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目的:探讨肝硬化患者并发糖尿病的发生率及其危险因素。方法:对660例肝硬化患者的临床资料进行回顾性分析。结果:肝硬化患者并发糖尿病的发生率在不同的年龄组、肝病病程组之间比较差异均有统计学意义,在丙型肝炎病毒阳性与阴性组及乙型肝炎病毒阳性与阴性之间差异均有统计学意义;而在不同的民族及性别,肝功能分级,门、脾静脉内径及有无嗜酒比较差异均无统计学意义。肝硬化并发糖尿病组的平均年龄高于单纯肝硬化组,差异有统计学意义;而血清白蛋白、总胆红素、ALT及肝功能ChildPugh评分在两组比较,差异均无统计学意义。Logistic回归分析结果显示,丙型肝炎病毒感染及肝病病程长是肝硬化并发糖尿病的主要危险因素。结论:肝硬化患者并发糖尿病与民族及性别,嗜酒,门、脾静脉内径,肝功能损害程度及血清白蛋白、总胆红素、ALT等无明显关系,而与年龄、肝病病程、丙型肝炎病毒感染等因素有关,其中与肝病病程、丙型肝病病毒感染关系最密切。
Objective: To investigate the incidence and risk factors of diabetic complications in cirrhotic patients. Methods: The clinical data of 660 patients with cirrhosis were analyzed retrospectively. Results: The incidence of diabetic complications in patients with cirrhosis was significantly different in different age groups and duration of liver disease. There was significant difference between the positive and negative groups of hepatitis C virus and the positive and negative of hepatitis B virus There was no statistical significance in different ethnic groups, gender, liver function classification, the diameter of portal vein and splenic vein, and the presence or absence of alcohol consumption. The average age of patients with cirrhosis complicated with diabetes was higher than that of patients with simple cirrhosis, and the difference was statistically significant. There was no significant difference in serum albumin, total bilirubin, ALT and ChildPugh scores of liver function between the two groups. Logistic regression analysis showed that hepatitis C virus infection and long course of liver disease were the main risk factors of cirrhosis and diabetes. Conclusions: There is no significant relationship between diabetic patients with cirrhosis and ethnicity and sex, alcohol abuse, portal vein, splenic vein diameter, degree of liver dysfunction, serum albumin, total bilirubin and ALT, but not with age, duration of liver disease, Hepatitis virus infection and other factors, of which the course of liver disease, hepatitis C virus infection is most closely related.