肝硬化合并糖尿病60例临床分析

Effect of treatment in 60 cases of cirrhosis with diabetes

关键词:  肝硬化  肝源性糖尿病  疗效

Key words:  hepatocirrhosis  hyperglycemia  curative effect

摘要:

肝硬化与糖尿病的关系及肝源性糖尿病的发生机制及治疗。方法：根据血糖水平分为口服降糖药物组（33例）、胰岛素治疗组（17例）及口服降糖药物效果不佳后改为胰岛素治疗组（10例），共3组。分别给予优降糖或二甲双胍口服及胰岛素皮下注射，并比较用药前后的血糖水平。结果：应用口服降糖药物组，血糖较治疗前下降21.2%；应用胰岛素治疗组血糖较治疗前下降60%；先用口服降糖药物效果不佳，改用胰岛素后血糖下降41.8%。结论：肝硬化患者易发生糖代谢紊乱，发生机制可能与胰岛素抵抗有关，血糖水平与肝功能受损程度有一定关系。肝硬化合并糖尿病应首选胰岛素治疗。

Abstract:

To investigate the relationship between hyperglycemia with hepatocirrhosis and Child-grades of liver function, and the pathogenesis and the therapy of hyperglycemia in patients with hepatocirrhosis. Methods: To study the condition of variation of glycemia in 60 patients with hepatocirrhosis, who were divided into three groups:33 patients with oral glyburide and metaformin,17 patients with hypodermic insulin, 10 patients with oral glyburide and metaformin first and with hypodermic insulin finally. Results: The level of glycemic was reduced by 21.2% in 33 patients group and 60% in 17 patients group after treatment with oral drugs and with hypodermic insulin. For the 10 patients, first given oral drugs, there was no difference between before and after treatment, and then insulin given, the level of glycemia was reduced by 41.8%. The level of glycemic also increased with the liver function having become weaker. Conclusions: Hyperglycemia in patients with hepatocirrhosis is related to the liver dysfunction which resulted in anti-insulin not insulin absent.Insulin therapy should be selected first in patients with hyperglycemia and hepatocirrhosis.