CAJ | 학술논문

目的探讨北京地区肝炎肝硬化患者伴发代谢紊乱的临床特征及代谢综合征(MS)发病率.方法对455例住院的肝炎肝硬化患者,统计各种代谢紊乱发病率,并根据病原学分为慢性乙型肝炎肝硬化(LCB)351例(LCB组)和慢性丙型肝炎肝硬化(LCC)104例(LCC组),分别比较分析肝硬化合并MS与肝硬化非MS代谢紊乱特征.结果肝炎肝硬化患者高血糖、高血压、高血脂、肥胖及MS的发病率分别为46.59%(212/455)、15.16%(69/455)、15.38%(70/455)、22.64%(103/455)、12.53%(57/455).LCB和LCC合并MS发病率分别为8.26%(29/351)、26.92%(28/104),LCB合并MS患者体重指数(BMI)、空腹血糖、高血压、总胆固醇、丙氨酸氨基转移酶(ALT)显著高于LCB非MS患者,但HBeAg和乙型肝炎病毒(HBV)DNA阳性率差异无统计学意义.LCC合并MS患者BMI、高血压、三酰甘油显著高于LCC非MS患者,但空腹血糖、总胆固醇、ALT差异无统计学意义.非条件Logistic回归分析结果显示BMI是影响LCB和LCC合并MS的独立危险因素.结论 LCB和LCC患者高血糖和肥胖的发病率较高,LCB合并MS发病率低于普通人群,而LCC合并MS发病率显著高于普通人群,其发生与病毒复制无关,BMI是影响肝炎肝硬化患者合并MS的重要因素.
목적 탐토북경지구간염간경화환자반발대사문란적림상특정급대사종합정(MS)발병솔.방법 대455례주원적간염간경화환자,통계각충대사문란발병솔,병근거병원학분위만성을형간염간경화(LCB)351례(LCB조)화만성병형간염간경화(LCC)104례(LCC조),분별비교분석간경화합병MS여간경화비MS대사문란특정.결과 간염간경화환자고혈당、고혈압、고혈지、비반급MS적발병솔분별위46.59%(212/455)、15.16%(69/455)、15.38%(70/455)、22.64%(103/455)、12.53%(57/455).LCB화LCC합병MS발병솔분별위8.26%(29/351)、26.92%(28/104),LCB합병MS환자체중지수(BMI)、공복혈당、고혈압、총담고순、병안산안기전이매(ALT)현저고우LCB비MS환자,단HBeAg화을형간염병독(HBV)DNA양성솔차이무통계학의의.LCC합병MS환자BMI、고혈압、삼선감유현저고우LCC비MS환자,단공복혈당、총담고순、ALT차이무통계학의의.비조건Logistic회귀분석결과현시BMI시영향LCB화LCC합병MS적독립위험인소.결론 LCB화LCC환자고혈당화비반적발병솔교고,LCB합병MS발병솔저우보통인군,이LCC합병MS발병솔현저고우보통인군,기발생여병독복제무관,BMI시영향간염간경화환자합병MS적중요인소.
Objective To explore the clinical characteristics of metabolic disorder and the incidence rate of metabolic syndrome (MS) in the patients with posthepatitic cirrhosis.Methods Four hundred and fifty-five patients with posthepatitic cirrhosis were included in the study and divided into hepatitis B related cirrhosis group (LCB group,351 cases) and hepatitis C related cirrhosis group (LCC group,104cases).The prevalence of metabolic disorder was recorded and the characteristics of posthepatitic cirrhosis with MS and without MS were compared and analysed.Results The prevalence of hyperglycemia,hypertension,hyperlipemia,obesity and MS in the posthepatitic cirrhosis patients was 46.59% (212/455),15.16% (69/455),15.38% (70/455),22.64% ( 103/455),12.53% (57/455) respectively.The prevalence of MS in LCB and LCC was 8.26% (29/351) and 26.92% (28/104).The levels of body mass index (BMI),fasting blood glucose,hypertension,cholesterol,aminotransferase (ALT) in LCB with MS patients were significantly higher than those in LCB without MS patients.There were no differences in the levels of HBeAg and HBV DNA between LCB with MS patients and LCB without MS patients.The levels of BMI,hypertension,triglyceride in LCC with MS patients were significantly higher than those in LCC without MS patients.There were no differences in fasting blood glucose,cholesterol and ALT between LCC with MS patients and LCC without MS patients.Logistic regression revealed that BMI was the independent factor in LCB and LCC with MS.Conclusions The prevalence of hyperglycemia and obesity are higher in LCB and LCC.The incidence rate of MS in LCB is less than that in the general population,while the incidence rate of MS in LCC is significantly higher than that in the general population,and it's nothing to do with the viral replication.BMI is an important factor affected in posthepatitic cirrhosis with MS.