肝硬化合并肝源性糖尿病56例临床分析

Clinical analysis of 56 cases of hepatic cirrhosis associated with hepatogenous diabetes

目的探讨肝源性糖尿病的临床特点和治疗方法。方法回顾性分析56例肝源性糖尿病患者的临床资料。结果肝源性糖尿病的血糖升高程度与肝功能损害程度呈正相关,予胰岛素治疗,症状改善、肝功能好转出院42例;6例因肝硬化并发症而死亡,空腹血糖均>11.1mmol/L;自动出院8例。结论肝源性糖尿病主要继发于肝硬化,临床上往往无典型的"三多一少"症状,主要予胰岛素治疗,大部分患者血糖随肝功能减轻而好转。

Objective To explore the clinical features and therapy of hepatogenous diabetes. Methods The data of 56 cases of hepatogenous diabetes were analyzed retrospectively. Results The level of blood glucose was positively correlated with the degree of damage of liver function. Insulin treatment could improve the clinical features and liver function of 42 cases. Six cases died of complications of liver cirrhosis （fasting glucose〉 11.1 mmol/L）. Eight cases were against advice discharge. Conclusion Hepatogenous diabetes is mainly secondary to hepatic cirrhosis, and the clinical symptoms are not typical. Insulin is used as a first-line agent to treat diabetes in cirrhotic patients. The insulin treatment could control blood glucose in majority of patients.