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目的 探讨肝硬化失代偿期患者血糖及胰岛素代谢变化及其机理。方法 对 1 6例肝硬化失代偿期患者 ,2 0例 2型糖尿病患者及 1 0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 ,同时查糖化血红蛋白 ,计算胰岛素释放指数和胰岛素敏感性指数 ,对各组检查结果进行比较分析。结果 肝硬化组空腹血糖水平显著低于 2型糖尿病组 (P <0 0 1 ) ,空腹胰岛素、C肽和胰岛素释放指数显著高于 2型糖尿病组 (P <0 0 1 ) ,但胰岛素敏感性指数两组之间无明显差异 (P >0 0 5 )。与正常对照组比较 ,肝硬化组空腹血糖、餐后血糖、糖化血红蛋白、空腹胰岛素、空腹C肽及胰岛素释放指数多种指标显著高于正常对照组 (P <0 0 1 ) ,胰岛素敏感性指数显著低于正常对照组 (P <0 0 1 )。结论 肝硬化患者存在糖代谢异常 ,且主要与胰岛素抵抗有关
Objective To investigate the changes of blood glucose and insulin metabolism and its mechanism in patients with decompensated liver cirrhosis. Methods Oral glucose tolerance test (OGTT) was performed on 16 patients with decompensated liver cirrhosis, 20 type 2 diabetes mellitus and 10 normal controls. The levels of blood glucose, insulin and C-peptide were measured. Meanwhile, glycosylated hemoglobin , Calculated insulin release index and insulin sensitivity index, comparative analysis of the test results of each group. Results The fasting blood glucose of patients with cirrhosis was significantly lower than that of patients with type 2 diabetes (P <0.01), and the fasting insulin, C peptide and insulin release index were significantly higher than those of type 2 diabetic patients (P <0.01), but the insulin sensitivity There was no significant difference between the two groups (P> 0.05). Compared with the normal control group, the indexes of fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, fasting insulin, fasting C-peptide and insulin release index in cirrhosis group were significantly higher than those in normal control group (P <0.01), insulin sensitivity index Significantly lower than the normal control group (P <0.01). Conclusion Patients with liver cirrhosis have abnormal glucose metabolism, which is mainly related to insulin resistance