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目的探讨肝硬变失代偿期患者血糖及胰岛素代谢变化及其机理。方法对肝硬变失代偿期患者 2 0例 ,2型糖尿病患者 2 4例及 10例正常健康者进行口服葡萄糖耐量试验 (OGTT) ,检测其血糖、胰岛素及C肽水平 ,计算其胰岛素敏感性 ,并进行比较分析。结果肝硬变患者餐后血糖明显高于健康者 (P <0 .0 1) ;血清胰岛素也高于健康者 (P <0 .0 5 ) ,但两组间C肽无显著性差异 (P >0 .0 5 )。而与 2型糖尿病相比 ,其餐后血糖明显低于糖尿病患者 (P <0 .0 1) ,但血清胰岛素却显著高于糖尿病患者 (P <0 .0 1)。肝硬变患者胰岛素敏感性优于 2型糖尿病患者 ,但低于正常健康者。结论肝硬变患者存在糖代谢异常 ,且主要与胰岛素抵抗和葡萄糖抵抗有关。
Objective To investigate the changes of blood glucose and insulin metabolism in patients with decompensated liver cirrhosis and its mechanism. Methods OGTT was performed in 20 patients with decompensated liver cirrhosis, 24 with type 2 diabetes mellitus and 10 healthy controls. The levels of blood glucose, insulin and C-peptide were measured and their insulin sensitivity Sex, and comparative analysis. Results Postprandial blood glucose in patients with cirrhosis was significantly higher than that in healthy subjects (P <0.01), serum insulin was also higher in healthy subjects (P <0.05), but there was no significant difference in C peptide between the two groups > 0 .0 5). Compared with type 2 diabetes, its postprandial blood glucose was significantly lower than that of patients with diabetes (P <0.01), but serum insulin was significantly higher than that of patients with diabetes (P <0.01). Insulin sensitivity in patients with cirrhosis is better than in patients with type 2 diabetes, but lower than normal healthy. Conclusion There are abnormal glucose metabolism in patients with cirrhosis, and mainly related to insulin resistance and glucose resistance.