糖尿病对乙肝肝硬化患者生存状况的影响

Effect of diabetes mellitus on survival of patients with hepatitis B cirrhosis

摘要:

目的 探讨糖尿病对乙肝肝硬化患者生存状况的影响。方法 选取2010 年3 月-2011 年5 月齐齐 哈尔医学院附属第三医院收治的乙肝肝硬化患者137 例，依据糖尿病合并情况分为糖尿病组和非糖尿病组，比 较两组患者的生存率和并发症发生率，并对患者的临床资料进行多因素Cox 比例风险模型分析。结果 糖尿病 组1 年生存率88.64%（39 例），非糖尿病组97.85%（91 例），经χ2 检验，差异有统计学意义（P <0.05），糖尿病 组低于非糖尿病组；糖尿病组3 年生存率61.36%（27 例），非糖尿病组80.65%（75 例），经χ2 检验，差异有统 计学意义（P <0.05），糖尿病组低于非糖尿病组；糖尿病组5 年生存率20.45%（9 例），非糖尿病组40.86%（38 例），经χ2 检验，差异有统计学意义（P <0.05），糖尿病组低于非糖尿病组。即糖尿病组患者的1、3 和5 年 生存率均低于非糖尿病组。糖尿病组并发症的总发病率为45.45%，非糖尿病组并发症的总发病率为25.81%， 经χ2 检验，差异有统计学意义（P <0.05），糖尿病组患者的不良并发症总发生率高于非糖尿病组。两组患者 饮酒、糖尿病病程、Child-Pugh C 级、HBV DNA ≥ 3 lg 拷贝/ml 的R^R 值的比较差异有统计学意义（P <0.05）。 结论 糖尿病是影响乙肝肝硬化患者生存状况的危险因素，合并糖尿病的乙肝肝硬化患者的远期生存率较低， 不良并发症发生风险较高。

Abstract:

Objective To investigate the effect of diabetes mellitus on the survival of the patients with hepatitis B cirrhosis. Methods In this study 137 patients with HBV-related liver cirrhosis treated in the Third Affiliated Hospital of Qiqihar Medical College from March 2010 to May 2011 were divided into diabetic group and nondiabetic group according to the diabetes mellitus. The survival rate and complication rate of the two groups were compared, and the clinical data were analyzed by multivariate COX proportional hazards model analysis. Results The 1-year survival rate (97.85%) in the non-diabetic group was much higher than that in the diabetic group (88.64%), the difference was statistically significant (P < 0.05). The 3-year survival rate in the non-diabetic group was significantly higher than that in the diabetic group (80.65% vs. 61.36%, P < 0.05). The 5-year survival rate in the non-diabetic group was significantly higher than that in diabetic group (40.86% vs. 20.45%, P < 0.05). The 1-year, 3-year and 5-year survival rates in the diabetic group were lower than those in the non-diabetic group. The total incidence of complications in the diabetic group was 45.45%, the total incidence of complications in the non-diabetic group was 25.81%, the difference was statistically significant by χ2 test (P < 0.05). The R^R values of alcohol drinking,diabetes course, Child-Pugh grade C, HBV DNA ≥ 3 lg copy/ml were significantly different between the two groups (P < 0.05). Conclusions Diabetes mellitus is a risk factor for the survival of the patients with hepatitis B cirrhosis. The long-term survival rate of the patients with hepatitis B cirrhosis complicated with diabetes is low and the risk of adverse complications is high.