慢性乙型肝炎患者代谢异常的表现形式分析

The Analysis of Expression of the Metabolism Abnormal Manifestations in Patients with Chronic Hepatitis B

目的探讨慢性乙型肝炎(CHB)患者代谢异常的表现形式。方法分析110例CHB患者各代谢指标的异常率。结果 1)CHB中93.64%存在HOMA-β减退,60.00%者平均减退70.00%以上;2)59.09%患者HOMA-IR升高,平均1.82;3)35.45%有糖代谢异常;4)52.73%至少有一种血脂成份异常,以HDL-c异常常见;5)少部份患者合并脂肪肝、高血压病或高尿酸血症。结论 CHB患者普遍存在胰岛β细胞功能减退及不同程度的胰岛素抵抗,糖脂代谢异常及脂肪肝亦常见,少见高血压及尿酸代谢异常。

Objective To analyze the expression of the metabolic abnormal manifestations in the patients with chronic hepatitis B（CHB）.Methods The metabolism abnormal manifestations and incidence of each manifestation in110 cases with CHB were analyzed by the prospective cross-section research.Results 1）The pancreas island beta cell function was dropping in the major part of patients（103/110,93.64%）.And the average value of the pancreas island beta cell function decreased above 70.00%in the 60.00%（66/110）cases;2）The insulin resistance（IR）had increased and the average value of HOMA-IR was 1.82 in the over half number of them（65/110,59.09%）.What＇s more,the obvious increasedly average value of HOMA-IR was 3.07 in 16cases;3）39patients which were more 1/3of the cases,had the glycometabolism＇s abnormal manifestation;4）Nearly half number of patients（50/110,45.45%）had at least one kind of dyslipidemia,which normally was HDL-c abnormal.It either reduced（35/110,31.82%）or elevated（23/110,20.91%）.Here,15.45%of the cases（17/110）had TC and the LDL-c ascension,And the 12.73%of the cases had TG ascension;5）Few partial patient had fatty liver（16/110,14.55%）,hypertension（13/110,11.82%）or hyperuricaemia（10/110,9.09%）.Conclusion The loss of the pancreas island beta cell function and the insulin resistance in varying degree in the patient with CHB are normally found.So are the abnormal glucose metabolism and lipid metabolism,like the fatty liver,while the hypertension and uric acid metabolism abnormal are found unusually.