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[目的]研究肝硬化患者糖脂代谢水平及其对疾病恶化的影响。[方法]选取我院在2015年5月~2016年5月收治的68例肝硬化患者的临床资料进行回顾性分析。所有患者按照Child-Pugh评分标准分为3组,观察3组患者血脂、血糖水平以及糖尿病的发生率,然后根据患者糖尿病发病情况将患者分成2组,观察2组患者肝肾功能、血脂水平以及并发症发生情况。[结果]在本组研究的患者中,患糖尿病有13例(19.12%),B组与C组糖尿病患病率为[(29.17%)、(36.36%)],明显高于A组[(6.06%),(P<0.05)]。空腹血糖受损有15例(22.06%),3组患者空腹血糖受损率比较差异无统计学意义[(21.21%)、(20.83%)、(27.27%)]。3组患者的空腹血糖[(5.50±1.26)mmol/L、(5.57±1.34)mmol/L、(5.61±1.46)mmol/L]以及TG[(1.21±0.67)mmol/L、(1.25±0.57)mmol/L、(1.14±0.45)mmol/L]随着病情的加重而降低,但是3组患者比较差异无统计学意义,TC随着病情的加重而降低,3组比较差异有统计学意义[(4.67±1.24)mmol/L、(3.86±1.14)mmol/L、(2.96±1.02)mmol/L,(P<0.05)];糖尿病组患者的年龄(54.67±11.04)岁,显著高于无糖尿病组[(47.16±10.48)岁,(P<0.05)];糖尿病饮酒者比无糖尿病更高[(54.55%vs.18.18%),(P<0.05)];糖尿病组患者ALB水平为(39.48±8.47)g/L,显著高于无糖尿病组患者[(31.04±5.78)g/L,(P<0.05)],糖尿病组与无糖尿病组在性别、TC、TG、TBil、PT、ALT、AST、BUN、CR方面比较差异无统计学意义;糖尿病组患者消化道出血、腹水、肝性脑病发病率为[(23.08%)、(46.15%)、(27.27%)],显著高于无糖尿病组的发病率[(3.64%)、(18.18%)、(3.51%),(P<0.05)]。[结论]肝硬化会提高患者发生糖代谢异常的发生率,而发生糖尿病后会加重肝硬化患者的病情。
[Objective] To study the level of glucose and lipid metabolism in cirrhotic patients and its effect on disease progression. [Methods] The clinical data of 68 patients with cirrhosis admitted in our hospital from May 2015 to May 2016 were retrospectively analyzed. All patients were divided into three groups according to the Child-Pugh score, and the levels of blood lipids, blood glucose and diabetes were observed in the three groups. The patients were divided into two groups according to the incidence of diabetes. The liver and renal function, Complications of the situation. [Results] The prevalence of diabetes in group B and group C was (29.17%) and (36.36%), respectively, 13 (19.12% 6.06%), (P <0.05)]. There were 15 cases (22.06%) with impaired fasting glucose and no significant difference in impaired fasting glucose between the three groups [(21.21%), (20.83%), (27.27%)]. The fasting blood glucose ([5.50 ± 1.26] mmol / L, (5.57 ± 1.34) mmol / L, (5.61 ± 1.46) mmol / L] and TG [(1.21 ± 0.67) mmol / L, (1.25 ± 0.57 ) mmol / L, (1.14 ± 0.45) mmol / L] decreased with the severity of the disease, but there was no significant difference between the three groups, TC decreased with the severity of the disease, the difference between the three groups was statistically significant (4.67 ± 1.24) mmol / L, (3.86 ± 1.14) mmol / L and (2.96 ± 1.02) mmol / L respectively, P <0.05). The age of patients with diabetes mellitus (54.67 ± 11.04) years was significantly higher (47.16 ± 10.48) years old, (P0.05). Compared with no-diabetes mellitus patients with diabetes mellitus, the level of ALB in diabetic patients was (54.55% vs 18..18% 39.48 ± 8.47) g / L were significantly higher than those in non-diabetic patients [(31.04 ± 5.78) g / L, P <0.05) , AST, BUN and CR were not statistically significant. The incidence of gastrointestinal bleeding, ascites and hepatic encephalopathy in diabetic patients was significantly higher than that in patients without diabetes (23.08%, 46.15%, 27.27%, respectively) The incidence of diabetes mellitus (3.64%), (18.18%), (3.51%), (P <0.05)]. [Conclusion] Cirrhosis can increase the incidence of abnormal glucose metabolism in patients, and the occurrence of diabetes will aggravate the condition of patients with cirrhosis.