幽门螺杆菌感染对慢性乙型肝炎肝硬化患者糖代谢影响的研究  

Effect of Helicobacter pylori infection on glucose metabolism in patients with chronic hepatitis B cirrhosis

作　　者：唐文哲 王忠玲 王雪娇[1] 林芳荣 李丹[1] TANG Wen-zhe;WANG Zhong-ling;WANG Xue-jiao;LIN Fang-rong;LI Dan(.The First Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570102,China)

机构地区：[1]海南医学院第一附属医院门诊部

出　　处：《中华医院感染学杂志》2019年第24期3715-3718,共4页Chinese Journal of Nosocomiology

基　　金：海南省医药卫生科研基金资助项目(1801032071A2003)

摘　　要：目的探究幽门螺杆菌感染对慢性乙型肝炎肝硬化患者糖代谢影响的研究,旨在为临床上治疗幽门螺杆菌感染慢性乙型肝炎肝硬化患者提供科学依据。方法选取2016年1月-2017年12月于海南医学院第一附属医院接受治疗的392例慢性乙型肝炎肝硬化患者为研究对象,按照C14呼气检查结果将所有患者分为两组,其中对照组共188例,未发生幽门螺杆菌感染,试验组共204例,发生幽门螺杆菌感染,比较两组患者的基本临床资料、血糖变化、胰岛素、胰高血糖素和生长抑素变化以及高胰岛素血症发生率。结果试验组空腹血糖为(6.24±0.11)mmol/L,服用葡萄糖溶液后2 h血糖为(8.09±0.74)mmol/L,对照组空腹血糖为(5.61±0.08)mmol/L,服用葡萄糖溶液后2 h血糖为(7.58±0.92)mmol/L,试验组空腹和服用葡萄糖溶液后2 h血糖高于对照组,差异均具有统计学意义(P<0.05);试验组空腹和服用葡萄糖溶液后2 h胰岛素水平和胰高血糖素水平高于对照组,生长抑素水平低于对照组,差异均具有统计学意义(P<0.05);试验组高胰岛素血症发病率为30.39%,高于对照组的11.17%,差异具有统计学意义(P<0.05)。结论慢性乙型肝炎肝硬化患者发生幽门螺杆菌感染后,胰岛素、胰高血糖素水平增加、生长抑素水平下降,血糖明显升高,会增加高胰岛素血症的发病率,临床上应该对患者进行抗幽门螺杆菌治疗控制患者的血糖水平。OBJECTIVE To explore the effect of Helicobacter pylori infection on glucose metabolism in patients with chronic hepatitis B cirrhosis, aiming to provide a scientific basis for the clinical treatment of the patients with chronic hepatitis B cirrhosis infected H. pylori. METHODS A total of 392 patients with chronic hepatitis B cirrhosis who were treated in the First Affiliated Hospital of Hainan Medical College from January 2016 to December 2017 were enrolled in this study. All patients were divided into two groups according to the results of C14 breath test: 188 cases with no H. pylori infection in the control group and 204 cases with H. pylori infection in the observation group. The basic clinical data, levels of blood glucose, insulin, glucagon and somatostatin, and the incidence of hyperinsulinemia were compared between the two groups. RESULTS The fasting blood glucose was(6.24±0.11) mmol/L, and the blood glucose was(8.09±0.74) mmol/L 2 h after taking glucose solution in the test group. The fasting blood glucose in the control group was(5.61±0.08) mmol/L, and the blood glucose was(7.58±0.92) mmol/L 2 h after taking glucose solution. The levels of fasting blood glucose and the blood glucose 2 h after taking the glucose solution in the test group were significantly higher than that in the control group(P<0.05). The fasting insulin and glucagon levels as well as insulin and glucagon levels 2 h after taking glucose solution in the test group were significantly higher than that in the control group(P<0.05). The incidence rate of hyperinsulinemia in the experimental group was 30.39%, which was higher than that in the control group(11.17%)(P<0.05). CONCLUSION After patients with chronic hepatitis B cirrhosis infected H. pylori, insulin and glucagon levels increased, somatostatin levels decreased, blood sugar levels increased significantly, and the incidence of hyperinsulinemia increased. The level of blood glucose should be controlled by anti-H. pylori therapy in clinical.

关 键 词：幽门螺杆菌感染 慢性乙型肝炎 肝硬化 糖代谢 高胰岛素血症 

分 类 号：R512.62[医药卫生—内科学]