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目的分析肝硬化并发糖尿病患者的临床特点,探讨肝源性糖尿病的临床特点、发病机制、诊断和治疗。方法对1998年8月至2009年9月本院诊治的68例肝源性糖尿病患者的临床资料进行回顾性分析。结果对68例诊断明确的肝源性糖尿病患者给予治疗原发病及应用胰岛素治疗,52例转氨酶明显下降,其中49例血糖降至正常;7例转氨酶下降、血糖好转;3例血糖无变化;6例肝功能恶化,血糖升高,其中消化道大出血死亡1例,肝性脑病1例。结论肝源性糖尿病临床表现复杂,以肝硬化表现为主,同时伴有糖代谢紊乱,很少出现典型的“三多一少”症状,有别于单纯的2型糖尿病。应做到早发现、早诊断、早治疗。积极治疗原发性肝病及严格控制血糖是主要治疗措施。
Objective To analyze the clinical features of patients with cirrhosis complicated with diabetes and to investigate the clinical features, pathogenesis, diagnosis and treatment of liver-derived diabetes mellitus. Methods The clinical data of 68 patients with liver-derived diabetes mellitus diagnosed and treated in our hospital from August 1998 to September 2009 were retrospectively analyzed. Results 68 cases of diagnosed patients with liver-derived diabetes were treated with primary therapy and insulin therapy, 52 cases of transaminases decreased significantly, of which 49 cases of blood glucose dropped to normal; 7 cases of transaminases decreased, blood glucose improved; 3 cases of blood glucose did not change; 6 cases of deterioration of liver function, elevated blood glucose, including gastrointestinal bleeding in 1 case, 1 case of hepatic encephalopathy. Conclusion The clinical manifestations of liver-derived diabetes are complex, with cirrhosis mainly manifested, accompanied by disorders of glucose metabolism, and rarely appear typical symptoms of “more than one less”, different from simple type 2 diabetes mellitus. Should be detected early, early diagnosis and early treatment. Active treatment of primary liver disease and strict control of blood glucose is the main treatment.