摘要
目的:了解不同血糖代谢状态患者肝硬化临床特征。方法:回顾性分析2017年7月至2018年9月于本院消化内科住院治疗的肝硬化失代偿期患者的临床资料,根据患者血糖代谢状态分为A组(肝硬化血糖代谢正常组)、B组("糖尿病前期"组)、C组(肝硬化糖尿病组),比较A组和血糖代谢异常组(B组和C组)的年龄、性别、肝硬化病因、肝功能Child-pugh分级并对A组、B组、C组的生化、凝血等血检指标和并发症进行分析。结果:60岁及以上的肝硬化失代偿期患者更易合并血糖代谢异常(P<0.05),血糖代谢正常组和血糖代谢异常组性别、肝硬化病因、肝功能Child-pugh分级差异无统计学意义(P>0.05),但随着肝功能恶化,肝硬化合并血糖代谢异常有升高趋势(肝功能A级、B级、C级合并血糖代谢异常占比分别为51.0%、53.5%、55.6%);3组间血尿素氮值、白蛋白值、上消化道出血发病率、电解质紊乱发病率差异有统计学意义(P<0.05),组间比较C组血尿素氮值和电解质紊乱发病率高于A组和B组(P<0.05),C组白蛋白低于B组(P<0.05),C组与B组上消化道出血发病率无统计学差异且均高于A组(P<0.05)。结论:高龄是肝硬化失代偿期合并血糖代谢异常的危险因素之一,肝硬化合并血糖代谢异常使得肝功能进一步恶化,肝硬化相关并发症发病率升高,合并糖尿病肝硬化患者并发症发病率升高更为明显。
Objective:To understand the clinical characteristics of cirrhosis in patients with different glucose metabolism.Methods:We analyzed the clinical data of patients with decompensated cirrhosis who were hospitalized in our hospital from July 2017 to September 2018.Patients was performed and patients were divided into Group A(normal blood glucose metabolism group),Group B("pre-diabetes"group),and Group C(cirrhosis diabetes group)according to the state of blood glucose metabolism.Comparison of age,gender,etiology of cirrhosis,liver function Child-pugh classification between Group A and abnormal glucose metabolism group(Group B and Group C)was conducted.Moreover,biochemical,coagulation and other blood test indexes and related complications of cirrhosis patients in groups A,B and C were also analyzed.Ruselts:Patients aged 60 years or older with decompensated cirrhosis were more likely to have abnormal glucose metabolism(P<0.05).There were no significant differences in gender,etiology of cirrhosis,and liver function Child-pugh classification between the normal glucose metabolism group and the abnormal glucose metabolism groups(P>0.05);however,with the deterioration of liver function,cirrhosis combined with abnormal blood glucose metabolism had an increasing trend(liver function Child-pugh classification A,B,and C with abnormal blood glucose metabolism accounted for 51.0%,53.5%,55.6%,respectively).There were significant differences in blood urea nitrogen value,albumin value,incidence of upper gastrointestinal bleeding and electrolyte imbalance among the three groups(P<0.05).The incidence of blood urea nitrogen and electrolyte imbalance in Group C was higher than that in Group A and Group B(P<0.05),and albumin in Group C was lower than Group B(P<0.05).There was no significant difference in the incidence of upper gastrointestinal bleeding between Group C and Group B,both higher than that in Group A(P<0.05).Conclusion:Old age is one of the risk factors of decompensated cirrhosis with blood glucose metabolism disorder.Abnormal blood glucose metabolism makes liver function worse and cirrhosis-related complications increase.The incidence of cirrhosis-related complications is higher in patients with decompensated cirrhosis with diabetes.
作者
佘倩
陈明锴
SHE Qian;CHEN Mingkai(Dept.of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2019年第6期982-986,共5页
Medical Journal of Wuhan University
关键词
血糖代谢状态
肝硬化失代偿期
肝静脉压力梯度
肝癌
肝性脑病
Blood Glucose Metabolism
Decompensated Cirrhosis
Hepatic Venous Pressure Gradient
Liver Cancer
Hepatic Encephalopathy
作者简介
佘倩,女,1993-,医学硕士生,主要从事肝硬化及其相关并发症临床研究,E-mail:2237167211@qq.com;通讯作者:陈明锴,男,1974-,医学博士,教授,主任医师,硕士生导师,主要从事肝硬化及其相关并发症的研究,E-mail:kaimingchen@163.com
