肝源性糖尿病40例临床分析

目的探讨肝源性糖尿病的临床特征及治疗方法。方法回顾性分析170例肝硬化患者的临床资料。结果170例肝硬化合并肝源性糖尿病40例，发生率23．5％，各型肝硬化均可发生；典型的“三多”症状多不明显；10例人院时空腹血糖≥7．0mmol／L，餐后2h血糖均≥11．1mmol／L；总胆红素水平高，血清白蛋白、胆碱脂酶、总胆固醇低。给予糖尿病饮食及小剂量的α-葡萄糖苷酶、短效胰岛素治疗；26例血糖正常，8例好转（血糖6．1～11．1mmol／L）；6例死亡。结论肝硬化患者易发生糖代谢紊乱，有其临床特点，治疗要兼顾肝损害和糖尿病两个方面。

The clinical features and treatment for 40 cases with hepatogenous diabetes

Objective To discuss the clinical features and treatment of hepatogenous diabetes. Method Retrospective analysis was conducted in January 2002-April 2009 170 cases of clinical data in patients with liver cir-rhosis. Result 170 cases of liver cirrhosis 40 cases of diabetes, the incidence was 23.5% ,various types of cirrhosis may occur;typical "over three" obvious symptoms; 10 cases admitted tohospital when fasting blood glucose≥7.0 mmol/L, postprandial 2 hours blood glucose were ≥1.1 mmol/L;high level of total bilirubin,serum albumin,cholin-esterase,total cholesterol low. Given to diabetic diet and small doses of ct-glucosidase, short-acting insulin treatment; 26 cases of normal blood glucose, improvement in 8 cases (blood glucose 6. 1～11.1 mmol/L) ;6 deaths. Conclusion Prone to occur in patients with liver cirrhosis glucose metabolism disorders, its clinical features, treatment of liver damage and the need to take into account two aspects of diabetes, the use of insulin as the main.