内镜下食管静脉曲张套扎术对乙型肝炎肝硬化患者短期血糖的影响  

Influence of endoscopic variceal ligation on short-term blood glucose in hepatitis B cirrhosis patients

作　　者：郑海燕[1] 熊锦华[1] 曹建彪[1] 李绍祥[1] 贾飞创[1] 刘艳飞[1] 

机构地区：[1]北京军区总医院全军肝病治疗中心,北京100700

出　　处：《北京医学》2014年第6期436-439,共4页Beijing Medical Journal

摘　　要：目的探讨内镜下食管静脉曲张套扎术(endoscopic variceal ligation,EVL)对乙肝肝硬化患者短期血糖的影响。方法 60例接受EVL的乙肝肝硬化患者检测糖化血红蛋白、空腹血糖,进行口服葡萄糖耐量试验(OGTT)。比较患者的临床资料,评价糖代谢异常的危险因素。根据OGTT分为糖代谢正常组和异常组,检测EVL术后即刻(0h)、术后1、2、3 h血糖值。结果年龄、性别、肝功能分级、肝功能生化指标等均不是乙肝肝硬化患者发生糖代谢异常的相关危险因素。糖代谢正常组中,EVL术后1、2、3 h与0 h血糖比较,差异均无统计学意义(P>0.05);糖代谢异常组中,EVL术后1 h血糖[(8.13±1.89)mmol/L]、2 h血糖[(8.11±1.57)mmol/L]明显高于EVL术后0 h血糖[(7.04±1.29)mmol/L],差异有统计学意义(P均<0.05)。结论乙肝肝硬化合并糖代谢异常者空腹血糖、糖化血红蛋白常在正常范围,需行OGTT明确是否有糖代谢异常。肝硬化合并糖耐量异常者EVL治疗后2 h内血糖易发生明显变化,应予以监测。Objective To investigate the influence of endoscopic variceal ligation on short-term blood glucose in hepatitis B cirrhosis patients. Methods FBG, HbAlc and oral glucose tolerance test （OGTT） were detected in a total of 60 hepatitis B cirrhosis patients who were ready to accepted EVL. The clinical data of patients were compared. The risk factors for abnormal glucose metabolism were evaluated. According to OGTT, patients were divided into normal and abnormal glucose metabolism group. Blood glucose （fasting state）levels were tested at 0, 1, 2, 3 h after EVL. Results Age, gender, liver function etc were not the risk factors for abnormal glucose metabolism in hepatitis B cirrhosis patients. In normal glucose metabolism group, there was no significant difference between the glucose level at 0 h and 1, 2, 3 h after EVL（P 〉 0.05）. In abnormal glucose metabolism group, the levels of blood glucose at 1 h [（8.13±1.89）mmol/L] and 2 h [（8.11± 1.57）mmol/L] were significantly higher than that of 0 h[（7.04±1.29）] after EVL （P 〈 0.05）. Conclusion FBG and HbAlc are in the normal range in patients with liver cirrhosis combined with abnormal glucose metabolism, so OGTT test is re- quired. After EVL, short-term blood glucose should be monitored in hepatitis B cirrhosis patients, especially 2 hours after EVL.

关 键 词：食管 内镜静脉曲张套扎术 肝硬化 血糖 

分 类 号：R575.2[医药卫生—消化系统] R587.1[医药卫生—内科学]