血糖水平对慢性重型乙型肝炎预后的影响

The impact of blood glucose levels on the prognosis of chronic severe hepatitis B

目的探讨空腹血糖水平对慢性重型乙型肝炎预后的影响。方法回顾分析387例住院治疗的慢性重型乙型肝炎患者，研究空腹血糖水平时疾病预后的影响。结果387例慢性重型乙型肝炎中，血糖低于2．8mmol／L者59例（15．2％），血糖在2．8～3．9mmol／L者138例（35．7％），血糖在3．9～6．1mmol／L者190例（49．1％）。不同空腹血糖组间的男女构成比、平均年龄差异均无显著；重型肝炎临床分期即早、中、晚期与空腹血糖水平密切相关，临床分期越晚，低血糖发生率越高（P〈0．01）；空腹血糖水平与疾病严重程度及预后密切相关，空腹血糖水平越低，平均总胆红素峰值越高，平均凝血酶原活动度谷值越低，临床好转率亦越低（均P〈0．01）。结论慢性重型乙型肝炎患者常易发生低血糖，其空腹血糖水平与临床分期、疾病严重程度及临床预后密切相关。

Objective To evaluate the impact of fasting blood glucose levels on the prognosis of chronic severe hepatitis B. Methods A total of 387 hospitalized patients with chronic severe hepatitis B in our hospital from January 2002 to December 2007 were analyzed. Results Of all the 387 patients with chronic severe hepatitis B, 59 （ 15.2% ） patients were hypoglycemia with fasting blood glucose less than 2. 8 mmol/L, 138 （35.7%）patients with fasting blood glucose from 2. 8 mmol/L to 3.9 mmol/L and the remaining 190（49. 1% ） normal blood glucose levels. There were no significant differences in constituent ratio of male and female, in average ages among three fasting blood glucose groups. Later was clinical stages, more was hypoglycemia（P value 〈 0. 01 ）. Lower fasting blood glucose levels, higher peak value of total bilirubin and lower valley value of prothrombin activity, lower improvement rate（ each P value 〈 0. 01 ）. Conclusion The patients with chronic severe hepatitis B have a higher proportion of hypoglycemia. There is a close relationship between fasting blood glucose levels and the clinical stages, severity and prognosis.