肝炎后肝硬化不同临床分期患者糖代谢改变的临床研究

目的探讨肝炎后肝硬化不同临床分期患者糖代谢变化的规律及其临床意义。方法对肝硬化代偿期和失代偿期病人的血糖及胰岛素水平进行为期3年的临床监测,并与正常对照组进行对比分析。结果肝硬化代偿期组患者的血糖及胰岛素水平与正常对照组比较差异无显著性(P>0.05);失代偿期病人空腹血糖水平轻度升高,与代偿期组及对照组相比较差异无显著性(P>0.05);但出现程度不一的糖耐量异常和胰岛素水平升高,其血糖及胰岛素水平的变化显著高于肝硬化代偿期组与正常对照组(P<0.01)。结论糖代谢的调节在肝硬化代偿期内并无明显异常,而肝硬化发展到失代偿期时,则出现程度不一的糖代谢障碍。早期有效的保护肝功能和合理的营养支持治疗是预防肝源性糖代谢障碍的关键。

Clinical study of the glycometabolism disorder in patients with different stages of posthepatitic cirrhosis

Objective To investigate the glycometabolism changes and clinical significance in patients with different stages of posthepatitic cirrhosis. Methods The blood sugar and insulin levels in patients with compensatory phase and decompensatory phase cirrhosis were monitored for 3 years and a comparison to the control group has also been done. Results The blood sugar and insulin levels in patients with compensatory phase were almost the same with those in the control group, there were no statistically significant difference (P>0.05); the fasting blood sugar level increased slightly in patients with decompensatory phase cirrhosis, and there was no statistically significant difference in comparison to the compensatory phase group and the control group (P>0.05); but showed different degrees of glucose tolerance disorder and elevated insulin, the blood sugar and insulin levels were significantly higher than those in the compensatory phase cirrhosis group and the control group (P<0.01). Conclusion Glycometabolism regulation was normal in compensatory phase cirrhosis, while the cirrhosis developed to the decompensatory phase, which will result in different degrees of glycometabolism disorder. Early effective protection liver function and reasonable nutrition support is the key to prevent the hepatogenic glycometabolism.