108例肝源性糖尿病临床分析

目的：探讨肝源性糖尿病的临床特点、治疗及与慢性肝病临床类型的关系。方法：对肝源性糖尿病108例临床资料进行回顾性分析。结果：肝源性糖尿病的发生率慢性肝炎为28．7％（31／108），慢性重型肝炎为19，4％（21／108），肝硬化为51．9％（56／108），与慢性肝炎、慢性重型肝炎相比，差异有显著性（P〈0．05）。血糖重度升高的比率，肝硬化为50％，与慢性肝炎、慢性重型肝炎相比，差异有显著性（P〈0．05）。35．2％（38／108）的肝源性糖尿病患者空腹血糖正常．餐后2小时血糖升高。通过饮食控制、保肝、抗病毒和（或）胰岛素治疗，除6例死于肝癌或重型肝炎外，余患者血糖水平均得到有效控制。结论：糖尿病轻重与肝损害程度成正相关。症状多不典型，须常规检查空腹、餐后血糖。经饮食控制、保肝、抗病毒和胰岛素治疗后。效果较好。

Clinical analysis of 108 cases of hepatogenous diabetes mellitus

Objective:To explore the clinical characteristics and treatment methods of hepatogenous diabetes mellitus as well as its relationship with clinical type of chronic liver disease. Methods:From June 2002 to June 2005,1415 patients with chronic virus hepatitis were admitted to our hospital. Data of 108 patients with hepatic diabetes mellitus were collected from patients' records and analyzed retrospectively.Results:The incidences of hepatogenous diabetes mellitus were 28.7% (31/108) in chronic hepatitis and 19.4% (56/108) in severe chronic hepatitis respectively; hepatocirrhosis accounted for 51.9% cases of hepatogenous diabetes mellitus and showed a significant difference comparing with that in chronic hepatitis and severe chronic hepatitis(P<0.05). Higher elevated plasma glucose levels in patients with cirrhosis (50%) than that in chronic hepatitis and severe chronic hepatitis were observed (P<0.05). 35.2% (38/108) cases of hepatic diabetes mellitus presented normal fasting plasma glucose levels, but elevated plasma glucose levels two hours after meal. Ideal plasma glucose level could be achieved in all patients with hepatogenous diabetes mellitus by combination of diet, preemptive liver protection therapy, antivirus drugs and insulin preparations administration except 6 died of hepatocellular carcinoma or severe hepatitis. Conclusion:Diabetes is common complications of chronic liver disease, especially in those with cirrhosis; the severities of diabetes mellitus are positively related to degrees of liver function damage.Most of patients present mild and atypical symptoms and diagnosis confirmation relied on regular examination of plasma glucose. A combination of diet, preemptive liver protection therapy,antivirus drugs and insulin preparations administration shows a desired effect in dealing with hepatogenous diabetes mellitus.