血糖和总胆固醇水平对肝衰竭患者预后的影响  

Blood glucose and total cholesterol in the prognosis of patients with liver failure

作　　者：吴凤萍[1] 李亚萍[1] 杨颖[1] 石娟娟[1] 李梅[1] 王文俊[1] 党双锁[1] Wu Fengping;LiYaping;Yang Ying(Department of Infectious Diseases, Second Affiliated Hospital, Medical School, JiaotongUniversity, Xi＇an 710004, Shaanxi Province, China)

机构地区：[1]西安交通大学医学院第二附属医院感染病科,西安市710004

出　　处：《实用肝脏病杂志》2018年第3期413-416,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金资助项目(编号:81170393)

摘　　要：目的分析血糖和总胆固醇(TC)水平对肝衰竭(LF)患者预后的影响。方法回顾性分析106例LF患者,根据入院时基线TC水平将患者分为TC≤1.0 mmol/L组(n=8)、1.0 mmol/L<TC≤2.0 mmol/L组(n=49)和TC>2.0 mmol/L组(n=49);排除10例糖尿病患者后,将96例LF患者分为血糖正常组(n=60)、高血糖组(n=12)和低血糖组(n=24);分别比较基线时患者血糖及TC的状态与其生存率的相关性。同时动态监测81例基线TC>1.0mmol/L的患者住院期间TC的动态变化,分析其与LF预后的关系。结果 106例LF患者的病因以慢性HBV感染为主,占66.0%;慢性肝衰竭(CLF)占46.2%;基线低血糖患者生存率为41.7%,显著低于血糖正常患者的71.7%(P<0.01);血清TC≤1.0 mmol/L组、1.0 mmol/L<TC≤2.0 mmol/L组和TC>2.0 mmol/L患者生存率分别为12.5%、51.0%和75.5%,三组差异有统计学意义,基线TC越低,生存率越低(P均<0.05);住院期间TC较基线呈下降趋势的35例患者生存率为28.6%,显著低于呈上升趋势的46例患者的93.5%(P<0.05)。结论 LF患者出现血糖降低、TC≤2.0 mmol/L以及在住院期间TC较基线呈下降趋势是预后不良的危险因素,特别是基线TC≤1.0 mmol/L的患者预后极差。Objective To analyze blood glucose and total cholesterol（TC）in the prognosis of patients withliver failure（LF） . Methods A retrospective analysis was performed on 106 LF patients who were admitted to inour hospital. The patients were divided into blood TC≤1.0 mmol/L group （n=8）, 1.0 mmol/L〈TC≤2.0 mmol/Lgroup （n =49）and TC〉2.0 mmol/L group （n=49） according to the TC level at admission. After excluding 10patients with diabetes, 96 patients were divided into normal blood glucose group（n=60）, hyperglycemia group（n=12）and hypoglycemia group（n=24）according to the blood glucose levels at admission. The correlation betweenblood glucose or TC and survival rate was compared respectively. TC was dynamically monitored in 81 patientswith TC 〉1.0 mmol/L at admission to explore the relationship between the dynamic changes of TC and theprognosis of patients with LF. Results Hepatitis B virus（HBV）infection was the main cause of LF in the 106patients,accounting for 66.0% and the proportion of chronic liver failure（CLF）accounted for 46.2%; the survivalrate in patients with hypoglycemia at admission was 41.7%, significantly lower than that in patients with normalblood glucose（71.7%, P〈0.01）; there were significant differences in survival rates between patients with blood TC≤1.0 mmol/L group, 1.0 mmol/L〈TC≤2.0 mmol/L group and TC〉2.0 mmol/L group and the lower the baseline TClevels, the lower the survival rates（12.5% vs. 51.0% vs. 75.5%, respectively, P〈0.05 for all）; the survival rate inpatients with a declining levels of TC during hospitalization was 28.6%, significantly lower than that in patientswith an increasing trend（93.5%, P〈0.05） . Conclusion Hypoglycemia and blood TC≤2.0 mmol/L at admission ordecreased TC level trend are associated with poor prognosis of patients with LF, especially in patients with bloodTC≤1.0 mmol/L at admission.

关 键 词：肝衰竭 血糖 总胆固醇 预后 

分 类 号：R575.3[医药卫生—消化系统]