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目的观察肝硬化患者血糖的改变,探讨糖代谢与肝性脑病(HE)的关系。方法 2008年8月至2010年8月间在嘉定区中心医院消化内科住院的肝硬化患者60人作为肝硬化组,非肝硬化住院患者30人作为对照组。收集一般资料,观察神志,体检有无扑翼样震颤,抽血检测患者血糖,根据患者检查结果,把肝硬化患者分为无扑翼样震颤组和有扑翼样震颤组,对肝硬化组与对照组糖代谢异常发生率进行比较,根据患者血糖情况分为血糖正常组及糖代谢异常组,对两组间扑翼样震颤及HE发生率进行比较。计量资料应用t检验,率的比较应用卡方检验。结果对照组30例,肝硬化组60例中无扑翼样震颤组28例,有扑翼样震颤组32例,对照组糖代谢异常发生率13.33%,肝硬化组糖代谢异常发生率26.67%,肝硬化组患者糖代谢异常发生率高于对照组(χ2=2.058,P<0.05)。糖代谢正常组扑翼样震颤发生率50.00%,HE发生率34.09%,糖代谢异常组扑翼样震颤发生率62.50%,HE发生率37.50%,两组间差异均无统计学意义(P>0.05)。结论肝硬化患者存在糖代谢的紊乱,但糖代谢异常不一定易于发生HE,提示存在大脑对糖的利用障碍。
Objective To observe the changes of blood glucose in cirrhotic patients and explore the relationship between glucose metabolism and hepatic encephalopathy (HE). Methods From August 2008 to August 2010, 60 patients with cirrhosis who were hospitalized in Department of Gastroenterology, Jiading Central Hospital were enrolled as the cirrhosis group and 30 non-cirrhotic inpatients as the control group. According to the results of the patient examination, the patients with cirrhosis were divided into no asymptomatic tremor group and a flapping wing tremor group, and the patients with cirrhosis group The incidence of abnormal glucose metabolism was compared with the control group. According to the blood glucose level, the patients were divided into normal glucose group and abnormal glucose metabolism group, and the incidence of asymptomatic tremor and HE in the two groups were compared. Measurement data using t test, the rate of comparison using chi-square test. Results 30 cases of control group, 60 cases of cirrhosis group without asterixis tremor in 28 cases, 32 cases of asterixis tremor group, control group, the incidence of abnormal glucose metabolism was 13.33%, liver cirrhosis group, the incidence of abnormal glucose metabolism was 26.67% The incidence of abnormal glucose metabolism in patients with cirrhosis was higher than that in the control group (χ2 = 2.058, P <0.05). The incidence of flapping-wing tremor was 50.00% in normal glucose metabolism group, 34.09% in HE group, and 62.50% in flanking glucose group and 37.50% in HE group. There was no significant difference between the two groups (P> 0.05). Conclusions Patients with liver cirrhosis have disorders of glucose metabolism, but abnormal glucose metabolism may not be prone to HE, suggesting that there is a barrier to the utilization of glucose in the brain.