120例肝源性糖尿病患者临床特点分析  

The Clinical Features of 120 Patients with Hepatogenous Diabetes

作　　者：罗玲[1] 吉丽[1] 王颖霞[2] 孙丹宁 王海霞[4] 马丽辉[2] 芦璇 宋春丽[5] 

机构地区：[1]邯郸市第二医院,河北邯郸056001 [2]邯郸市中心医院,河北邯郸056000 [3]邯郸市钢铁集团有限责任公司职工医院,河北邯郸056000 [4]河北省冀中能源峰峰集团总医院,河北石家庄056200 [5]石家庄市第三医院,河北石家庄050000

出　　处：《现代生物医学进展》2013年第12期2345-2348,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨肝源性糖尿病的临床特点及其治疗,以提高对该病的诊疗水平。方法:120例肝源性糖尿病(HD)患者,其中46例行OGTT试验,检测了血糖、胰岛素、C肽、胰岛素敏感指数(ISI),HOMA-IR及空腹血糖、空腹胰岛素(FPG/FINS)评估胰岛素抵抗,并与50例2型糖尿病(T2DM)患者进行对比分析。结果:21例(17.5%)HD患者有三多一少糖尿病典型症状。OGTT结果显示HD组空腹血糖低于T2DM组(P<0.05);胰岛素+C肽释放试验显示T2DM组和HD组胰岛素分泌呈高峰延迟型,HD患者各时段胰岛素及C肽水平高于T2DM患者(P<0.05,P<0.01)。HD组的FPG/FINS及HOMA-IR低于HD组,ISI高于HD组,差异均有统计学意义(P<0.05)。经治疗后血糖大部分控制在正常或接近正常水平,9例病例均死于肝病并发症。结论:胰岛素抵抗可能是肝源性糖尿病重要的发病机制。肝源性糖尿病以餐后高血糖为特征,临床症状不典型,短期不良预后主要与原发慢性肝病有关。Objective： To investigate the clinical features and treatment methods of hepatogenous diabetes （HI））. Methods：The clinical data of 120 patients with HD were analyzed from June 2007, to December, 2011. Oral glucose tolerance test （OGTT） was carried out on 46 patients. Plasma glucose, insulin, c-peptide, HOMA-IR and insulin sensitivity index （ISI） were measured and compared with those of primary type 2 diabetes mellitus（T2DM）, Rosults： Only 21（17.5%） patients with HD showed the typical diabetic symptoms such as dry mouth, polydipsia, polyphagia, polyuria, et al. In OGTT, the patients with HD showed a much lower level of FPG than that of T2DM （P〈 0.05）. In insulin and C- peptide release test, both the two groups showed a delayed insulin peak, but the patients with HD sho- wed higher insulin values at all the five period than those of T2DM （P〈0.05, P〈0.01）. FPG/FINS and HOMA-IR in the patients with HD were significantly lower than that in the patients with T2DM, while the ISI was higher than those patients with T2DM. After the treatment, most patients showed normal or near normal levels of blood glucose. Only 9 cases died of complications of underlying chronic hepatic diseases. Conclusion： Insulin resistance may play a key role in the etiology of the HD, which is clinically asymptomatic, and is characterized by higher PPG. The short- time prognosis is more likely to be affected by the underlying hepatic disease.

关 键 词：肝源性糖尿病 胰岛素抵抗 胰岛素敏感指数 

分 类 号：R587.1[医药卫生—内分泌]