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目的探讨糖尿病对慢性重型病毒性肝炎糖类、脂类代谢的影响。方法回顾性分析慢性重型病毒性肝炎合并糖尿病患者的血糖、血脂水平。结果慢性重型肝炎入院时空腹血糖(FPG)值在以下三组患者中依次递降:合并糖尿病且TBIL≤540μmol/L组(DM1)、合并糖尿病且TBIL>540μmol/L组(DM2)、无合并糖尿病组(NDM),三组差异有统计学意义(P<0.01)。DM组、NDM组两组的不同转归患者之间FPG差异无统计学意义;两组患者均可出现空腹低血糖现象。两组患者之间血中总胆固醇(CHOL)、甘油三酯(TG)、高密度脂蛋白(HDL)值差异无统计学意义(P>0.05)。结论慢性重型病毒性肝炎合并糖尿病的血糖水平主要受糖尿病影响导致血糖升高,另一方面,空腹血糖可随肝功能损害的加重、黄疸的加深而降低。在慢性重型病毒性肝炎、肝功能衰竭时,血中血脂水平主要受肝脏脂肪代谢的影响。
Objective To investigate the effect of diabetes on carbohydrate and lipid metabolism in patients with chronic severe viral hepatitis. Methods A retrospective analysis of patients with chronic severe viral hepatitis with diabetes, blood glucose and blood lipid levels. Results The fasting plasma glucose (FPG) value of patients with chronic severe hepatitis was decreased in the following three groups: diabetes with TBIL≤540μmol / L group (DM1), diabetes with TBIL> 540μmol / L group (DM2) without diabetes mellitus Group (NDM), the difference between the three groups was statistically significant (P <0.01). There was no significant difference in FPG between different outcome groups in DM group and NDM group. Fasting hypoglycemia occurred in both groups. There was no significant difference in total cholesterol (CHOL), triglyceride (TG) and high density lipoprotein (HDL) between the two groups (P> 0.05). Conclusion The blood glucose level of patients with chronic severe viral hepatitis complicated by diabetes is mainly caused by the increase of blood glucose caused by diabetes. On the other hand, fasting blood glucose may decrease with the worsening of liver dysfunction and the deepening of jaundice. In chronic severe viral hepatitis, liver failure, blood lipid levels are mainly affected by liver fat metabolism.