目的：探讨慢性乙型肝炎（乙肝）相关性糖尿病的临床特点及其危险因素。方法回顾性分析187例乙肝相关性糖尿病患者（病例组）及187例同期住院乙肝患者（对照组）的相关资料。结果病例组患者的空腹血糖（FBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FIns）、γ‐谷氨酰转肽酶（GGT）、HBV DNA载量、肌酐（Cr）、三酰甘油（TG）表达以及脂肪肝和肝硬化比例均高于对照组（P＜0．05）。单因素及多因素Logistic回归分析显示，乙肝病程长、高HBV DNA载量（≥106 copies／ml）、高GGT（≥200 U／L）、高TG（≥1.7 mmol／L）、合并酒精性脂肪肝、肝硬化等6项为乙肝相关性糖尿病的独立危险因素（P＜0．05）。结论慢性乙肝患者应当控烟控酒、监测生化及病毒学指标、防治脂肪肝和肝硬化，以期减少乙肝相关性糖尿病的发病风险。%Objective To investigate the clinical features and risk factors of patients with chronic hepatitis B (CHB)‐associated diabetes mellitus .Methods The clinical data ,laboratory and imaging examinations of 187 cases with CHB‐associated diabetes mellitus(group A) and 187 cases hospitalized with CHB(group B) were retrospectively analyzed .Results The levels of fasting blood glucose(FBG) ,glycated hemoglobin(HbA1c) ,fasting insulin(FIns) ,gamma glutamyl transpeptidase (GGT) ,HBV DNA loads ,creatinine(Cr) ,triacylglycerol(TG) and the proportion of fatty liver ,liver cirrhosis were higher in group A than those in group B(P<0 .05) .The univariate and multivariate logistic regression analysis showed that long duration of illness ,high HBV DNA loads(≥ 106 copies/ml) , high GGT(≥200 U/L) ,high TG(≥1.7 mmol/L) ,combined with fatty liver and liver cirrhosis were the independent risk factors of the patients with CHB‐associated diabetes mellitus ( P<0 .05 ) . Conclusion Patients with CHB should take the restrictions on tobacco and wine ,monitor biochemical and virological indexs ,prevent and treat fatty liver and liver cirrhosis in order to reduce the risk for C HB‐associated diabetes mellitus .
展开▼
