自身免疫性肝炎与肝源性糖尿病的相关性研究

Relationship between autoimmune hepatitis and hepatogenous diabetes

目的分析自身免疫性肝炎(autoimmune hepatitis,AIH)的血糖变化,探讨肝源性糖尿病(hepatogenous diabetes,HD)的发病机制。方法回顾性分析2000年1月-2008年4月在天津医科大学总医院确诊的Ⅰ型AIH患者的临床资料,并就空腹血糖水平与乙型病毒性肝炎(viral hepatitis type B,HBV)对比分析。结果 75例AIH患者中,38例出现高血糖(50.67%);在无肝硬化组及合并肝硬化肝功能Child-Pugh分级A级组中,AIH高血糖的发生率分别为33.33%和51.16%,高于HBV患者,二者差异具有统计学意义(P<0.05)。合并肝硬化肝功能Child-Pugh分级处于B级或C级时,二者高血糖的发生率差异无统计学意义(P>0.05)。结论 AIH患者较易出现高血糖,临床AIH患者常规血糖检查具有重要意义。AIH免疫紊乱导致肝炎的同时,也可能引起自身免疫性胰腺炎,可能是HD的发生机制之一。

Objective To analyze the blood glucose of AIH patients, and furthermore investigate the pathogenesis of hepatogenous diabetes. Methods A retrospective study was made in patients with AIH in Tianjin Medical University General Hospital from Jan. 2000 to Apr. 2008. Then the blood glucose was comparatively analyzed between AIH and HBV. Results Among 75 patients with AIH, 38 patients （50.67%） emerged hyperglycemia. The incidence rates of hyperglycemia in the group without cirrhosis and the group complicated with cirrhosis （child-pugh A） were 33.33% and 51.16% respectively, both of them were higher than those in H BV respectively, and there was statistically different between them. There was no statistical significance in the group with cirrhosis （ Child-Pugh B or C） （P 〉 0.05）. Conclusion While hyperglycemia is frequently detected in patients with AIH, routine blood glucose test is important for these patients. Patients with AIH may further emerge autoimmune pancreatitis, which may be a pathogenesy of hepatogenous diabetes.