血糖水平与肝衰竭患者预后的关系

Relationship Between Blood Glucose Levels and The Prognosis of Patients with Liver Failure

目的:观察肝衰竭患者的空腹血糖水平,探讨其与肝衰竭预后的关系。方法:对98例肝衰竭患者的临床资料进行回顾性分析,分别以肝衰竭临床分类和空腹血糖水平分组,评价空腹血糖水平在判断肝衰竭预后中的临床意义。结果:肝衰竭患者糖代谢紊乱发生率高,但肝衰竭临床分类与血糖水平变化无关(P>0.05);肝衰竭患者出现血糖异常组的病死率明显高于血糖正常组,且空腹血糖水平越低,病死率越高(P<0.01),并发症发生率也越高(P<0.05);低血糖组肝性脑病、肝肾综合征、电解质紊乱等发生率明显高于正常血糖组,高血糖组中原发性腹膜炎的发生率明显高于血糖正常组。结论:血糖水平与肝衰竭患者的预后密切相关,监测空腹血糖水平对于判断肝衰竭的预后和指导治疗有重要意义。

Objective： To observe fasting blood glucose levels in patients with liver failure,and to explore the relationship between blood glucose and liver failure prognosis. Methods： The clinical data of 98 cases of liver failure patients in our hospital were retrospectively analyzedand were divided into liver failure of clinical classification group and fasting blood glucose level group. The clinical significance of fasting blood glucose levels in determining the prognosis was evaluated.Results： Glucose metabolism disorder was prevalent in patients with liver failure,but liver failure clinical classification had nothing to do with blood glucose level（ P〈0. 05）. The mortality of blood glucose in patients with liver failure in abnormal group was significantly higher than that in normal blood glucose group. The lower the fasting blood glucose level,the higher the fatality rate（ P〈0. 01） and the higher the rate of complications（ P〈0. 05）; the incidences of hypoglycemia group with hepatic encephalopathy,hepatorenal syndrome and electrolyte disorder were significantly higher than those of normal blood glucose group; the incidence of idiopathic peritonitis in hyperglycemia group was obviously higher than that of normal blood glucose group. Conclusion： Blood glucose level is closely related to the prognosis of patients with liver failure. Monitoring the fasting blood glucose level for judging the prognosis of liver failure and guiding treatment has important significance.