肝硬化患者高胰岛素血症对血清瘦素水平的影响  

The effect of hyperinsulinemia in patients with cirrhosis on serum leptin levels

作　　者：汤武亨[1] 厉有名[1] 陈国光[2] 李松财 

机构地区：[1]浙江大学附属第一医院消化科,310003 [2]浙江省舟山市第三人民医院消化内科

出　　处：《临床内科杂志》2007年第1期32-34,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨肝炎后肝硬化患者高胰岛素血症对血清瘦素水平的影响,以及瘦素在肝纤维化形成中的作用。方法采用化学发光酶联免疫分析和酶联免疫吸附法分别测定30例肝炎后肝硬化患者的血清胰岛素和瘦素水平。同时选取健康体检者30例作对照组。并用HOMA模式计算胰岛素抵抗指数。结果肝硬化患者血清瘦素、空腹胰岛素、胰岛素抵抗指数分别为(7.2±2.2)ng/ml、(17.3±6.8)mIU/L和3.97±0.48,显著高于对照组的(3.4±1.2)ng/ml、(9.7±4.1)nIU/L和1.98±0.11(P<0.01)。肝硬化ChildC级患者的血清瘦素水平明显高于ChildA级和ChildB级患者(P<0.01),其空腹胰岛素和胰岛素抵抗指数明显上升(P<0.01)。结论肝炎后肝硬化患者存在高胰岛素血症,其胰岛素和瘦素间的反馈调节失衡是导致肝硬化患者血清瘦素水平上升的重要原因之一,瘦素可能是肝纤维化形成的重要促进因子。Objective Exploring the influence of hyperinsulinemia in the patients with post-hepatitis cirrhosis on serum leptin levels and the effect of leptin in the formation of liver fibrosis. Methods The serum insulin and leptin levels of 30 patients with post-hepatitis cirrhosis were measured by the chemilurainescence enzyme-linked immunoassay and enzyme-linked immunosorbent assay respectively. 30 healthy volunteers were selected as the control. HOMA mode was adopted to calculate the insulin resistance index. Results The serum hptin, fasting insulin, and insulin resistance index of the patients with cirrhosis （7.2 ± 2.2ng/ml, 17.3 ± 6.8mIU/L, and 3.97 ± 0.48） were significantly higher than those in the control group （3.4 ± 1.2ng/ml,9.7 ±4. 1nIU/L,and 1.98 ±0. 11,P〈0.01）.The serum leptin levels in Child C patients were significantly higher than that by Child A and Child B patients （ P 〈 0.01 ）. Fasting insulin and insulin resistance index in the Child A patiets were increased significantly （P 〈0.01 ）. Condusions Patients with post-hepatitis cirrhosis usually suffer from hyperinsulinemia. Unbalance of the feedback regulation between their insulin and leptin is one of the major reasons resulting in the increase of serum leptin level. Leptin is an important stimulating factor to liver fibrosis.

关 键 词：肝硬化 高胰岛素血症 瘦素 胰岛素抵抗 肝纤维化 

分 类 号：R575.2[医药卫生—消化系统]