2型糖尿病合并慢性乙肝对血糖控制的影响分析  

Effect of glycemic control of type 2 diabetes with chronic hepatitis B

作　　者：寿岚[1] 娄国强[1] 

机构地区：[1]杭州师范大学附属医院内分泌科

出　　处：《中国临床药理学与治疗学》2016年第9期1046-1049,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨2型糖尿病合并慢性乙肝对血糖控制的影响,旨在为临床提供更为有效的治疗方案。方法:选取2010年1月至2015年1月本院收治的新诊断为2型糖尿病且既往明确诊断为慢性乙型肝炎患者共135例,作为观察组。同时选取同期的内分泌科收治的新发2型糖尿病患者135例,作为对照组。比较两组患者在诊断为2型糖尿病后采取相应降糖治疗后6个月以及12个月后空腹血糖、糖化血红蛋白(Hbalc)以及相关糖尿病知识评分。考察2型糖尿病慢性乙肝患者不同口服降糖药物对患者血糖干预的结果。结果:两组患者治疗前空腹血糖和Hbalc比较差异均无统计学意义(P>0.05)。治疗后6个月、12个月,对照组患者的空腹血糖和Hbalc均明显低于观察组,组间比较差异有统计学意义(P<0.05)。两组患者的自我管理能力、饮食依从性、药物治疗、运动锻炼、血糖或尿糖监测以及糖尿病知识问卷(diabetes knowledge test,DKT)得分比较,观察组均明显低于对照组(P<0.05)。二甲双胍干预组血糖显著低于干预前(P<0.05),且干预后的空腹血糖水平显著优于噻唑烷二酮组(TZDs)以及磺酰脲组(SU)(P<0.05);Hbalc的结果也与血糖结果相一致,二甲双胍干预显著优于TZDs和SU类。结论:2型糖尿病患者合并慢性乙肝的血糖控制显著差于单纯2型糖尿病,患者的主观依从性,以及对疾病的积极性均是影响患者血糖控制的因素,同时选用合理的降糖药物也是控制血糖的关键。AIM： To investigate the effect of glycemic control of type 2 diabetes with chronic hepatitis B,and to provide reference for clinical application. METHODS： 135 patients,newly diagnosed with type 2 diabetes and chronic hepatitis from January 2010 to January 2015 in our hospital were admitted as the observation group. Another 135 patients admitted by endocrinology as new-onset type 2 diabetes were selected as the control group. Fasting blood glucose Hbalc and diabetes-related knowledge scores were compared between the two groups after their treatment type 2 diabetes for 6 and 12 months.Intervention results of different oral hypoglycemic drugs on blood glucose were observed. RESULTS：No difference of fasting blood glucose and Hbalc was observed between the two groups before treatment（ P〉0. 05）. After treatment for 6 and 12 months,fasting blood glucose and Hbalc in control group were significantly lower than those in the observation group（ P〈0. 05）. Self management capabilities,dietary compliance, medication, exercise, blood sugar or glucose monitoring and DKT scores compared in the observation group were significantly lower than control group（ P〈0. 05）. Levels of blood glucose was significantly lower than before metformin intervention（ P〈0. 05） and the prognosis of fasting blood glucose level was significantly better than results of ZDs and SU（ P〈0. 05）. Glycosylated hemoglobin results were also consistent with the results of blood glucose,metformin intervention was significantly better than the TZDs and SU. CONCLUSION： Glycemic control of type 2diabetes patients with chronic hepatitis B blood is worse than the simple type 2 diabetes. Patient＇s subjective compliance,as well as disease enthusiasm are factors influencing the effect of glycemic control,yet reasonable choice of anti-diabetic drugs is crucial to control the blood glucose.

关 键 词：2型糖尿病 慢性乙肝病毒感染 血糖控制 

分 类 号：R587.1[医药卫生—内分泌]