目的：探讨2型糖尿病合并戊型肝炎患者的临床特征。方法：回顾性分析119例2型糖尿病合并戊型肝炎患者的性别、年龄等临床特征,另设无肝炎的2型糖尿病组（单纯糖尿病组）及单纯戊型肝炎组患者作为对照,比较3组的实验室检查结果。结果：2型糖尿病合并戊型肝炎组中,50~69岁年龄段的患病人数较多（占65%）。2型糖尿病合并戊型肝炎组患者的糖化血红蛋白（hemoglobinA1c, HbA1C）水平低于单纯糖尿病组患者[（8.0±1.8）%比（8.4±2.0）%]（P<0.01）,但2组间比较空腹血糖及餐后血糖差异无统计学意义（P>0.05）;2型糖尿病合并戊型肝炎组的总胆红素及天冬氨酸转氨酶明显低于单纯戊型肝炎组（P<0.05）;单纯糖尿病组、单纯戊型肝炎组、2型糖尿病合并戊型肝炎组这3组间比较的肾功能、血脂指标差异均无统计学意义（P>0.05）。结论：2型糖尿病合并戊型肝炎患者的HbA1c低于单纯糖尿病患者,其余血糖指标没有差异;与单纯戊型肝炎组患者相比,2型糖尿病合并戊型肝炎组患者的肝功能并没有出现进一步的减退。
Objective: To study the clinical characteristics of type 2 diabetes mellitus complicated with hepatitis E.Methods: The clinical characteristics of 119 type 2 diabetes patients complicated with hepatitis E were retrospectively analyzed. The results were compared with type 2 diabetes patients without hepatitis E (simpletype 2 diabetes mellitus) and with simple hepatitis E patients. Results: The number of patients between 50-69 years of age was higher in type 2 diabetes complicated with hepatitis E group (65%). HbA1C was lower than that in simple type 2 diabetes group（P<0.01）. There were no statistical significant differences between the two groups in fasting and postprandial blood glucose（P>0.05）. Compared with simple hepatitis E group, total bilirubin and AST were lower in type 2 diabetes patients complicated with hepatitis E（P<0.05）. There were no significant differences in renal function and blood lipid indexes between these three groups. Conclusions: HbA1C in type 2 diabetes patients complicated with hepatitis E was lower than that in patients with type 2 diabetes alone.Thereare no significant differences in other blood glucose indice. Compared with simple hepatitis E patients, there was no further decline in liver function in type 2 diabetes patients complicated with hepatitis E. The three groups had no significant differences in renal function and blood lipid indice.
[1] Xu Y, Wang L, He J, et al.Prevalence and control of diabetes in Chinese adults[J]. JAMA,2013,310(9):948-959.
[2] Jia Z, Yi Y, Liu J, et al.Epidemiology of hepatitis E virus in China: results from the Third National Viral Hepatitis Prevalence Survey, 2005-2006[J]. PLoS One,2014,9(10):e110837.
[3] 包叶江, 高孟, 姜立民, 等. 中国2004-2013年戊型肝炎的流行病学特征分析[J]. 国际流行病学传染病学杂志,2016,43(1):35-38.
[4] 胡虹英, 刘颖, 杨金奎. 2型糖尿病合并乙型肝炎病毒携带患者的临床分析[J]. 首都医科大学学报,2011,32(5):602-604.
[5] 刘大凤, 冉兴无, 王林, 等. 病毒性肝炎合并糖尿病的流行病学特征分析[J]. 中华实验和临床感染病杂志,2012,6(2):121-124.
[6] 中华医学会传染病寄生虫病学会和肝病学分会. 病毒性肝炎防治方案[J]. 中华肝脏病杂志,2000,8(6):324-329.
[7] 张军, 吴婷, 夏宁邵. 戊型肝炎诊断、预防及治疗新进展[J]. 传染病信息,2013,26(2):89-92.
[8] 陈奕娟, 秦淑文, 缪梓萍. 戊型肝炎流行病学研究新进展[J]. 预防医学,2016,28(10):1014-1018.
[9] 叶建明. 散发性急性戊型肝炎与乙型肝炎的临床特征比较[J]. 肝脏,2012,17(9):684.
[10] 李燕婷, 朱奕奕, 申伟国, 等. 上海市部分地区散发性戊型肝炎病毒基因型别和发病危险因素研究[J]. 中华流行病学杂志,2006,27(4):298-301.
[11] 曾国兵, 侯金林. 戊型病毒性肝炎的临床特点和诊断要点[J]. 中华肝脏病杂志,2004,12(1):49.
[12] 李晖, 汪亚玲, 杨永锐, 等. 云南省394例散发性急性戊型肝炎流行病学特点和临床特征分析[J]. 中华实验和临床感染病杂志,2011,5(4):414-422.
[13] 马英杰, 陈焕永, 姜宏齐, 等. 108例散发性戊型肝炎临床分析[J]. 哈尔滨医科大学学报,2007,41(3):265-267.
[14] 陆伟明. 老年戊型肝炎的特点[J]. 胃肠病学和肝病学杂志,2007,16(1):65-68.
[15] 蒋晓飞. 老年糖尿病患者慢性并发症及影响因素分析[J]. 安徽医学,2017,38(7):923-924.
[16] 程艳冬, 黄红玉, 陈姗姗, 等. 2型糖尿病患者戊型肝炎病毒感染状况调查[J]. 医学研究杂志,2017,46(4):36-40.
[17] 邵福灵. 肝源性糖尿病[J]. 临床荟萃,1998,13(2):576-578.
[18] Dhanwal DK, Agarwal S, Garg S, et al.Clinical & immunological profile of newly diagnosed patients with youth onset diabetes mellitus[J]. Indian J Med Res,2014, 140(3):356-360.
[19] Singh KK, Panda SK, Shalimar, et al. Patients with Diabetes Mellitus are Prone to Develop Severe Hepatitis and Liver Failure due to Hepatitis Virus Infection[J]. J Clin Exp Hepatol,2013,3(4):275-280.
[20] Murthy KA, Khan IM, Kiran PK, et al. A study of viral hepatitis e infection in a tertiary care hospital in mysore, South India[J]. Open Forum Infect Dis,2014,1(1):ofu036.
[21] Singh MP, Majumdar M, Goyal K, et al.Investigation of suspected viral hepatitis outbreaks in North West India[J]. Diagn Microbiol Infect Dis,2016,84(4):309-314.
