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2600例经组织学确诊的急慢性肝病患者的葡萄糖耐量紊乱(作者译)

[Disorders of glucose tolerance in 2600 histologically confirmed acute and chronic liver patients (author's transl)].

作者信息

Mütting D, Kaufmann M

出版信息

MMW Munch Med Wochenschr. 1975 Oct 17;117(42):1689-94.

PMID:810695
Abstract

Oral glucose tolerance tests (100 g glucose) and the intravenous tolbutamide test were carried out. The glucose tolerance was seen to be disordered even in acute infectious hepatitis, but returning to normal when cured. If chronic hepatitis develops, however, the proportion of manifest diabetes increases to 7.2% in chronic persistent hepatitis and to 16.3% in chronic progressive hepatitis, while 30% each have latent diabetes. The glucose tolerance is most impaired in fatty liver (stage III) and in active cirrhosis of the liver with portal hypertension, where more than half of all patients present manifest or latent diabetes. Conversely, glucose tolerance improves even in chronic hepatitis and in cirrhosis of the liver as the inflammatory activity subsides. The main cause for the development of "liver diabetes" is therefore likely to be the activity of the inflammatory process, the extent of portal hypertension, disorders of glucose regulation in the liver and the increased insulin inactivation in the cirrhotic liver.

摘要

进行了口服葡萄糖耐量试验(100克葡萄糖)和静脉注射甲苯磺丁脲试验。即使在急性传染性肝炎中也可见葡萄糖耐量紊乱,但治愈后恢复正常。然而,如果发展为慢性肝炎,显性糖尿病的比例在慢性持续性肝炎中增至7.2%,在慢性进行性肝炎中增至16.3%,而各有30%的患者有潜在糖尿病。葡萄糖耐量在脂肪肝(Ⅲ期)和伴有门静脉高压的活动性肝硬化中受损最严重,所有患者中有一半以上存在显性或潜在糖尿病。相反,随着炎症活动消退,即使在慢性肝炎和肝硬化中葡萄糖耐量也会改善。因此,“肝源性糖尿病”发生的主要原因可能是炎症过程的活动、门静脉高压的程度、肝脏葡萄糖调节紊乱以及肝硬化肝脏中胰岛素灭活增加。

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