乙型肝炎肝硬化合并糖尿病患者糖脂代谢分析

目的：分析乙型肝炎肝硬化合并糖尿病患者糖脂代谢的特点及其与Child分级的关系。方法：检测肝硬化合并2型糖尿病糖尿病组（A组）、2型糖尿病无肝硬化组（B组）患者的血脂（Tch、TG、HDL—C、LDL—C、apoA、apoB）、空腹血糖（FBG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1C）、C肽及餐后2hc肽水平，同时探讨其与Child分级的关系。结果：（1）A组患者FPG、空腹c肽、餐后2hC肽水平均高于B组（P〈0．05）。（2）A组患者HDL—C、LDL—C、apoA、apoB水平均低于B组（P〈0．05）。随着肝功能child分级的上升，A纽患者HDL-C、LDL—C、apoA、apoB水平进一步下降．尤以apoB及HDL-C最为显著。结论：肝硬化合并2型糖尿病患者存在较严重的胰岛素抵抗，其脂代谢紊乱主要以HDL—C、apoB显著降低为特点．下降程度与肝功能child分级有关。

Glucose and lipid metabolism in patients with hepatitis B-associated liver cirrhosis who had diabetes mellitus

Objective：To determine the characteristics of glucose and lipid metabolism in patients with hepatitis B-associated liver cirrhosis who had diabetes mellitus and to link with the Child stage. Methods： Patients with type 2 diabetes were alloeated to concomitant liver cirrhosis group （ group A） and cirrhosis-free group （group B ） and tested for blood lipids （total cholesterol TCh ], total glycerol TG ], low-density lipoprotein-eholesterol LDL-C ], high-density lipoprotein-eholesterol HDL-C], apoA and apoB）, fasting blood glucose （FBG） , postprandial 2h blood glucose （2hPG）, glycosylated hemoglobin （HbA1 C） , fasting C peptide and postprandial 2 h C peptide, thus allowing to determine their correlation with Child Stage. Results： Group A had high levels of FPG, fasting C peptide and postprandial 2h C peptide （ all P 〈 0.05 ） yet lower levels of HDL- C, LDL-C, apoA and apoB （ all P 〈 0.05 ）. The increased Child stage was associated with reduced levels of LDL-C, apoA, HDL-C and apoB, particularly the latter two indices, in group A. Conclusion： Insulin resistance is remarkable in patients with liver cirrhosis and concomitant type 2 diabetes mellitus who are characterized by aberrant lipid metabolism （ i. e. HDL-C and apoB） , the reduction of which is correlated with Child stage.