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目的:分析乙型肝炎肝硬化合并糖尿病患者糖脂代谢的特点及其与Child分级的关系。方法:检测肝硬化合并2型糖尿病糖尿病组(A组)、2型糖尿病无肝硬化组(B组)患者的血脂(Tch、TG、HDLC、LDL-C、apoA、apoB)、空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1C)、C肽及餐后2 h C肽水平.同时探讨其与Child分级的关系。结果:(1)A组患者FPG、空腹C肽、餐后2 h C肽水平均高于B组(P<0.05)。(2)A组患者HDL-C、LDL-C、apoA、apoB水平均低于B组(P<0.05)。随着肝功能child分级的上升,A组患者HDL-C、LDL-C、apoA、apoB水平进一步下降,尤以apoB及HDL-C最为显著。结论:肝硬化合并2型糖尿病患者存在较严重的胰岛素抵抗,其脂代谢紊乱主要以HDL-C、apoB显著降低为特点.下降程度与肝功能child分级有关。
Objective: To analyze the characteristics of glycolipid metabolism in patients with hepatitis B cirrhosis complicated with diabetes and its relationship with Child classification. Methods: The levels of serum lipids (Tch, TG, HDLC, LDL-C, apoA, apoB) and fasting blood glucose (FBG) in patients with cirrhosis and type 2 diabetes mellitus (group A) and type 2 diabetes mellitus without cirrhosis (group B) ), 2 h postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1C), C-peptide and postprandial 2-h C-peptide levels were also detected. Results: (1) FPG, fasting C-peptide and postprandial 2-h C peptide in group A were higher than those in group B (P <0.05). (2) The levels of HDL-C, LDL-C, apoA and apoB in group A were lower than those in group B (P <0.05). With the grading of liver function, the levels of HDL-C, LDL-C, apoA and apoB in group A decreased further, especially apoB and HDL-C. Conclusion: Patients with cirrhosis complicated with type 2 diabetes have more severe insulin resistance, and the disturbance of lipid metabolism is characterized mainly by the decrease of HDL-C and apoB, which is related to the grading of liver function.