实用肝脏病杂志 ›› 2018, Vol. 21 ›› Issue (3): 413-416.doi: 10.3969/j.issn.1672-5069.2018.03.024

• 肝衰竭 • 上一篇    下一篇

血糖和总胆固醇水平对肝衰竭患者预后的影响*

吴凤萍, 李亚萍, 杨颖, 石娟娟, 李梅, 王文俊, 党双锁   

  1. 710004 西安市 西安交通大学医学院第二附属医院感染病科
  • 收稿日期:2017-01-19 出版日期:2018-05-10 发布日期:2018-05-25
  • 通讯作者: 党双锁,E-mail:dang212@126.com
  • 作者简介:吴凤萍,女,26岁,硕士研究生。主要从事肝病与免疫相关研究。E-mail:wfp612526@163.com
  • 基金资助:
    * 国家自然科学基金资助项目(编号:81170393)

Blood glucose and total cholesterol in the prognosis of patients with liver failure

Wu Fengping, Li Yaping, Yang Ying, et al   

  1. Department of Infectious Diseases,Second Affiliated Hospital,Medical School,Jiaotong University,Xi'an 710004,Shaanxi Province,China
  • Received:2017-01-19 Online:2018-05-10 Published:2018-05-25

摘要: 目的 分析血糖和总胆固醇(TC)水平对肝衰竭(LF)患者预后的影响。方法 回顾性分析106例LF患者,根据入院时基线TC水平将患者分为TC≤1.0 mmol/L组(n=8)、1.0 mmol/L<TC≤2.0 mmol/L组(n=49)和TC>2.0 mmol/L组(n=49);排除10例糖尿病患者后,将96例LF患者分为血糖正常组(n=60)、高血糖组(n=12)和低血糖组(n=24);分别比较基线时患者血糖及TC的状态与其生存率的相关性。同时动态监测81例基线TC>1.0mmol/L的患者住院期间TC的动态变化,分析其与LF预后的关系。结果 106例LF患者的病因以慢性HBV感染为主,占66.0%;慢性肝衰竭(CLF)占46.2%;基线低血糖患者生存率为41.7%,显著低于血糖正常患者的71.7%(P<0.01);血清TC≤1.0 mmol/L组、1.0 mmol/L<TC≤2.0 mmol/L组和TC>2.0 mmol/L患者生存率分别为12.5%、51.0%和75.5%,三组差异有统计学意义,基线TC越低,生存率越低(P均<0.05);住院期间TC较基线呈下降趋势的35例患者生存率为28.6%,显著低于呈上升趋势的46例患者的93.5% (P<0.05)。结论 LF患者出现血糖降低、TC≤2.0 mmol/L以及在住院期间TC较基线呈下降趋势是预后不良的危险因素,特别是基线TC≤1.0 mmol/L的患者预后极差。

关键词: 肝衰竭, 血糖, 总胆固醇, 预后

Abstract: Objective To analyze blood glucose and total cholesterol (TC) in the prognosis of patients with liver failure (LF). Methods A retrospective analysis was performed on 106 LF patients who were admitted to in our hospital. The patients were divided into blood TC≤1.0 mmol/L group(n=8),1.0 mmol/L<TC≤2.0 mmol/L group(n=49) and TC>2.0 mmol/L group(n=49) according to the TC level at admission. After excluding 10 patients with diabetes,96 patients were divided into normal blood glucose group (n=60),hyperglycemia group (n=12) and hypoglycemia group(n=24) according to the blood glucose levels at admission. The correlation between blood glucose or TC and survival rate was compared respectively. TC was dynamically monitored in 81 patients with TC>1.0 mmol/L at admission to explore the relationship between the dynamic changes of TC and the prognosis of patients with LF. Results Hepatitis B virus(HBV) infection was the main cause of LF in the 106 patients, accounting for 66.0% and the proportion of chronic liver failure(CLF) accounted for 46.2%;the survival rate in patients with hypoglycemia at admission was 41.7%,significantly lower than that in patients with normal blood glucose (71.7%,P<0.01);there were significant differences in survival rates between patients with blood TC≤1.0 mmol/L group,1.0 mmol/L<TC≤2.0 mmol/L group and TC>2.0 mmol/L group and the lower the baseline TC levels,the lower the survival rates(12.5% vs. 51.0% vs. 75.5%,respectively,P<0.05 for all);the survival rate in patients with a declining levels of TC during hospitalization was 28.6%,significantly lower than that in patients with an increasing trend (93.5%,P<0.05). Conclusion Hypoglycemia and blood TC≤2.0 mmol/L at admission or decreased TC level trend are associated with poor prognosis of patients with LF,especially in patients with blood TC≤1.0 mmol/L at admission.

Key words: Liver failure, Blood glucose, Total cholesterol, Prognosis