糖尿病性肝损害相关因素分析

Analysis on factors related to diabetic hepatic damage

目的:了解糖尿病及伴酮症或酮症（DK）或酮症酸中毒（DKA）时肝损害的情况,进一步探讨糖尿病肝损害的相关因素。方法:在354例糖尿病患者中,把有肝损害的52例分为有或无DK或DKA两组,做丙氨酸转氨酶（ALT）,天冬氨酸转氨酶（AST）及总胆红素（TB）值的比较。把伴DK或DKA的57例分为有或无肝损害两组,观察肝损害与二氧化碳结合力（CO2CP）,尿素氮（BUN）,血糖（GLU）及血浆渗透浓度（OSM）水平的关系。结果:糖尿病肝损害的发生率为14.68％,伴DK或DKA时发生率增至29.82％;伴DK或DKA组ALT,AST,TB升高显著高于无DK或DKA组（P<0.05）;伴DK或DKA者有肝损害组CO2CP明显低于无肝损害组;BUN,GLU,OSM明显高于无肝损害组,二组均有显著性差异（P<0.01）。结论:酸中毒和脱水是引起糖尿病肝损害的重要因素,肝功能损害程度与糖尿病病情严重程度相关。

ve:To understand hepatic damage in diabetes with diabetic ketosis(DK) or ketoacidosis( DKA) and to investi-gate the related factors with the damage. Methods:From 354 patients with diabetes, 52 cases of diabetic hepatic damage were selected and devided into the group with DK and the group with DKA. Alanine aminotransferase( ALT) ,aspartate aminotransferase( AST) and total bilirabin(TB) were measured and compared between these two groups. Another 57 cases with DK or DKA were divided into two groups, one with hepatic damage, the other without. And their carbon dioxide combining power( CO2CP) ,urea nitrogen( BUN) , glucose (GLU) ,osmotic pressure( OSM) levels were determined. Results:The incidence of hepatic damage was 14. 68% in patients with dia-betes; those with DK or DKA accounted for 29. 82% and in these cases the levels of ALT, ASY and TB were higher than those without DK or DKA (P <0. 05) ;the level of CO2CP was significantly lower. Concentrations of BUN,GLU and OSM also became signficantly higher than in the patients without hepatic damage ( P< 0.01). Conclusions: Acidosis and dehydration were considered as two major risk factors for diabetic hepatic damage. The degree of hepatic damage was highly correlated to the severity of diabetes.