肝硬化患者糖代谢紊乱与肝脏贮备功能的关系探讨  

The liver storage capacity and disorders of carbohydrate metabolism in patients with liver cirrhosis

作　　者：应光荣[1] 朱旭星[1] 洪小飞[1] 金晓蓉[1] 陈圣洁[1] 

机构地区：[1]义乌市中心医院消化科,322000

出　　处：《浙江医学》2005年第8期568-570,共3页Zhejiang Medical Journal

摘　　要：目的探讨肝硬化患者糖代谢与胰岛细胞分泌功能及肝脏贮备功能的关系。方法肝硬化患者清晨静卧进行葡萄糖耐量试验(OGTT),结合以往病史,根据WHO(1999)糖尿病诊断标准把患者分为糖耐量正常组、糖耐量减低组和糖尿病组,并以健康献血员作对照,每位研究对象均进行14C-氨基比林呼气试验(14C-ABT)测定肝脏贮备功能,同时观察各组的胰岛素抵抗指数(Homa-IR)及β细胞分泌功能指数(BCFI)。结果糖尿病组与对照组、糖耐量减低组、糖耐量正常组比较,14C-ABT及BCFI值均明显降低(均P<0.01);糖耐量减低组和糖耐量正常组14C-ABT值也较对照组明显降低(均P<0.01),Homa-IR值均明显高于对照组(均P<0.01);糖尿病组空腹胰岛素水平比其他各组均高(均P<0.01)。结论肝硬化患者糖代谢紊乱与血清胰岛素水平及肝贮备功能的下降、β细胞分泌功能紊乱有关。Objective To explore the relationship between carbohydrate metabolism and the liver storage capacity in patients with liver cirrhosis. Methods Fasting blood sugar measurement and oral glucose tolerance test （OGTT） were performed in patients with liver cirrhosis. All diabetic patients were divided into three groups： 16 cases with normal glucose tolerance （NGT）, 16 cases with impaired glucose tolerance （IGT） and 16 cases with hepatogenous diabetes; 16 healthy subjects were in control group. ^14C-aminopyrine breath test （^14C-ABT）, Homa insulin resistance index （Homa-IR） and β-cell secretory functional index （BCFI） were observed. Results ^14C-ABT values and BCFI in diabetes group were lower than those in other groups（P〈0.01）, ^14C-ABT values in NGT group and IGT group were lower than those in control group （P〈0.01）, Homa-IR in NGT group and IGT group was higher than that in control group（P〈0.01）.Fast insulin levels in hepatogenous diabetes group were higher than those in control group （P〈0.01）.Conclusion Disorders of carbohydrate metabolism and serum insulin levels in patients with liver cirrhosis are closely related to liver storage capacity and secretory function of β-cell.

关 键 词：肝性糖尿病 糖耐量 胰岛素抵抗 氨基比林呼气试验 β细胞分泌指数 肝硬化患者 肝贮备功能 糖代谢紊乱 关系探讨 肝脏 

分 类 号：R575.2[医药卫生—消化系统] R657.304[医药卫生—内科学]