133例肝硬化并发糖尿病患者发病相关危险因素和预后分析

doi:10.3969/j.issn.1672-5069.2015.01.011

摘要/Abstract

摘要： 目的分析肝硬化合并糖尿病患者的临床特征、转归及预后,并探讨其相关危险因素。方法回顾性分析2011年1月至2011年12月间住院的133例肝硬化合并糖尿病患者,并随机抽取同期住院的137例肝硬化无糖尿病患者,从临床特点、生化检查、并发症、肝功能分级、转归等进行对比分析研究。结果肝硬化合并糖尿病患者和肝硬化无糖尿病患者的平均年龄分别为（55.9±11.0）岁和（50.2±12.0）岁,平均住院天数为（15.6±11.3）天和（12.8±8.4）天,入院时空腹血糖为（9.8±5.5） mmol/L和（5.1±2.1） mmol/L,天门冬氨酸氨基转移酶为（83.2±98.6） u/L和（65.3±88.8） u/L,白蛋白为（29.1±4.7） g/L和（30.5±5.5）g/L,甘油三脂为（1.1±0.9） mmol/L和（0.7±0.4）mmol/L,血钠为（134.3±5.1） mmol/L和（135.8±5.7） mmol/L,差异均具有显著统计学意义（P均<0.05）;合并糖尿病患者酒精性病因（11.3%）、Child-Pugh C级（26.3%）、腹水（36.8%）、自发性腹膜炎（33.8 %）、肝性脑病（18.0%）和高血压（21.1%）所占比例显著高于无糖尿病患者（3.7%、11.3%、29.9%、 22.6% 、9.0%和2.9%,P均<0.05）;合并糖尿尿病患者住院期间病死率为18.8%,显著高于无糖尿病患者（9.5%,P<0.05）;经Logistic分析显示,高龄、住院时间、高血压、高血糖、高甘油三酯（OR 值分别1.054、1.052、16.182、1.503和1.503,P均<0.01）是肝硬化患者发生糖尿病的危险因素。结论与肝硬化无糖尿病患者相比,合并糖尿病的肝硬化患者肝功能状况和预后差,糖尿病可能是肝硬化患者预后不佳的危险因素。

关键词: 肝硬化, 糖尿病, Logistic分析, 危险因素, 预后

Abstract: Objective To analyze the clinical features,outcomes,prognosis and related risk factors of cirrhotic patients complicated with diabetes. Methods Retrospective analysis was conducted in 133 cases of cirrhotic patients complicated with diabetes and 137 random cases of cirrhotic patients without diabetes from January 2011 to December 2011;the clinical characteristics,biochemical examination,complications,classification of liver function and disease outcome were recorded and compared. Results Average age of cirrhotic patients complicated with diabetes and non-diabetic cirrhotic patients were（55.9±11.0） years and（50.2 ±12.0） years respectively,average hospital stays were（15.6±11.3） days and （12.8±8.4） days,fasting blood glucose were （9.8±5.5） mmol/L and （5.1±2.1） mmol/L,aspartate aminotransferase （AST） were（83.2±98.6） u/L and（65.3±88.8） u/L,albumin （ALB） were （29.1±4.7） g/L and （30.5±5.5） g/L,triglycerides were （1.1±0.9） mmol/L and （0.7±0.4） mmol/L,and serum sodium were （134.3±5.1） mmol/L and（135.8 ± 5.7） mmol/L,respectively （P<0.05 for all）. In patients with diabetes,the numbers of alcoholic causes,Child-Pugh C grade,ascites,spontaneous bacterial peritonitis,hepatic encephalopathy and hypertension were significantly higher than those without diabetes（11.3 vs 3.7%,26.3 vs 11.3%,36.8 vs 29.9%,33.8 vs 22.6%,18.0 vs 9.0% and 21.1 vs 2.9%,respectively,P<0.05 for all）;Meanwhile,the mortality during hospitalization of patients with diabetes was significantly higher than that of patients without diabetes（18.8 vs 9.5%,P<0.05）. The Logistic analysis revealed that advanced age,duration of hospitalization,hypertension,hyperglycemia and triglyceride were the risk factor for diabetes in cirrhotic patients（odds ratio were 1.054, 1.052,16.182,1.503 and 1.503 respectively,P<0.01 for all）. Conclusion Compared with cirrhotic patients without diabetes,liver function and prognosis of cirrhotic patients with diabetes was poorer. Diabetes may contribute to the poor prognosis of patients with cirrhosis.

Key words: Cirrhosis, Diabetes, Logistic analysis, Risk factor, Prognosis

袁松松, 向天新, 刘娟, 邬小萍. 133例肝硬化并发糖尿病患者发病相关危险因素和预后分析[J]. 实用肝脏病杂志, 2015, 18(1): 43-46.

Yuan Songsong, Xiang Tianxin, Liu Juan, et al. Analysis of risk factors and prognosis in 133 cases of cirrhotic patients complicated with diabetes[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2015, 18(1): 43-46.

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