HBV感染对肝泡型包虫病肝切除患者术后肝功能及糖脂代谢和胰岛β细胞功能的影响  

Effect of HBV infection on postoperative liver function,glucose and lipid metabolism and isletβ-cell function of hepatic alveolar echinococcosis patients undergoing hepatectomy

作　　者：邵雪飞[1] 盛晓燕[1] 聂建军[2] 王俊霞[2] 袁六六 SHAO Xue-fei;SHENG Xiao-yan;NIE Jian-jun;WANG Jun-xia;YUAN Liu-liu(Nanyang Medical College,Nanyang,Henan 473000,China;不详)

机构地区：[1]南阳医学高等专科学校实验科,河南南阳473000 [2]南阳医学高等专科学校第一附属医院临床药学部,河南南阳473058

出　　处：《中华医院感染学杂志》2021年第17期2609-2613,共5页Chinese Journal of Nosocomiology

基　　金：河南省科技发展计划基金资助项目(1721023160219)。

摘　　要：目的探讨乙型肝炎病毒(HBV)感染对肝泡型包虫病肝切除患者术后肝功能、糖脂代谢和胰岛β细胞功能的影响。方法选择2017年2月-2019年12月南阳医学高等专科学校第一附属医院收治的85例肝泡型包虫病合并HBV感染患者及35例单纯肝泡型包虫病患者纳入肝泡型包虫病合并HBV感染组及单纯肝泡型包虫病组,根据HBsAg定量结果将肝泡型包虫病合并HBV感染组患者分为低载量组(<200IU/ml,27例)、中载量组(200~20000IU/ml,33例)、高载量组(>20000IU/ml,25例),患者均行根治性肝切除术,收集围手术期指标,测定术前及术后1d、3d时肝功能、糖脂代谢、胰岛β细胞功能指标。结果肝泡型包虫病合并HBV感染组手术前后肝功能指标总胆红素(TBIL)、直接胆红素(DBIL)、丙氨酸转氨酶(ALT)及天冬氨酸转氨酶(AST)均高于单纯肝泡型包虫病组(P<0.05),低载量组、中载量组、高载量组手术前后各时间点肝功能指标比较差异无统计学意义。各组患者术前空腹血糖(FPG)比较差异无统计学意义,肝泡型包虫病合并HBV感染组手术前后胰岛素抵抗指数(HOMA-IR)及术后FPG高于单纯肝泡型包虫病组,手术前后胰岛素分泌指数(IGI)低于单纯肝泡型包虫病组(P<0.05);高载量组、中载量组患者手术前后HOMA-IR及术后FPG高于低载量组,手术前后IGI低于低载量组(P<0.05)。结论与单纯肝泡型包虫病患者比较,HBV感染可进一步降低患者手术前后肝功能,引起糖代谢紊乱及胰岛β细胞功能的异常。OBJECTIVE To explore the influence of hepatitis B virus(HBV) infection on postoperative liver function, glucose and lipid metabolism and islet β-cell function of the hepatic alveolar echinococcosis patients undergoing hepatectomy. METHODS From Feb 2017 to Dec 2019, a total of 85 hepatic alveolar echinococcosis patients complicated with HBV infection who were treated in the First Affiliated Hospital of Nanyang Medical College were assigned as the hepatic alveolar echinococcosis complicated with HBV infection group, and 35 patients with simple hepatic alveolar echinococcosis were set as the simple hepatic alveolar echinococcosis group.The hepatic alveolar echinococcosis patients complicated with HBV infection were divided into the low load group with 27 cases(<200 IU/ml), the medium load group with 33 casers(200-20000 IU/ml), and the high load group with 25 cases(>20000 IU/ml).All of the patients underwent radical hepatectomy, the perioperative indexes were collected, and the liver function, glucose and lipid metabolism and islet β-cell function indexes were determined before the surgery and after the surgery for 1 and 3 days. RESULTS The levels of liver function indexes total bilirubin(TBIL), direct bilirubin(DBIL), alanine aminotransferase(ALT) and aspartate aminotransferase(AST) of the hepatic alveolar echinococcosis complicated with HBV infection group were significantly higher than those of the simple hepatic alveolar echinococcosis group(P<0.05).There were no significant differences in the liver function indexes among the low-load group, the medium-load group and the high load group at the time points before and after the surgery.There was no significant difference in the fasting plasma glucose(FPG) among the groups before the surgery.The homeostasis model assessment of insulin resistance(HOMA-IR) of the hepatic alveolar echinococcosis complicated with HBV infection group was significantly higher than that of the simple hepatic alveolar echinococcosis group before and after the surgery, the FPG level of the

关 键 词：乙型肝炎病毒 肝泡型包虫病 肝功能 胰岛Β细胞 糖代谢 

分 类 号：R575[医药卫生—消化系统]