病毒性肝炎合并糖尿病的流行病学特征分析  

Epidemiological characteristics of viral hepatitis complicated with diabetes mellitus

作　　者：刘大凤[1] 冉兴无[2] 王林[1] 胡蓉[1] 王丽[1] 张鸿[1] 李亚玲[1] 李波[1] 

机构地区：[1]成都市传染病医院,成都市610061 [2]四川大学华西医院内分泌科

出　　处：《中华实验和临床感染病杂志（电子版）》2012年第2期28-31,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：四川省卫生厅项目(070385);成都市卫生局青年基金项目(局0715)

摘　　要：目的探讨病毒性肝炎合并糖尿病的流行病学特征。方法回顾性分析本院住院的502例病毒性肝炎合并糖尿病患者的性别、年龄、感染病毒型别、临床类型特征,并分别与糖尿病组、病毒性肝炎组比较。结果病毒性肝炎中糖尿病患病率为3.34%,其中乙型肝炎患者中的糖尿病患病率为3.26%,丙型肝炎患者中为4.40%。性别以男性为主,男∶女为2.99∶1,高于病毒性肝炎组和糖尿病组。平均年龄(52.79±12.15)岁,年龄分段以40～60岁者最多,年长于病毒性肝炎患者,年轻于糖尿病患者。临床类型以肝硬化为主,其次是慢性肝炎和重型肝炎,但肝硬化所占比例是肝炎组的3倍多,而慢性肝炎所占比例仅为肝炎组的1/2。以乙型肝炎病毒感染为主,其他型别少见,与单纯肝炎组类似。绝大部分患者均为2型糖尿病,与糖尿病组相似;肝源性糖尿病占14.74%,但1型糖尿病所占比例仅为糖尿病组的1/6左右。结论 40岁以上男性肝炎后肝硬化及慢性乙型肝炎患者易合并糖尿病,以2型糖尿病为主,其次是肝源性糖尿病,1型糖尿病少见。针对此类人群进行糖耐量试验及糖化血红蛋白(HbA1c)检测是必要的。Objective To analyze epidemiological characteristics of viral hepatitis complicated with diabetes mellitus. Methods The data of gender, age, viral type,clinical type of viral hepatitis, type of diabetes mellitus of 502 patients with viral hepatitis complicated with diabetes mellitus from January 1st 2004 to December 31th 2010 in our hospital were analyzed, retrospectively. Results The prevalence of diabetes mellitus in patients with viral hepatitis was 3.34% （3.26% in hepatitis B and 3.40% in hepatitis C）. Male were the majority （74.90%）. The ratio of male to female was 2.99∶ 1, higher than that in viral hepatitis without diabetes mellitus group and diabetes mellitus without viral hepatitis group. Average age was 52.79 years, which was older than those in viral hepatitis without diabetes mellitus group but younger than those in diabetes mellitus without viral hepatitis group. The majority age was from 40 to 60 years. The major clinical type was cirrhosis, 3 times of that in viral hepatitis without diabetes mellitus group. Chronic hepatitis B was followed, but only half of that in viral hepatitis without diabetes mellitus group. The third clinical type was severe hepatitis. The major viral type was hepatitis B virus, other types were rare, which was the same as that in viral hepatitis without diabetes mellitus group. The first type of diabetes mellitus was type 2,which was the same as that in diabetes mellitus without viral hepatitis group. The ratio of hepatic diabetes was 14.745. Type 1 was only 1/6 of that in diabetes mellitus without viral hepatitis group. Conclusions Male who were older than 40 years with cirrhosis or chronic hepatitis B might be easily complicated with diabetes mellitus. The major type of those patient are type 2. Hepatic diabetes is followed and type 1 diabetes is rare. HbA1c and glucose tolerance test are necessary for early diagnosis, treatment and misdiagnosis avoiding.

关 键 词：肝炎 病毒性 人 糖尿病 流行病学研究 

分 类 号：R512.6[医药卫生—内科学] R587.1[医药卫生—临床医学]