摘要
目的：探讨2型糖尿病（T2DM）发生肝纤维化的临床危险因素。方法选择新疆医科大学第一附属医院内分泌科2013年4月至9月收治的112例T2DM患者为研究对象，男69例，女43例，平均年龄（53±1）岁，平均病程4年（1-10年）。根据瞬时弹力成像（Fibroscan）检测结果，肝脏硬度值≥6.65 kPa为病例组（A组）：T2DM合并肝纤维化组（44例），肝脏硬度值〈6.65 kPa为对照组（B组）：单纯T2DM组（68例）。检测患者肝酶、B超等实验室各项指标，通过单因素及多因素分析进行统计学分析。结果（1）病例组高血压发生率（52.3%）、脂肪肝比率（90.9%）、血糖控制不良的比率（70.5%）、体质指数[（28.49±0.16）kg/m^2]、谷丙转氨酶[20.04（14.75-47.40）U/L]、谷草转氨酶[26.70（17.10-36.91） U/L]水平显著高于对照组[分别为26.5%、69.1%、50.0%、（26.32±0.39）kg/m^2、16.30（13.63-20.40）U/L、19.25（14.50-27.68）U/L]，差异有统计学意义（分别为χ2=7.664、7.316、4.589；t=-3.121、Z=-2.121、-2.821；均P〈0.05）；病例组患者白细胞计数（6.58±0.25）、中性粒细胞计数（3.75±0.18）、平均红细胞体积水平（87.51±0.59）显著低于对照组（分别为7.54±0.25、4.47±0.19、89.74±0.49），差异有统计学意义（t=2.740、2.789、2.876；均P〈0.01）。（2）多因素Logistic回归分析显示：高血压、脂肪肝、谷草转氨酶升高、白细胞计数降低、平均红细胞体积降低是T2DM发生肝纤维化的独立危险因素（OR=3.576、3.850、1.110、0.669、0.808，均P〈0.05）。结论高血压、脂肪肝、谷草转氨酶升高、白细胞计数降低、平均红细胞体积降低是T2DM发生肝纤维化的临床相关危险因素。本研究为T2DM患者早期筛查肝纤维化提供了一定的理论依据。
Objective To investigate the clinical risk factors of type 2 diabetes mellitus（T2DM） combined with hepatic fibrosis. Methods Totally 112 patients with T2DM from Department of Endocrinology,the First Affiliated Hospital of Xinjiang Medical University from April to September in 2013 were enrolled in our study. Male patients were 69,female patients were 43,age was 53 ± 1,the average of duration of T2DM was 4 year（1-10 year）. They were divided into 2 groups,according to the fibroscan measured,T2DM combined with hepatic fibrosis group（liver hardness value ≥6.65 kPa,group A,case group,n=44）;T2DM without hepatic fibrosis（liver hardness value〈6.65 kPa,group B,control group,n=68）. The gender,age,ethnic,disease history,laboratory examination（liver enzyme）and ultrasound were collected and analyzed with univariate analysis and multivariate analysis. Results （1）Patients of case group had a significantly higher ratio of having hypertension history（52.3%）,fatty liver（90.9%）,rate of poor blood glucose control（70.5%）,body mass index（BMI）（（28.49 ± 0.16）kg/m^2）,alanine aminotransferase（ALT） （20.04（14.75-47.40）U/L）,aspartate aminotransferase（AST）（26.70（17.10-36.91）U/L）than those in control group（26.5%,69.1%,50.0%,26.32 ± 0.39,16.30（13.63-20.40）,19.25（14.50-27.68）,χ^2=7.664, 7.316,4.589;t=-3.121,Z=-2.121,-2.821;P〈0.05 all above）. White blood cell count（6.58 ± 0.25）, neutrophile count（3.75 ± 0.18）,mean corpuscular volume（MCV）（87.51 ± 0.59）in case group were significantly lower than those in control group（7.54±0.25,4.47±0.19,89.74±0.49）（t=2.740,2.789,2.876;P〈0.01 all above）.（2）Multivaiate logistic regression analysis showed that hypertension history,fatty liver, increased AST,decreased white blood cell count and decreased MCV were the independent risk factors of T2DM combined with hepatic fibrosis （OR=3.576,3.850,1.110,0.669,0.808,P〈0.05 all above）. Conclusion Hypertension history,fatty liver,increased
出处
《中华糖尿病杂志》
CAS
CSCD
2015年第3期156-160,共5页
CHINESE JOURNAL OF DIABETES MELLITUS
基金
国家自然科学基金（81360138）
新疆维吾尔自治区科技计划基金（201141137）
关键词
糖尿病
2型
肝纤维化
危险因素
Diabetes mellitus,type 2
Hepatic fibrosis
Risk factors
