HCV感染患者糖脂代谢与病情的变化规律研究

Study on the variation of glucose and lipid metabolism in patients with HCV

目的探讨慢性HCV感染以伴发胰岛素抵抗相关性肝纤维化的流行病学特征。方法选取HCV慢性感染者的血标本进行糖脂代谢的相关指标测定,根据HCV慢性感染者病情的进展程度分为肝脏炎症、纤维化、肝硬化及肝细胞肝癌分组,与健康体检对照组比较,以及各组之间的比较。结果胰岛功能两项(CPS和IRI)和空腹血糖(GLU)、以及血脂四项水平在病毒携带组、肝炎组、肝硬化组总体趋势变化中呈上升趋势,肝硬化到肝癌组中的水平却下降;其中CPS和IRI水平升高到肝炎组有统计学差异(P<0.05),GLU水平升高到肝硬化组有统计学差异(P<0.05);血脂四项中,肝硬化组和肝癌组中CHOL水平明显减低,肝癌组中TG、HDL水平升高,LDL水平在组间起伏较大。结论HCV慢性感染过程中常发生胰岛素抵抗,且糖脂代谢异常和肝纤维化之间存在明显的相关性,与病情的发展程度呈正相关。

Objective To investigate the epidemiological characteristics of HCV chronic infection with insulin resistance associated liver fibrosis by investigating glycolipid metabolism in patients with chronic hepatitis c(HCV).Methods Blood samples of chronic HCV infected patients were selected for the determination of relevant indicators of glucose and lipid metabolism.According to the degree of disease progression of chronic HCV infected patients,they were divided into groups of liver inflammation,fibrosis,cirrhosis and hepatocellular carcinoma,which were compared with the control group on physical examination,as well as between each group.Results The levels of two islet function items(CPS and IRI),Empty stomach blood glucose(GLU)and four lipid items showed an increasing trend in the overall trend of the virus carrying group,the hepatitis group and the liver cirrhosis group,while the level of liver cirrhosis to liver cancer group suddenly decreased.There was a statistical difference between the CPS and IRI levels in the chronic hepatitis group(P<0.05),and the GLU levels in the cirrhosis group(P<0.05).Among the four lipid terms,the levels of CHOL in the liver cirrhosis group and the liver cancer group were significantly reduced,the levels of TG and HDL in the liver cancer group were increased,and the levels of LDL fluctuated significantly between the groups.Conclusion Insulin resistance often occurs during chronic infection of HCV,and there is an obvious correlation between abnormal glucose and lipid metabolism and liver fibrosis,which is positively correlated with the degree of disease development.