血糖正常与糖耐量减低的乙型肝炎后肝硬化失代偿期患者再次发生食管静脉曲张破裂出血的临床比较

Comparision of esophageal variceal rebleeding in decompensated HBV cirrhosis with normal glucose or impaired glucose tolerance

目的对血糖正常与糖耐量减低的乙型肝炎后肝硬化失代偿期患者再次发生食管静脉曲张破裂出血进行临床比较。方法乙型肝炎后肝硬化失代偿期并首次食管静脉曲张破裂出血者通过口服葡萄糖耐量试验(OGTT)将84例患者分为血糖正常组(A组)与糖耐量减低组(B组),比较2组间再次发生食管静脉曲张破裂出血的情况。结果血糖正常组患者32例,8例3个月内再次发生食管静脉曲张破裂出血,17例1年内再次发生食管静脉曲张破裂出血;糖耐量减低组患者52例,25例3个月内再次发生食管静脉曲张破裂出血,45例1年内再次发生食管静脉曲张破裂出血,无论3个月内或1年内A组患者食管静脉曲张再次破裂出血发生率均明显低于B组患者(P<0.05)。结论糖耐量减低的乙型肝炎后肝硬化失代偿期患者较血糖正常者更易于发生食管静脉曲张再次破裂出血。

Objective To compare esophageal variceal rebleeding in decompensated HBV cirrhosis with normal glucose or impaired glucose tolerance.Methods By oral glucose tolerance test（OGTT）,decompensated HBV cirrhosis with first esophageal variceal bleeding with normal glucose were recruited in group A,those with impaired glucose tolerance were recruited in group B.Compared the rate of rebleeding between groups A and B.Results Group A contained 32 patients,8 patients occurred esophageal variceal rebleeding in three months,17 patients occurred esophageal variceal rebleeding in one year.Group B contained 52 patients,25 patients occurred esophageal variceal rebleeding in three months,45 patients occurred esophageal variceal rebleeding in one year.No matter in three months or in one year,the rate of esophageal variceal rebleeding of group A was notably lower than that of group B（P0.05）.Conclusion Patients of decompensated HBV cirrhosis with impaired glucose tolerance have more chance of esophageal variceal rebleeding than those with normal glucose.