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目的探讨慢性乙型肝炎及乙型肝炎后肝硬化伴糖代谢异常的临床特点。方法比较慢性乙型肝炎伴糖代谢异常、乙肝肝硬化伴糖代谢异常以及无肝病糖代谢异常“三多一少”症状的出现率,空腹血糖(FPG)、餐后血糖(PPG)水平,空腹胰岛素水平(FINS)、空腹C肽水平(FCP)、葡萄糖负荷后胰岛素释放水平(PINS)及C肽分泌水平(PCP)。结果无肝病糖代谢异常患者“三多一少”出现率为52.4%,慢性肝病患者则无“三多一少”症状;与无肝病糖代谢异常患者相比,慢性乙型肝炎伴糖代谢异常患者FPG、PPG显著较低(P<0.05),FINS、FCP、PINS、PCP显著较高(P<0.05);乙肝肝硬化伴糖代谢异常患者FPG、PPG无显著差异(P>0.05),FINS、FCP、PINS、PCP显著较高(P<0.05),但显著低于慢性乙型肝炎伴糖代谢异常患者水平(P<0.05)。结论慢性肝病伴糖代谢异常患者无典型糖尿病表现,而慢性乙型肝炎伴糖代谢异常患者胰岛功能增强,而乙肝肝硬化伴糖代谢异常患者胰岛功能减弱。
Objective To investigate the clinical characteristics of chronic hepatitis B and hepatitis B cirrhosis with abnormal glucose metabolism. Methods The incidences of chronic hepatitis B with abnormal glucose metabolism, hepatitis B cirrhosis with abnormal glucose metabolism, and abnormal glucose metabolism without hepatopathy were compared between the two groups. The incidences of “three to less” symptoms, fasting blood glucose (FPG), postprandial blood glucose (PPG) , Fasting insulin (FINS), fasting C-peptide (FCP), post-glucose release (PINS) and C peptide secretion (PCP). Results No abnormalities in the metabolism of liver disease patients with “more than three less” appearance rate of 52.4%, chronic liver disease patients without “more than one less” symptoms; and no liver disease patients with abnormal glucose metabolism, chronic hepatitis B FPG and PPG in patients with abnormal glucose metabolism were significantly lower (P <0.05), FINS, FCP, PINS and PCP were significantly higher (P <0.05); FPG and PPG were no significant differences between patients with hepatitis B cirrhosis and glucose metabolism (P> 0.05). FINS, FCP, PINS and PCP were significantly higher (P <0.05), but significantly lower than those of chronic hepatitis B patients with abnormal glucose metabolism (P <0.05). Conclusion Patients with chronic liver disease and abnormal glucose metabolism have no typical diabetes mellitus, while patients with chronic hepatitis B and abnormal glucose metabolism have increased pancreatic function. However, those with hepatitis B cirrhosis and abnormal glucose metabolism have weakened pancreatic function.