糖代谢与肝性脑病关系的临床观察  

Relationship between glucose metabolism and hepatic encephalopathy in patients with liver cirrhosis

作　　者：张丽航[1] 毛峻岭[1] 任海峰[1] 王善娟[1] 张慧[1] 万坚[1] 刘艳丽[1] 王一飞[1] 林永辉[1] 

机构地区：[1]上海交通大学仁济医院嘉定分院消化内科,上海201800

出　　处：《临床肝胆病杂志》2013年第7期532-534,共3页Journal of Clinical Hepatology

基　　金：上海市嘉定区卫生局2008年科研项目(KYXM 2008-11-03)

摘　　要：目的观察肝硬化患者血糖的改变,探讨糖代谢与肝性脑病(HE)的关系。方法 2008年8月至2010年8月间在嘉定区中心医院消化内科住院的肝硬化患者60人作为肝硬化组,非肝硬化住院患者30人作为对照组。收集一般资料,观察神志,体检有无扑翼样震颤,抽血检测患者血糖,根据患者检查结果,把肝硬化患者分为无扑翼样震颤组和有扑翼样震颤组,对肝硬化组与对照组糖代谢异常发生率进行比较,根据患者血糖情况分为血糖正常组及糖代谢异常组,对两组间扑翼样震颤及HE发生率进行比较。计量资料应用t检验,率的比较应用卡方检验。结果对照组30例,肝硬化组60例中无扑翼样震颤组28例,有扑翼样震颤组32例,对照组糖代谢异常发生率13.33%,肝硬化组糖代谢异常发生率26.67%,肝硬化组患者糖代谢异常发生率高于对照组(χ2=2.058,P<0.05)。糖代谢正常组扑翼样震颤发生率50.00%,HE发生率34.09%,糖代谢异常组扑翼样震颤发生率62.50%,HE发生率37.50%,两组间差异均无统计学意义(P>0.05)。结论肝硬化患者存在糖代谢的紊乱,但糖代谢异常不一定易于发生HE,提示存在大脑对糖的利用障碍。Objective To observe the changes in blood glucose in patients with liver cirrhosis and investigate the relationship between glu- cose metabolism and hepatic encephalopathy （HE）. Methods Sixty patients with liver cirrhosis （cirrhosis group） and 30 patients without liver cirrhosis （ control group）, who were hospitalized in Department of Gastroenterology, Jiading District Central Hospital from August 2008 to August 2010, were included in the study. The general data were collected ; the consciousness of patients was observed ; the physical exam- ination was performed for detecting flapping tremors; blood samples were collected for measuring blood glucose. The cirrhosis group was fur- ther divided into flapping tremor subgroup and non - flapping tremor subgroup. The cirrhosis group and control group were compared in terms of the incidence rate of abnormal glucose metabolism. The patients were divided into normal glucose metabolism group and abnormal glucose metabolism group, and the two groups were compared in terms of the incidence rates of flapping tremors and HE. Results Of the 60 pa- tients in cirrhosis group, 28 had no flapping tremors, and 32 had flapping tremors. The incidence rate of abnormal glucose metabolism was significantly lower in the control group than in the cirrhosis group （ 13.33% vs 26.67% ; X2 = 2. 058, P 〈 0.05 ）. The incidence rates of flapping tremors and HE were 50.00% and 34.09% in the normal glucose metabolism group, versus 62.50% and 37.50% in the abnormal glucose metabolism group （ P 〉 0.05 ）. Conclusion The patients with liver cirrhosis have abnormal glucose metabolism, but which is not necessarily associated with HE. It suggests that the patients with HE may have impaired glucose utilization in the brain.

关 键 词：肝硬化 肝性脑病 葡萄糖代谢障碍 

分 类 号：R747.9[医药卫生—神经病学与精神病学]