丁惠国 闵佳 林秀玉 于中麟 郭雁宾 金瑞 吴昊 闵福援 杨东旭 100054 北京佑安医院(丁惠国、闵佳、林秀玉、郭雁宾、金瑞、吴昊、闵福援)首都医科大学(杨东旭)；北京友谊医院(于中麟) 中华肝脏病杂志 1998 0 0 1


    关键词：肝硬化 胰岛素抵抗 相关因素 治疗 期刊 zhgzbzz 0 临床研究 fur -->


    

【摘要】 目的 研究肝硬化患者胰岛素敏感性及其相关因素，并探讨降门脉压力药物治疗肝硬化胰岛素抵抗的可行性。 方法 肝硬化患者22例，正常对照15例。治疗前后(心得安40mg/d，硝苯吡啶20mg/d)分别测定胰岛素敏感性及多肽激素变化。 结果 肝硬化患者血清胰岛素及GH水平增加(P<0.05～0.01)，胰岛素敏感性降低(P<0.05)，联合治疗后3周，肝硬化患者胰岛素敏感性增加(P<0.05)，血浆SS水平升高，而GH与VIP降低(P<0.05～0.01)；多元回归相关因素分析发现肝硬化患者胰岛素敏感性与GH及胰岛素呈负相关(rr＝0.903，P<0.05～0.01)。 结论 肝硬化患者存在高胰岛素血症及胰岛素抵抗，联合应用心得安与硝苯吡啶不仅能有效的治疗门脉高压症，而且能增加肝硬化患者胰岛素敏感性，改善异常的糖代谢。

    

CLINICAL RESEARCH ONINSULIN RESISTANCE IN CIRRHOTIC PATIENTS

Ding Huiguo, Min Jia, Lin Xiuyu, et al. Beijing You'an Hospital, Beijing 100054

【Abstract】 Objective Toresearch on insulin sensitivity and its relative factors. The treatment with propanololand nifedipine on insulin resistance in cirrhotic patients was also studied. Methods 22cirrhotic patients (Child classifications A/B was in 5:6) and 15 healthy control subjectswere studied. Insulin sensitivity and poly-peptide hormone were detected before and aftertreatment with propanolol (40mg/d) and nifedipine (20mg/d). Results Increasedserum insulin and GH and decreased insulin sensitivity in cirrhotic patients were observed(P<0.05-0.001). After 3 weeks′treatment, improvedinsulin sensitivity and SS, decreased GH and VIP in cirrhotic patients were also observed(P<0.05). The negative relationship between insulin sensitivity and GH was observed. Conclusion Hyperinsulinemiaand insulin resistance in liver cirrhosis are the most common clinical features. Insulinresistance is related with increased GH. Propanolol and nifedipine may be effective intreatment on insulin resistance and glucose metabolic abnormalities, but effective intreatment on portal hypertension.

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