【摘要】 目的　观察肝炎后肝硬化继发糖尿病患者糖代谢紊乱和胰岛素抵抗相关指标。方法　 30例既往有肝硬化病史 (Child pughA、B级 )但无糖尿病史 ,血压正常的肝源性糖尿病患者 (组 1) ,分别检测空腹血糖 (FPG)、空腹血浆胰岛素 (FPI)、空腹C 肽 ,糖化血红蛋白 (HbA1c) ,计算胰岛素敏感性指数 (ISI) ,并以非糖尿病患者 30例 (组 2 )和 2 6例正常人 (组 3)为对照研究。结果　与组 2组 3比较 ,组 1空腹血糖升高 (分别为 P<0 .0 5和 P<0 .0 1) ,空腹C 肽水平无明显差异 ,但空腹血浆胰岛素水平升高 (P均 <0 .0 5 ) ,胰岛素敏感性指数降低 (分别为P <0 .0 5和P <0 .0 1)。组 2与组 3间比较 ,组 2空腹血浆胰岛素水平轻度升高 ,胰岛素敏感性指数降低 ,但差异无统计学意义。结论　胰岛素抵抗和高胰岛素血症可能为肝源性糖尿病形成的危险因素更多还原

【Abstract】 Objective To determine glucose metabolic disorder and insulin resistance and their correlation index in patients with hepatic diabetes.Methods Thirty patients with cirrhosis secondary hepatic diabetes mellitus but normal blood pressure and without historic diabetes (Groups 1, G1) were selected to investigate the changes of fasting plasma glucose (FPG),fasting plasma insulin (FPI),fasting C peptide levels and HbA 1c.Insulin sensitivity index (ISI) was calculated.As control group,30 patients with cirrhosis without diabetes (G2) and 26 normal subjects (G3) whose age,sex and body mass index (BMI) corresponding to G1 were selected.Results Compared with control group,the levels of FPG of G1 were all significantly higher than G2 and G3 (respectively P< 0.05 and P< 0.01 ),there was no obvious difference for fasting C peptide in plasma (P> 0.05 ),but the level of fasting plasma insulin (FPI) of G1 obviously rose and insulin sensitivity index remarkably decreased (respectively P< 0.05 and P< 0.01 ).Conclusion The results indicated that insulin resistance and hyperinsulinemia might be risk factors for the development of hepatic diabetes.更多还原