摘要
目的观察肝硬化失代偿期患者空腹血糖值变化及终末期肝病模型(MELD)分值与空腹血糖值的相关性。方法收集120例肝硬化失代偿期患者,按研究开始时是否死亡分为死亡组及生存组,记录死亡组距死亡时间6个月内任何时间点前18、12、6个月及生存组距2009年3月起之前的任何时间点前18、12、6个月空腹血糖值、Child-Turcotte-Pugh(CTP)分级及MELD评分。结果死亡组CTP分级随时间多呈进行性上升或不变,生存组CTP分级随时间多呈不变或波动(P=0.000);死亡组空腹血糖值在死亡前18个月内随时间呈进行性下降,生存组空腹血糖值在生存期18个月内随时间呈波动上升(P=0.000);死亡组MELD评分和空腹血糖值呈负相关,评分每增加1分,空腹血糖值平均降低0.08 mmol/L;生存组MELD评分和空腹血糖值无显著相关性;死亡组距死亡时间前6个月时空腹血糖平均值为(4.36±0.81)mmol/L。结论肝硬化失代偿期患者在死亡前18个月内空腹血糖值有进行性下降的变化趋势,且其MELD评分和空腹血糖值呈负相关。CTP分级进行性上升至C级且伴空腹血糖进行性下降至(4.36±0.81)mmol/L时,可能提示近期(6个月)预后差。
Objective To observe the variation of the level of fasting plasma glucose and relationship between model for end-stage liver disease （MELD） score and level of fasting plasma glucose in patients with decompensated liver cirrhosis.Methods Medical data of 120 cases of decompensated liver cirrhosis were collected and divided into death group and survival group,according to whether they were dead till the beginning of this research.The level of fasting plasma glucose,Child-Turcotte-Pugh （CTP） score and MELD score were recorded at 18,12,6 months before any time point within six months early just right than death in the death group and at 18,12,6 months before any time point early than Mar.2009 in the survival.Results As time went on,CTP largely rose gradually or kept constant in the death group,and it largely kept constant or fluctuant in the survival group （P =0.000）.The level of fasting plasma glucose in the death group had a gradual downtrend along with time within 18 months before death,whereas it had a tendency of fluctuating and increasing while surviving in the survival group （P =0.000）.Significant negative correlation was observed between MELD score and level of fasting plasma glucose in the death group,as the MELD score added one,level of fasting plasma glucose was decreased 0.08 mmol/L.No significant correlation was observed between MELD and level of fasting plasma glucose in the survival group.The average level of fasting plasma glucose 6 months before death in the death group reached （4.36 ± 0.81） mmol/L.Conclusion Level of fasting plasma glucose had a gradual downtrend in patients with decompensated liver cirrhosis within 18 months before death and significant negative correlation was observed between MELD score and level of fasting plasma glucose.Patients whose CTP gradually went up to grade C probably had bad short-term （6 months） prognosis if average level of fasting plasma glucose droped to （4.36±0.81） mmol/L.
出处
《胃肠病学和肝病学杂志》
CAS
2014年第7期813-815,共3页
Chinese Journal of Gastroenterology and Hepatology
