摘要
目的探讨慢性乙型肝炎患者出现肝纤维化的代谢影响因素,为临床诊治提供参考。方法选取2012年5月-2014年5月收治的慢性乙型肝炎代谢异常患者112例为研究对象,根据患者的糖代谢状态和脂代谢情况进行分组,探讨患者的糖脂代谢异常和脂肪肝对慢性乙型肝炎患者出现肝纤维化的影响。结果慢性乙型肝炎患者胰岛素抵抗指数(HOMA-IR)越大,肝脏弹性值(LSM)越高,各项肝酶、总胆红素(TB)亦随HOMA-IR增大而有所升高;胰岛β细胞功能(HOMA-β)差,LSM高,各项肝酶、TB亦随HOMA-β降低而有所升高;检测结果显示,患者的糖代谢功能越差,其LSM、ALP及GGT就越高,患者出现脂肪肝的可能性就越大,检测的LSM的F值为4.563,P值为0.031,ALP的F值为9.387,P值为0.008,GGT的F值为12.672,P值为0.01,患者体内的其他肝酶和TB也会因糖代谢的恶化而升高,但组间比较无统计学意义。结论慢性乙型肝炎患者胰岛素抵抗、胰岛β细胞功能减退、糖脂代谢状态的恶化可促进肝纤维化的进程。
OBJECTIVE To explore the metabolism-related influencing factors for liver fibrosis in patients with chronic hepatitis B so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 112 chronic hepatitis B patients with metabolic abnormality who were treated in the hospital from May 2012 to May 2014 were recruited as the study objects and were grouped according to the glucometabolic state and lipid metabolism status.The influence of glycolipid metabolic abnormalities and fatty liver on liver fibrosis was observed.RESULTS The greater the HOMA-IR of the patients with chronic hepatitis B,the higher the liver elasticity value（LEV）was;the liver enzymes and TB were elevated with the increase of HOMA-IR.The poorer the HOMA-β,the higher the LSM,and the liver enzymes and TB were elevated with the decrease of HOMA-β.The test result indicated that the poorer the glucose metabolism,the higher the LSM,ALP,and GGT were,the greater the possibility of the fatty liver.The F value was 4.563 in detection of LSM,with the P value 0.031;the F value was 9.387 in detection of ALP,with the P value 0.008;the F value was 12.672 in detection of GGT,with the P value 0.01.The other liver enzymes and TB were also elevated due to the deterioration of glucose metabolism,however,there was no significant difference.CONCLUSION The patients with chronic hepatitis B have the insulin resistance,isletβcell dysfunction,and deterioration of glucose and lipid metabolism,which may accelerate the process of liver fibrosis.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第17期3889-3891,共3页
Chinese Journal of Nosocomiology
基金
山东省自然科学基金资助项目(2014ZRB14544)
