糖尿病对慢性重型肝炎糖类脂类代谢影响分析  

Effect of diabetes on the glucose and lipid metabolism of chronic liver failure

作　　者：张宇锋[1] 朱翔[1] 赖菁[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18期1-2,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：目的探讨糖尿病对慢性重型病毒性肝炎糖类、脂类代谢的影响。方法回顾性分析慢性重型病毒性肝炎合并糖尿病患者的血糖、血脂水平。结果慢性重型肝炎入院时空腹血糖(FPG)值在以下三组患者中依次递降:合并糖尿病且TBIL≤540μmol/L组(DM1)、合并糖尿病且TBIL>540μmol/L组(DM2)、无合并糖尿病组(NDM),三组差异有统计学意义(P<0.01)。DM组、NDM组两组的不同转归患者之间FPG差异无统计学意义;两组患者均可出现空腹低血糖现象。两组患者之间血中总胆固醇(CHOL)、甘油三酯(TG)、高密度脂蛋白(HDL)值差异无统计学意义(P>0.05)。结论慢性重型病毒性肝炎合并糖尿病的血糖水平主要受糖尿病影响导致血糖升高,另一方面,空腹血糖可随肝功能损害的加重、黄疸的加深而降低。在慢性重型病毒性肝炎、肝功能衰竭时,血中血脂水平主要受肝脏脂肪代谢的影响。Objective To research the effect of diabetes on the glucose and lipid metabolism of chronic liver failure.Methods To retrospectively analyse the serum levels of glucose and lipid of patients with chronic liver failure of viral hepatitis accompanying with diabetes.Results The fast plasma glucose（FPG） of chronic liver failure of viral hepatitis at the moment of admission reduced gradually among the three groups：patients with diabetes and TBIL≤540μmol/L,patients with diabetes and TBIL540μmol/L,patients without diabetes.The three groups had significant difference（P〈0.01）.The FPG between the different prognosis patients（worsening） had no significant difference,in group with diabetes or without diabetes.Patients in both groups had phenomenon of fasting hypoglycemia.Serum levels of total cholesterol,triglyceride and high density lipoprotein in two groups had no significant difference（P〉0.05）.Conclusions Serum levels of glucose in patients of chronic liver failure of viral hepatitis accompanying with diabetes rose due to diabetes mainly.On the other hand,the fast plasma glucose could reduce because of serious liver function、deepen jaundice.Serum levels of lipid was affected on the liver metabolism mainly when liver function was failure.

关 键 词：慢性重型肝炎 糖尿病 代谢 

分 类 号：R363.2[医药卫生—病理学] R512.6[医药卫生—基础医学]