乙型病毒性肝炎不同状态合并2型糖尿病临床特征

Clinical analysis of different viral hepatitis B status with type 2 diabetes

目的探究乙型病毒性肝炎不同状态合并2型糖尿病患者的临床特点。方法对62例乙型肝炎病毒携带合并2型糖尿病(组1)、129例乙型病毒性肝炎合并2型糖尿病(组2)和83例乙型病毒性肝炎肝硬化合并2型糖尿病(组3)患者的临床资料进行回顾性分析。结果各组间在性别和年龄上差异有统计学意义(χ^(2)=11.133、P=0.004,F=7.640、P=0.001)。3组研究对象糖化血红蛋白(HbA1c)、总胆固醇(Tch)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血清白蛋白(ALB)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)和总胆汁酸(TBA)水平差异有统计学意义(F=4.028、P=0.019,F=4.140、P=0.017,F=3.172、P=0.044,F=6.701、P=0.002,F=53.156、P<0.001,F=4.920、P=0.008,F=4.173、P=0.017,F=7.181、P=0.001,F=9.170、P<0.001)。进一步两两比较,肝炎肝硬化组HbA1c、Tch、LDL-C、ALB水平降低,但TBIL、IBIL、TBA增高,分别与另2组比较差异有统计学意义(P<0.05);组2空腹血糖(FBG)、HDL-C水平最高,前者高于组1,后者高于组3。各组糖尿病并发症居前三的都是周围神经病变、糖尿病肾病和糖尿病视网膜病变。结论乙型病毒性肝炎合并2型糖尿病时其不同状态间具有不同的疾病特点,主要体现在携带状态Tch、TG、LDL-C高水平,肝炎状态FBG高水平,肝炎肝硬化状态HbAlc、ALB低水平但胆红素、胆汁酸水平高,在糖尿病并发症方面均以周围神经病变、糖尿病肾病和糖尿病视网膜病变为主。

Objective To study the clinical feature of different viral hepatitis B status with type 2 diabetes.Methods A retrospective analysis was carried out on 62 hepatitis B virus carriers with type 2 diabetes(group 1),129 viral hepatitis B patients with type 2 diabetes(group 2)and 83 viral hepatitis B cirrhosis patients with type 2 diabetes(group 3).Results The differences in gender and age among the three groups were significantly different(χ^(2)=11.133,P=0.004 and F=7.640,P=0.001).The levels of HbA1c,total cholesterol(Tch),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),serum albumin(ALB),total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL)and total bile acid(TBA)in three groups were significantly different(F=4.028,P=0.019.F=4.140,P=0.017.F=3.172,P=0.044.F=6.701,P=0.002.F=53.156,P<0.001.F=4.920,P=0.008.F=4.173,P=0.017.F=7.181,P=0.001.F=9.170,P<0.001).In further pairwise comparison,the levels of HbA1c,Tch,LDL-C and ALB of group 3 decreased significantly compared with other two groups,but the levels of TBIL,IBIL and TBA increased,with significant differences.The levels of fasting blood glucose(FBG)and HDL-C in group 2 were the highest,and the FBG was significantly higher than that in group 1,while the HDL-C was significantly higher than that in group 3.In the three groups,the top three diabetic complications were peripheral neuropathy,diabetic nephropathy and diabetic retinopathy.Conclusion Different statuses of viral hepatitis B with type 2 diabetes had different disease characteristics,mainly reflected in the high levels of Tch,TG and LDL-C in the hepatitis B virus carriers,high FBG level in the viral hepatitis B patients,low levels of HbAlc and ALB but high levels of bilirubin and bile acid in the cirrhosis patients.Peripheral neuropathy,diabetic nephropathy and diabetic retinopathy were the main complications of diabetes.