安徽铜陵市血吸虫病患者肝纤维化、糖尿病患病情况调查

Investigation of liver fibrosis and diabetes mellitus in schistosomiasis patients in Tongling of Anhui province

目的调查安徽省铜陵市血吸虫病患者肝纤维化、糖尿病患病情况。方法调查2015年1月～2016年12月安徽省铜陵市疾控中心登记的100例血吸虫病患者肝纤维化、糖尿病患病情况,分析其发病特点。结果 100例血吸虫病患者,其中肝纤维化30例(30.00%),糖尿病16例(16.00%),肝纤维化糖尿病12例(12%),血吸虫肝纤维化饮酒、家族肝病史、腹水、自发性腹膜炎、黄疸所占比例均高于非肝纤维化患者(P<0.05),其血吸虫病史长于非肝纤维化患者,空腹血糖(FPG)、餐后2h血糖(2h PG)、谷草转氨酶(AST)、天门冬氨酸氨基酸转移酶(ALT)、总胆红素(TBil)水平高于非肝纤维化患者,血总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平低于非肝纤维化患者(P<0.05);血吸虫糖尿病患者饮酒、多尿、多饮及体重减轻所占比例均高于非糖尿病患者(P<0.05),其血吸虫病程长于非糖尿病患者,FPG、2h PG、AST、ALT水平均高于非糖尿病患者,血清TC、HDL-C水平低于非糖尿病患者(P<0.05)。结论安徽省铜陵市血吸虫病患者肝纤维化、糖尿病患病率较高,且血吸虫糖尿病的发生可能与肝纤维化存在一定的关联。

Objective To investigate the prevalence status of liver fibrosis and diabetes mellitus in patients with schistosomiasis in Tongling area of Anhui province. Methods One hundred cases of liver fibrosis and diabetes mellitus registered in the Center for Disease Control in Tongling city were included from January 2015 to December2016,and analyzed for the disease associations. Results In the 100 patients with schistosomiasis,30（ 30%） were liver fibrosis,16（ 16%） diabetes mellitus,and 12（ 12%） complicated with liver fibrosis and diabetes. The proportion of drinking history and family history of liver diseases as well as incidences of ascites,spontaneous peritonitis and jaundice was higher in patients with hepatic fibrosis from schistosomiasis than in those without liver fibrosis（ P〈0. 05）. Patients with liver fibrosis from schistosomiasis had longer disease history,higher serum levels of fasting blood glucose（ FPG）,2 hour postprandial blood glucose（ 2 h PG）,aspartate aminotransferase（ AST）,alanine aminotransferase（ ALT） and total bilirubin（ TBil）,yet lower levels of total cholesterol（ TC）,triglyceride（ TG）,high density lipoprotein cholesterol（ HDL-C） and low density lipoprotein cholesterol（ LDL-C） than those absent of hepatic fibrosis patients（ all P〈0. 05）. The percentage was higher in diabetes patients associated with schistosomiasis than in those without diabetes regarding the alcohol use,incidences of polyuria,polydipsia and weight loss（ P〈0. 05）.Diabetes patients from schistosomiasis had longer course of schistosomiasis,higher levels of FPG,2 h PG,AST and ALT,yet lower levels of serum TC and HDL-C than schistosomiasis patients without diabetes（ all P〈0. 05）.Conclusion The schistosomiasis patients in Tongling of Anhui province have higher prevalence of liver fibrosis and diabetes mellitus,and schistosomiasis complicated with diabetes may be the result of liver fibrosis.