糖尿病对慢性重型肝炎病情的影响分析  

Effect of diabetes on the prognosis of chronic liver failure

作　　者：张宇锋[1] 徐启桓[1] 陈禄彪[1] 江元森[1] 

机构地区：[1]中山大学附属第三医院,广州510630

出　　处：《中国医疗前沿》2010年第17期3-4,共2页China Healthcare Innovation

基　　金：国家十一五科技重大专项课题(编号:2008ZX10002-007)

摘　　要：目的分析慢性重型病毒性肝炎合并糖尿病临床转归上的特点。方法回顾性分析慢性重型病毒性肝炎合并糖尿病患者肝功能各项指标、各种并发症以及转归。结果在相同住院时间段慢性重型病毒性肝炎合并糖尿病组患者胆红素值较无合并糖尿病组高(P<0.05),且合并糖尿病组患者起病后总胆红素增至峰值的时间延长(51.4±36.7Vs40.9±34.6d,P=0.039),住院期间总胆红素恢复的速率更缓慢(P<0.001)。合并糖尿病组患者更容易并发感染、肝肾综合症、肝性脑病(P<0.05)。合并糖尿病组患者病情未愈或死亡的比例更高(54/87Vs46/121,P=0.001)。结论慢性重型病毒性肝炎合并糖尿病导致病情不易恢复,预后差。易并发感染、肝肾综合症、肝性脑病等,总胆红素增至峰值所需的时间延长,恢复缓慢。Objective To analysis the characters on the prognosis of chronic liver failure of viral hepatitis accompanying with diabetes. Methods To retrospectively analysis the liver function, complications and the prognosis of patients with chronic liver failure of viral hepatitis accompanying with diabetes. Results The level of bilirubin in patients with chronic liver failure of viral hepatitis accompanying with diabetes was higher than that in patients without diabetes （P〈0.05）. The time from the onset to the peak level of total bilirubin was longer in patients with diabetes than that in patients without diabetes （51.4±36.7 Vs 40.9±34.6 days, P=0.039）. The recovering speed of total bilirubin was slower in patients with diabetes than that in patients without diabetes （P〈0.001）. Patients with diabetes took higher risk of infection, hepatorenal syndrome and hepatic encephalopathy （P〈0.05） than those without diabetes. The rate of worsening conditions of illness or death was higher in patients with diabetes than those without diabetes （54/87 Vs 46/121, P=0.001）. Conclusion Patients with chronic liver failure of viral hepatitis accompanying with diabetes were hard to recover. Their prognosis was poorer. They took higher risk of infection, hepatorenal syndrome and hepatic encephalopathy. They took longer time to reach the peak level of serum total bilirubin and recovered slowly.

关 键 词：慢性重型肝炎 糖尿病 转归 

分 类 号：R575.1[医药卫生—消化系统] R587.1[医药卫生—内科学]