肝炎肝硬化患者代谢综合征临床特征分析  

Clinical study on metabolic syndrome in the patients with posthepatitic cirrhosis

作　　者：张维燕[1] 王晓杰[1] 申戈[1] 徐寒[1] 池频频[1] 李蕴铷[1] 范小玲[1] 

机构地区：[1]首都医科大学北京地坛医院综合科,100015

出　　处：《中国医师进修杂志》2010年第28期4-7,共4页Chinese Journal of Postgraduates of Medicine

基　　金：基金项目：国家自然科学基金（30600524）

摘　　要：目的 探讨北京地区肝炎肝硬化患者伴发代谢紊乱的临床特征及代谢综合征（MS）发病率.方法 对455例住院的肝炎肝硬化患者,统计各种代谢紊乱发病率,并根据病原学分为慢性乙型肝炎肝硬化（LCB）351例（LCB组）和慢性丙型肝炎肝硬化（LCC）104例（LCC组）,分别比较分析肝硬化合并MS与肝硬化非MS代谢紊乱特征.结果 肝炎肝硬化患者高血糖、高血压、高血脂、肥胖及MS的发病率分别为46.59%（212/455）、15.16%（69/455）、15.38%（70/455）、22.64%（103/455）、12.53%（57/455）.LCB和LCC合并MS发病率分别为8.26%（29/351）、26.92%（28/104）,LCB合并MS患者体重指数（BMI）、空腹血糖、高血压、总胆固醇、丙氨酸氨基转移酶（ALT）显著高于LCB非MS患者,但HBeAg和乙型肝炎病毒（HBV）DNA阳性率差异无统计学意义.LCC合并MS患者BMI、高血压、三酰甘油显著高于LCC非MS患者,但空腹血糖、总胆固醇、ALT差异无统计学意义.非条件Logistic回归分析结果显示BMI是影响LCB和LCC合并MS的独立危险因素.结论 LCB和LCC患者高血糖和肥胖的发病率较高,LCB合并MS发病率低于普通人群,而LCC合并MS发病率显著高于普通人群,其发生与病毒复制无关,BMI是影响肝炎肝硬化患者合并MS的重要因素.Objective To explore the clinical characteristics of metabolic disorder and the incidence rate of metabolic syndrome （MS） in the patients with posthepatitic cirrhosis.Methods Four hundred and fifty-five patients with posthepatitic cirrhosis were included in the study and divided into hepatitis B related cirrhosis group （LCB group,351 cases） and hepatitis C related cirrhosis group （LCC group,104cases）.The prevalence of metabolic disorder was recorded and the characteristics of posthepatitic cirrhosis with MS and without MS were compared and analysed.Results The prevalence of hyperglycemia,hypertension,hyperlipemia,obesity and MS in the posthepatitic cirrhosis patients was 46.59% （212/455）,15.16% （69/455）,15.38% （70/455）,22.64% （ 103/455）,12.53% （57/455） respectively.The prevalence of MS in LCB and LCC was 8.26% （29/351） and 26.92% （28/104）.The levels of body mass index （BMI）,fasting blood glucose,hypertension,cholesterol,aminotransferase （ALT） in LCB with MS patients were significantly higher than those in LCB without MS patients.There were no differences in the levels of HBeAg and HBV DNA between LCB with MS patients and LCB without MS patients.The levels of BMI,hypertension,triglyceride in LCC with MS patients were significantly higher than those in LCC without MS patients.There were no differences in fasting blood glucose,cholesterol and ALT between LCC with MS patients and LCC without MS patients.Logistic regression revealed that BMI was the independent factor in LCB and LCC with MS.Conclusions The prevalence of hyperglycemia and obesity are higher in LCB and LCC.The incidence rate of MS in LCB is less than that in the general population,while the incidence rate of MS in LCC is significantly higher than that in the general population,and it＇s nothing to do with the viral replication.BMI is an important factor affected in posthepatitic cirrhosis with MS.

关 键 词：肝炎 肝硬化 肝炎病毒 乙型肝炎病毒 丙型 代谢综合征X 

分 类 号：R575[医药卫生—消化系统] R51[医药卫生—内科学] R589[医药卫生—临床医学]