肝硬化并发糖尿病的相关危险因素分析

Risk factors for diabetes mellitus in liver cirrhosis of 32 cases

目的分析肝硬化患者并发糖尿病的相关危险因素。方法对160例肝硬化患者的临床资料进行回顾性分析,对有糖尿病和非糖尿病患者,从病因、病史、实验室检查、肝功能分级和病毒载量等方面进行对照研究。结果在160例肝硬化中并发糖尿病的为32例,糖尿病患者中,中老年男性的患病率和有糖尿病家族史的患者高于无糖尿病组(P<0.05);但在体重指数和血脂方面无统计学意义(P>0.05);在糖尿病患者中,肝功能C级的患病率较A级和B级高(P<0.05);乙肝的发生率高于其它病因(P<0.05),且乙肝肝硬化患者中,糖尿病患者的病毒载量高于无糖尿病患者。结论肝硬化患者并发糖尿病的危险性与年龄、饮酒、有无糖尿病家族史等有关,肝功能状况和乙型肝炎病毒感染可作为肝硬化并发糖尿病的相对独立危险因素。

Objective To analyze the risk factors of liver cirrhosis patients with diabetes mellitus. Methods 160 liver cirrhosis patients were retrospectively analyzed to assess the effect of etiology, family history of DM, experimental test, grading of liver function and viral load on the occurrence of DM. Results 32 of the 160 were diabetic （20.0%）. Patients with diabetes were higher than those without diabetes in sex ratio, mean age, family history of diabetes （ P 〈 0.05 ）, but no significant difference in BMI and glycemia. There were also significant differences among the grading of liver function in the diabetes patients. The prevalence of diabetes in HBV infection is higher than in other reasons caused liver cirrhosis. And the viral load is higher in diabetes group than in non - diabetes group. Conclusion The findings indicate that the sterner sex, older age, alcohol and family history of diabetes help identify those cirrhosis patients who might have potential risk factors for development of DM. HBV infection and liver function may be the relatively independent risk factors.