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糖尿病对肝硬化患者并发原发性肝癌的影响 被引量:4

Effect of diabetes mellitus on concurrent primary hepatic carcinoma in patients with liver cirrhosis
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摘要 目的探讨糖尿病对肝硬化患者发生原发性肝癌(primary hepatic carcinoma,PHC)的影响。方法将2009年1月~2014年9月南昌市第九医院和江西省肿瘤医院诊断为肝炎肝硬化、酒精性肝硬化患者1110例作为研究对象,回顾性分析肝硬化合并糖尿病(DM)与未合并DM的患者发生PHC的发病率差异,按病因、年龄分层分析其相关程度,并分析糖化血红蛋白(GHb)水平与PHC发病率的关系。结果肝硬化合并糖尿病患者发生PHC为非糖尿病肝硬化患者的1.852倍,差异有统计学意义(P〈0.05)。丙型肝炎肝硬化患者糖尿病患病率高且糖尿病因素的促癌作用最显著。年龄分为〈50岁、50~70岁、〉70岁三组后,糖尿病均可增加肝硬化患者并发PHC的发病危险性(均P〈0.01)。在DM组中,糖化血红蛋白(GHb)≥8%亚组中PHC患病率为60.0%(36/60),显著高于GHb〈8%亚组的28.6%(10/56)(P〈0.05)。结论糖尿病是肝硬化患者发生PHC的危险因素,在丙型肝炎肝硬化患者最为明显。年龄分层后,糖尿病仍可增加肝硬化患者并发PHC的风险。积极控制血糖可能有助于降低肝硬化患者PHC的发病率,提高肝硬化患者的生存率。 Objective To discuss the effect diabetes mellitus on primary hepatic carcinoma(PHC) in patients with liver cirrhosis. Methods 1110 patients with hepatitis cirrhosis or alcoholic cirrhosis diagnosed in our hospitals from January 2009 to September 2014 were selected. The morbidity of PHC were reviewed and compared between patients combined with diabetes mellitus(DM) and those without DM. The degree of correlation between PHC and DM was analyzed by pathogenesis and age stratification, and the relation between glycosylated hemoglobin(GHb) level and PHC was also analyzed. Results The morbidity of PHC in patients combined with DM was 1.852 times higher than that in patients without DM, which was significantly different(P〈0.05). The prevalence rate of DM was high in patients with hepatitis C cirrhosis and the cancer-promoting effect of DM was most significant in those patients. When the patients were divided into three groups by ages(〈50 y, 50-70 y, and 〉70 y), the increase of PHC risk by DM could be observed in all three groups(all P〈0.01). In the DM group, the PHC prevalence rate was 60.0%(36/60) in the subgroup with GHb ≥8%,which was significantly higher than the 28.6%(10/56) in the subgroup with GHb8%(P〈0.05). Conclusion DM is a risk factor of PHC in patients with liver cirrhosis, which is most common in patients with hepatitis C cirrhosis. After age stratification, DM can still increase the risk of PHC. Positive control of blood glucose can help to reduce the morbidity of PHC in patients with liver cirrhosis and enhance the survival rate of those patients.
作者 戴颖 孙杨安
出处 《中国现代医生》 2016年第21期14-17,共4页 China Modern Doctor
关键词 原发性肝癌 肝炎肝硬化 酒精性肝硬化 糖尿病 糖化血红蛋白 Primary hepatic carcinoma Hepatitis cirrhosis Alcoholic cirrhosis Diabetes mellitus Glycosylated hemoglobin
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