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探讨原发性肝癌患者（ＰＨＣ）糖代谢紊乱（ＤＧＭ）的发生率，ＰＨＣ患者并ＤＧＭ时空腹血浆胰岛素、Ｃ肽水平变化；ＰＨＣ并ＤＧＭ的临床特点；与肿瘤大小的关系及对患者预后的影响。方法用酶法测定２７１例ＰＨＣ患者的空腹血糖，４５例异常者用酶法加测餐后２小时血糖，用ＲＩＡ法测定空腹血浆胰岛素（ＩＮＳ）和Ｃ肽。结果ＰＨＣ并ＤＧＭ的发生率为１６６％。ＤＧＭ发生时空膜ＩＮＳ和Ｃ肽水平无明显变化。临床表现不典型，高血糖患者无明显糖尿病症状，而低血糖患者以意识障碍为突出表现。ＰＨＣ并ＤＧＭ发生与病变范围有关。结论ＰＨＣ患者ＤＧＭ并不少见，多见于病变范围广泛者且提示预后不良。ＤＧＭ发生并非仅由ＩＮＳ、Ｃ肽水平变化所致。对此有ＰＨＣ患者应常规监测血糖变化。
To investigate the incidence of glycometabolism disorder (DGM) in patients with primary liver cancer (PHC), changes in fasting plasma insulin and C-peptide levels in PHC patients and DGM; clinical features of PHC and DGM; relationship with tumor size and prognosis for patients influences. Methods Enzymatic determination of fasting blood glucose in 271 patients with PHC was performed. Forty-five patients with abnormalities were measured by enzymatic plus 2 hours postprandial blood glucose. Fasting plasma insulin (INS) and C peptides were measured by RIA. The incidence of PHC and DGM was 16.6%. There was no significant change in the levels of INS and C peptides in the temporal and spatial membranes of DGM. The clinical manifestations were not typical. Hyperglycemic patients had no obvious symptoms of diabetes, and patients with hypoglycemia showed prominent disturbance of consciousness. The incidence of PHC and DGM is related to the extent of the lesion. Conclusions DGM in patients with PHC is not uncommon. It is more common in patients with a wide range of lesions and suggests a poor prognosis. The occurrence of DGM is not caused only by changes in the levels of INS and C peptides. Patients with PHC should routinely monitor blood glucose changes.