慢肝患者糖代谢异常的相关因素分析

ANALYSIS ON RELATIVE FACTORS OF DISTURBANCES OF GLUCOSE METABOLISM OF PATIENTS WITH CHRONIC HEPATIC DISEASES

目的 :探讨慢肝患者糖代谢异常的发病机理。方法 :对 35例慢性肝病患者进行糖耐量试验 ,同步应用放免法检测 IRI、C肽、K1 - 2 、R1 - 2 ;计算 ISI并与年龄、K1 - 2 、R1 - 2 以及各时相 IRI、C肽进行多元相关分析。结果 :慢肝特别是肝硬化病人呈现进行性血糖升高。当发展到糖耐量损害时 ,血糖高峰移行至餐后 1～ 3h,伴随餐后 2～ 3h高 IRI、 C肽血症、R1 - 2 下降、胰岛素敏感指数减低并与 IRI、C肽呈负相关 ,与年龄、K1 、R2 呈正相关。结论 :慢肝患者糖耐量损害是肝脏以及靶组织受体和受体后胰岛素抵抗等综合因素相互作用的结果。

Objective:To explore the pathogenesis of the disturbances of glucose metabolism of the patients with chronic hepatic diseases Methods:①The OGGT was performed with serum IRI and C peptide tested synchronously by RIA method and the insulin receptors of erythrocyte assayed by radioactivity analysis in the patients with chronic hepatic diseases;②ISI was counted and multi factor correlation analysis was performed between the ISI and IRI,C peptide,K 1 2 ,R 1 2 and ages Results:The patients with chronic hepatic diseases presented progressive serum glucose rise,especially in cirrhosis;When their disease developed to glucose intolerance,their serum glucose peak transfer to postprandial 1-3h with high serum IRI,C peptide at postprandial 2~3 h and their R 1 2 and ISI dropped;ISI had negative correlation with IRI,C peptide and positive correlation with age,K 1 and R 2 Conclution:The glucose intolerance of the patients with chronic hepatic diseases resulted from hepatic insulin resistance,receptor and postreceptor insulin resistance of peripheral tissue