肝硬化并肝源性糖尿病临床特征分析

目的分析肝硬化患者中并发糖尿病的临床特征，探讨肝源性糖尿病发生的相关因素，归纳其临床特点，并作出临床评价。方法对我院35例肝硬化并发糖尿病患者与与同期住院36例肝硬化无糖尿病患者从临床症状、实验室检查、治疗效果等方面进行对照分析。结果肝硬化患者普遍存在糖耐量异常，糖尿病发病率约为49％，并发糖尿病以消化症状为主要表现，很少出现典型的“三多一少”症状；肝功能越差，糖尿病发生率越高；糖尿病亦会加重肝功能损害，并发上消化道出血、肝性脑病、自发性腹膜炎的发生率与对照组比较，差异有显著性（P〈0．05）。结论肝硬化并发糖尿病临床表现复杂，应积极治疗原发肝病及适当控制血糖，可减少并发症的发生,延长患者寿命。

Analysis of Clinical Characteristics of hepatogenous Diabetes in Patients with Liver Cirrhosis

Objective To explore eorrlation factors of hepatogenous diabetes, sum up its clinical characteristic and then make the clinical evaluation. Methods Thirty-five cases of hepatogenic diabetes with liver cirrhosis served as the experimental group and 36 cases of liver cirrhosis without diabetes served as the control group. Their clinical symptoms ,laboratory examination and complications were cross-check analyzed. Results Patients with liver cirrhosis generally have abnormal glucose tolerance. The incidence of diabetes is about 49%. In most cases, the main symptom of hepatogenous diabetes was gastrointestinal discomfort,and few patients had typical diabetic symptoms. The worse liver function, the higher incidence of diabetes is, and vice versa, the diabetes may aggravate the liver function, so the incidence of complications（ upper gastrointestinal bleeding,hepatocerebral disease and spontaneous peritonitis） in hepatogenous diabetics was higher than that in the control group （ P 〈 0.05 ）. Conclusions The clinical manifestation of hepatogenous diabetes with liver cirrhosis was very complicated. Active treatment on primary hepatic disease and adequate antihyperglycemic treatment can reduce the incidence of complications and prolong the patients＇ survival time.