肝硬化患者口服葡萄糖耐量试验的变化

Correlation between oral glucose tolerance test and liver function in cirrhotic patients

目的 了解口服葡萄糖耐量试验的血糖值与肝硬化患者肝功能状况的关系。方法 3 8例肝硬化患者按Child Pugh肝功能分级 ,分为A级 ( 10例 )、B级 ( 14例 )和C级 ( 14例 )三组。 11例健康者为对照组。抽取空腹血 2ml后 ,行糖耐量试验 ,以葡萄糖氧化酶法测定血糖浓度。结果 肝硬化各组的基础血糖浓度与对照组比较无显著差异 ,60和12 0分钟血糖浓度均显著高于对照组 (P <0 .0 0 2～ 0 .0 5 ) ,且随着肝硬化严重程度的增加 (即A级→B级→C级 ) ,血糖浓度有增高的趋势。肝硬化各组的血糖12 0 /0 值均显著高于对照组 (P <0 .0 0 1～ 0 .0 0 2 ) ,并随着肝硬化严重程度的增加而增高。 12 0分钟血糖及血糖12 0 /0 值与血清白蛋白浓度呈显著负相关 (P <0 .0 0 1) ,与血清总胆红素浓度、凝血酶原延长时间、R151CG及Child Pugh肝功能评分呈显著正相关 (P <0 .0 0 1～ 0 .0 0 5 )。结论 口服葡萄糖耐量试验的 2小时血糖值及血糖12 0 /0 值与肝硬化患者的肝功能状况密切相关 ,是反映肝硬化患者肝功能状况的良好指标 ,有一定的临床应用价值。

Objective To investigate the correlation between oral glucose tolerance test and liver function in cirrhotic patients.Methods 38 cirrhotic patients were classified into A,B and C groups(grade A:10 patients,grade B:14 patients;grade C:14 patients)according to Child-Pugh score.38 cirrhotic patients and 11 normal controls were given oral glucose tolerance test (OGTT)of 75g glucose after over night fasting.Venous blood samples of the OGTT 0,60 and 120 minute's were obtained.Results The baseline blood glucose concentration wasn't significantly different between the cirrhotic patient's and the controls.The OGTT 60 and 120 minute's blood glucose values in total cirrhotic group,grade A,grade B and grade C were significantly higher than that in the controls(P<0.001～0.005).And the OGTT 60 and 120 minute's blood glucose values had an increasing tendency as liver function got bad.The rates of the OGTT 120 minute's blood glucose and the OGTT O minute's blood glucose (OGTTR 120/0 )in all cirrhotic groups were significantly higher than that in the controls(P<0.001～0.002).And the OGTTR 120/0 also had an increasing tendency following a more deteriorated liver function.The OGTT 120 minutes blood glucose values and the OGTTR 120/0 had a significant correlation with ALB(r=-0.54,P<0.001;r=-0.58,P<0.001),TBIL(r=0.42,P<0.001;r=0.39,P<0.002),prolonged PT(r=0.43,P<0.01;r=0.46,P<0.005),R 151GCG (r= 0.41 ,P<0.002;r-0.37,P<0.005,and Child-Pugh score(r=0.56,P<0.001;r=0.56,P<0.001).Conclusion The OGTT 120 minute's blood glucose values and the OGTTR 120/0 have a significant correlation with the liver function in cirrhotic patients.