肝硬化胰岛素抵抗及药物治疗可行性研究  

CLINICAL RESEARCH ON INSULIN RESISTANCE IN CIRRHOTIC PATIENTS

作　　者：丁惠国[1] 闵佳[1] 林秀玉[1] 于中麟[2] 郭雁宾[1] 金瑞[1] 吴昊[1] 闵福援[1] 杨东旭[3] 

机构地区：[1]北京佑安医院,100054 [2]北京友谊医院 [3]首都医科大学

出　　处：《中华肝脏病杂志》1998年第1期28-30,共3页Chinese Journal of Hepatology

摘　　要：目的研究肝硬化患者胰岛素敏感性及其相关因素,并探讨降门脉压力药物治疗肝硬化胰岛素抵抗的可行性。方法肝硬化患者22例,正常对照15例。治疗前后(心得安40mg/d,硝苯吡啶20mg/d)分别测定胰岛素敏感性及多肽激素变化。结果肝硬化患者血清胰岛素及 GH 水平增加(P<0.05～0.01),胰岛索敏感性降低(P<0.05),联合治疗后3周,肝硬化患者胰岛索敏感性增加(P<0.05),血浆 SS 水平升高,而 GH 与 VIP 降低(P<0.05～0.01);多元回归相关因素分析发现肝硬化患者胰岛素敏感性与 GH 及胰岛素呈负相关(rr=0.903,P<0.05～0.01)。结论肝硬化患者存在高胰岛索血症及胰岛素抵抗,联合应用心得安与硝苯吡啶不仅能有效的治疗门脉高压症,而且能增加肝硬化患者胰岛素敏感性,改善异常的糖代谢。Objective To research on insulin sensitivity and its relative factors.The treatment with propanolol and nifedipine on insulin resistance in cirrhotic patients was also studied.Methods 22 cir- rhotic patients(Child classifications A/B was in 5:6)and 15 healthy control subjects were studied.Insulin sensitivity and poly-peptide hormone were detected before and after treatment with propanolol(40mg/d) and nifedipine(20rag/d).Results Increased serum insulin and GH and decreased insulin sensitivity in cirrhotic patients were observed(P<0.05-0.001).After 3 weeks' treatment,improved insulin sensitivity and SS,decreased GH and VIP in cirrhotic patients were also observed(P<0.05).The negative relation- ship between insulin sensitivity and GH was observed.Conclusion Hyperinsulinemia and insulin resist- ance in liver cirrhosis are the most common clinical features.Insulin resistance is related with increased GH.Propanolol and nifedipine may be effective in treatment on insulin resistance and glucose metabolic abnormalities,but effective in treatment on portal hypertension.

关 键 词：肝硬变 胰岛素抵抗 相关因素 药物疗法 

分 类 号：R575.205[医药卫生—消化系统]