肝硬化合并糖代谢异常的临床特征分析  

Clinical study of liver cirrhosis and abnormal glucose metabolism

作　　者：方雪芬 王军军 郑碧云[1] 黄月红[1] 王小众[1] 

机构地区：[1]福建医科大学附属协和医院消化内科,福建福州350001 [2]福建省立金山医院检验科

出　　处：《胃肠病学和肝病学杂志》2017年第11期1237-1240,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：国家自然科学基金项目(81300321);福建省自然科学基金项目(2016J01462);福建省临床医学重点专科资助项目{闽卫科教[2012](149号)}

摘　　要：目的分析肝硬化的病因及其与糖代谢异常发生的关系,进一步分析肝硬化合并糖代谢异常的临床特征及其对并发症的影响。方法回顾性分析福建医科大学附属协和医院2015年7月至2016年8月住院肝硬化患者共131例,根据其是否合并糖代谢异常分为单纯肝硬化组与肝硬化合并糖代谢异常组,比较两组肝硬化的病因构成比与各病因发生糖代谢异常发生率,并分析两组患者的临床特征、并发症、血生化等相关指标。结果肝硬化最常见的病因是慢性乙型病毒性肝炎;各个病因糖代谢异常发生率存在差异,以隐源性肝硬化、自身免疫性肝硬化及酒精性肝炎肝硬化更为常见;肝硬化合并糖代谢异常患者在年龄、体质量指数(BMI)、合并高血压、上消化道出血、血电解质紊乱、Child-Pugh(B或C级)、血尿素氮异常、低白蛋白血症的发生率明显高于单纯肝硬化组(P<0.05),两组在性别、原发性肝癌、腹水发生率,以及血胆红素、ALT、AST、血肌酐、甘油三酯水平异常发生率的比较无明显差异(P>0.05)。结论不同病因的肝硬化合并有糖代谢异常发生率存在差异,合并糖代谢异常的肝硬化患者肝功能储备能力更差,并发症发生率高,是预后不佳的危险因素。Objective To study the relation between etiology classification of liver cirrhosis and liverr cirrhosis and abnormal glucose metabolism. Furter to investigate the clinical features and complications of cirrhotic patients complicat- ed with abnormal glucose metabolism. Methods Retospective analysis was conducted in 131 cirrhotic patients in Fujian Medical University Union Hosital from Jul. 2015 to Aug. 2016. According to glucose metabolism function, they were di- vided into liver cirrhosis without abnormal glucose metabolism group and liver cirrhosis complicated with abnormal glu- cose metabolism group. They were classified by etiology, the incidence of abnormal glucose metabolism were analyzed respectively. The clinical characteristics, complication and biochemical examination were recorded and compared be- tween two groups. Results Hepatitis B disease was the leading cause of the 131 liver cirrhosis patients. The incidence of abnormal glucose metabolism was different in all the etiological factors, which was more common in cryptogenic cirrho- sis, autoimmune cirrhosis and alcoholic hepatitis cirrhosis. In the cirrhotic patients complicated with glucose metabo- lism, age, BMI, hypertension, upper gastrointestinal hemorrhage, electrolytes disturbance, Child-pugh B or C, obnor- mal blood urea nitrogen, hypoalbuminemia were significantly higher than those in without glucose metabolism group （ P 〈 0.05 ） , while there were no siginficant differences in gender, the incidence of primary carcinoma of liver and asci- tes, serumbilirubin, ALT, AST, creatinine, triglyceride level （P 〉 0.05）. Conclusion There are differences in the incidence of abnormal glucose metabolism among different causes of liver cirrhosis. Compared with cirrhotic patients without abnormal glucose metabolism, abnormal glucose metabolism lead to poor liver function and progression of liver disease, which may contribute to poor prognosis.

关 键 词：肝硬化 糖代谢异常 临床特点 并发症 

分 类 号：R575.2[医药卫生—消化系统]