乙型肝炎肝硬化患者2型糖尿病流行情况及相关因素研究

Prevalence of Type 2 Diabetes Mellitus in HBV-related Liver Cirrhosis

目的调查分析乙型肝炎肝硬化（HBV-related Liver Cirrhosis）患者2型糖尿病的流行情况，并探讨与2型糖尿病发病相关的危险因素。方法调查了济南市传染病医院504例住院成年乙型肝炎肝硬化患者的人口资料、血生化、HBV血清学及病毒学指标。结果504例患者中，55例合并2型糖尿病，总的患病率为10．91％。在20～40岁、41～50岁、51～60岁及大于60岁年龄段，糖尿病患病率分别为4．95％、13．25％、13．22％及7．94％（P=0．104）。单因素分析显示合并糖尿病的患者，在城乡分布上有显著性差异，城市、城镇、农村患者的患病牢分别为8．31％、12．09％和19．32％（P=0．012）：多因素Logistic回归分析显示：城市居民、ALB异常、TG异常是乙型肝炎肝硬化并发糖尿病的独立危险因素，而总胆红素（TBil）〉50μmol／L是保护性因素。结论城市居民、TG升高、ALB降低是乙肝肝硬化并发糖尿病的独立危险因素，而反映肝脏损伤的TBil升高为并发糖尿病的保护性因素。

Objective To investigate the prevalence of type 2 diabetes mellitus （DM） in adult patients with Hepatitis B virus （ HBV）-related liver cirrhosis and risk factors associated with presence of DM. Methods 504 patients with HBV-related liver cirrhosis hospitalized in Jinan Infectious Disease Hospital were investigated. Demographic data and biochemical parameters of the patients were analyzed using SPSS software. Results The overall prevalence rate of DM in HBV-related liver cirrhosis was 10. 91%. Among 20 -40,41 -50,51 -60, and 〉 60 years old age groups, the prevalence rate were 4.95 % , 13.25 % , 13.22%, and 7.94% , respectively （ P = 0. 104）. Univariate analysis showed that DM was associated with city resident. Multilogistic regression analysis showed city resident,ALB abnormal and TG abnormal were independent risk factors and TBil 〉 50 μmoL/L was protective factor of the presence of DM. Conclusion City resident,ALB abnormal and TG abnormal are independent risk factors and TBil 〉 50 μmoL/L is protective factor of the presence of DM in HBV-related liver cirrhosis.