重型肝炎糖代谢紊乱的临床分析及防护对策

Clinical Analysis of Metabolic Disorder of Glucose in Patients with Grave Hepatitis and the Countermeasures

目的探讨重型肝炎患者糖代谢紊乱的临床意义,为针对性的防护提供依据,减少其病死率。方法检测重型 肝炎(53例)、慢性肝炎(51例)、急性肝炎(44例)患者空腹血糖,并与30例正常人进行比较。结果重型肝炎患者 空腹血糖明显低于慢性、急性肝炎和正常人(均P<0.01);低血糖发生率明显高于急、慢性肝炎患者(均P<0.01); 死亡者空腹血糖明显低于存活者(P<0.01)。结论重型肝炎患者存在明显的糖代谢紊乱,常发生空腹低血糖,早 期识别低血糖先兆、合理饮食、做好健康宣教是预防的关键;检测空腹血糖对判断重型肝炎危重程度和评估预后有 重要意义。

Objective To study the clinical significance of metabolic disorder of glucose in patients with grave hepatitis and provide the measures for prevention and care. Methods The levels of serum glucose in 53 patients with grave hepatitis, 51 patients with chronic hepatitis, and 44 patients with acute hepatitis were determined and compared with those in 30 normal controls. Results The levels of fasting blood glucose (FBG) in patients with grave hepatitis were significantly lower than those in patients with chronic, acute hepatitis and controls (all P<0.01). The incidence of hypoglycemia in patients with grave hepatitis was significantly higher than that in patients with chronic hepatitis (all P<0.01). The FBG levels in the patients who died of grave hepatitis were also significantly lower than those in survivors (P<0.01). Conclusion Metabolic disorder of glucose and lower FBG often happens in patients with grave hepatitis. How to identify the sign of hypoglycemia in the early stage, suitable meal and publicity and education is the key for prevention. Detecting FBG is helpful for judging the severity of hepatitis and its prognosis.