Thus, if we follow the dynamics of blood serum lipids, it is likely that the development of cholelithiasis is realized through the preceding chronic cholecystitis. Moreover, the maximum probability of formation of gall stones is seen during the remission of the inflammatory lesions of gallbladder. The increase of cholesterol level in blood serum is an additional risk factor of exacerbation of chronic cholecystitis.

Date: 2014-12-28; view: 1020