30例肝硬化患者胰岛素分泌和糖代谢的变化

OBSERVATION ON INSULIN SECRETING FUNCTION AND GLUCOSE METABOLISM IN LIVER CIRRHOSIS PATIENTS (AN ANALYSIS OF 30 CASES)

目的：探讨肝硬化患者胰岛素抵抗及胰岛素分泌功能和糖代谢的改变。方法：对３０例肝硬化患者和２６例正常人进行口服葡萄糖耐量及胰岛素释放试验，以Ｈｏｍａ模型计算胰岛素抵抗指数（ＩＲＩ）及胰岛β细胞功能指数（ＨＢＣＩ），并对结果进行分析。结果：肝硬化组糖耐量较对照组显著降低（Ｐ＜００１），血清胰岛素水平增高，并呈现释放延迟，ＩＲＩ及ＨＢＣＩ指数高于对照组。结论：肝硬化患者存在胰岛素抵抗、肝源性糖耐量异常及内源性高胰岛素血症或胰岛素释放延迟，与肝功能损害有关。

Objective:To evaluate the effect of insulin resistance and secretion function on liver cirrhosis patients' glucose metabolism. Methods:Thirty liver cirrhosis patients and 26 healthy individuals were enrolled in the oral glucose tolerance test(OGTT)and insulin releasing test.Insulin resistance index(IRI)derived from Homa model and β cell function index(HBCI) were used for analysis.Results:Significant reduction in OGTT was observed while a rise in IRI and HBCI was found in the liver cirrhosis group in comparison with the control group( P <0 01).Serum insulin level was increased and insulin release was delayed in the patient group.Conclusion:There are insulin resistance,hepatogenous glucose tolerance impairment,endogenous hyperinsulinemia and insulin releasing delay in the liver cirrhosis patients,which is associated with hepatic dysfunction.