Hyperlipoproteinämie bei Erkrankungen der Leber

  • D. Seidel
Part of the Handbuch der inneren Medizin book series (INNEREN, volume 7 / 4)

Zusammenfassung

Störungen der Leberfunktion führen häufig zu erhöhten Plasmalipidwerten. Mit der sich in den letzten Jahren entwickelten Analytik der Plasmalipoproteine hat sich eine Vielzahl von Hinweisen ergeben, die neue Einblicke in die Zusammenhänge dieser Störungen gestatten und darüber hinaus von differentialdiagnostischer Bedeutung sind.

So ist es gelungen, aus dem Plasma von Patienten mit intra- oder extrahepatischer Cholestase ein abnormes Lipoprotein (LP-X) zu isolieren, für das später eine einfache und empfindliche Nachweismethode entwickelt wurde. Dieser Parameter gilt heute als der sicherste klinischchemische Test zum Nachweis oder Ausschluß einer Cholestase. Zusätzlich können sich, besonders bei der cholestasebedingten Leberschädigung, triglyceridreiche Lipoproteine im Plasma ansammeln, die — durch einen Lipasemangel hervorgerufen — zu der Hypertriglyceridämie jener Patienten führen. Das Verschwinden der prä-β- und α-Lipoproteinbanden in der Agaroseelektrophorese als häufiges Zeichen einer schweren Leberschädigung gleich welcher Genese wird wahrscheinlich durch ein defektes Apolipoprotein A verursacht, dessen Bindungskapazität für bestimmte Lipidfraktionen vermindert oder aufgehoben ist.

Obgleich man heute noch weit davon entfernt ist, alle Mechanismen zu kennen, die bei Störungen der Leberfunktion zu den strukturellen Veränderungen der Plasmalipoproteine und zur Hyperlipoproteinämie führen, unterstreichen die neuen Befunde die zentrale Rolle, die die Leber in der Synthese und im Abbau der Plasmalipoproteine spielt.

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© Springer-Verlag Berlin · Heidelberg 1976

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  • D. Seidel

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