Clinical Relevance And Significance Of The Level Of Lipids And The MELD-Na Score In Patients With Liver Cirrhosis

Background and Objective: Liver Cirrhosis is the end stage of liver disease that caused by a variety of different reasons for a long term. Liver cirrhosis has a very high morbidity and mortality in China. Statistics show that the annual incidence rate of liver cirrhosis is 17/10 million, mainly involving the 20-50 year-old males, while the mortality of city men in age of 50-60 up to 112/10 million.The liver is known as human chemical plant, which participates almost all the substance metabolism. The liver play an important role in lipid metabolism. Once the liver function is damaged will disrupt the balance of substances metabolism and the corresponding abnormal indicators appeared. Our country has not detected blood lipids as routine monitoring indicators in patients with liver cirrhosis.At present, China is still use the Child-Pugh classification to be the standard of liver function classification in patients with liver cirrhotic as well as to assess the prognosis of patients, but the Child-Pugh classification has certain limitations and limits its clinical application. The clinical application value of MELD-Na is more and more attention by scholars.This paper mainly explored blood lipids / lipoproteins levels in patients with liver cirrhosis, the indicators mainly including serum total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), apolipoprotein AⅠ(Apo- AⅠ) and apolipoprotein B(Apo-B). Through these indicators reflect the degree of impaired liver function. To analyze the correlation between serum lipids level and MELD-Na score, so as to combine serum lipids level and MELD-Na score, and can better judge the disease, evaluate the prognosis of patients and guide clinical treatment. Methods: A total of 90 patients with liver cirrhosis who were hospitalized for treatment in Yanan University Affiliated Hospital were retrospectively analyzed. 30 cases who were selected at the same period as the physical examination center were normal control group. To exclude hyperthyroidism, hypertension, diabetes, kidney disease and other disease affecting blood lipids. The subjects were fasting 12 hours, then blood collection in the morning, detection of serum total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), apolipoprotein AⅠ(Apo- AⅠ) and apolipoprotein B(Apo-B). Child-Pugh grading and MELD-Na score for patients with cirrhosis. The results of the measurement were expressed in mean±standard deviation. Independent sample t test for measurement data. The non-parametric analysis for the correlation of lipids and MELD-Na score. Spearman correlation coefficient is calculated. When P<0.05 the difference was statistically significant. Results:1. Compared with the normal control group, lipids level in patients with liver cirrhotic were significantly lower(P <0.05).2. Compared with different Child-Pugh classification patients with cirrhosis, the blood lipids have different levels. All indicators in class C were significantly lower than class A and class B(P <0.05); the indicators in class B only HDL-C, LDL-C, Apo- AⅠ was significantly lower than that in class A(P <0.05), and TC, TG, Apo-B was no significant difference(P> 0.05).3. The levels of TC, TG, HDL-C, LDL-C, Apo- AⅠ and Apo-B were negative correlation compared with MELD-Na scores.Conclusion: The lipids level in patients with liver cirrhosis were significantly lower than that in normal control group. With the aggravation of liver function damage, the level of serum lipids gradually decreased. Moreover, the lipids level and MELD-Na score system were correlated. So we should pay more attention to the lipids level and MELD-Na score in patients with liver cirrhosis. Combined application of the two in order to better judge the disease, predict prognosis and guide clinical treatment.