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目的 检测肝炎肝硬化患者血清瘦素水平 ,并探讨瘦素与肝硬化患者肝功能、胰岛素抵抗及其营养参数之间的关系。方法 2 0 0 2 - 0 3～ 2 0 0 3- 0 1河北医科大学第二医院 32例男性肝炎肝硬化患者及 14名男性健康受试者均测定空腹血糖 (FPG)、空腹胰岛素 (FINS)和瘦素 ,同时测量肝硬化患者的营养参数 ,并对肝硬化患者进行Child -pugh分级。结果 肝硬化患者血清瘦素水平显著高于正常对照组 (P <0 . 0 5 ) ;但依据Child -pugh分级后的 3组肝硬化患者间的血清瘦素水平差异无显著性 (P >0 . 0 5 ) ;血清瘦素水平与体重指数 (BMI)、三头肌皮褶厚度 (TSF)及FINS均呈显著性正相关 (r值分别为 0 . 343、0 .340和 0 . 35 2 ,P值均 <0 . 0 5 ) ,而与肌酐身高指数 (CHI)及胰岛素敏感指数 (ISI)均呈负相关 (r值分别为 - 0 .36 0和 - 0 . 4 16 ,P值均 <0 . 0 5 )。结论 肝炎肝硬化患者血清瘦素水平的改变可能与肝功能无关 ,但参与了肝硬化的营养不良和胰岛素抵抗。
Objective To detect serum leptin levels in patients with liver cirrhosis and to investigate the relationship between leptin and liver function, insulin resistance and nutritional parameters in patients with liver cirrhosis. Method 2 0 0 2 - 0 3 ~ 2 0 0 3- 0 1 32 cases of hepatitis and cirrhosis of male patients and 14 male healthy subjects in the Second Hospital of Hebei Medical University were measured fasting blood glucose (FPG), fasting insulin (FINS) And leptin, at the same time measure the nutritional parameters of patients with cirrhosis, and cirrhosis patients Child-pugh classification. Results The level of serum leptin in patients with cirrhosis was significantly higher than that in the normal control group (P <0.05). However, there was no significant difference in serum leptin levels between the three groups according to Child-Pugh classification (P> 0 .05). Serum leptin level was positively correlated with body mass index (BMI), triceps skinfold fold (TSF) and FINS (r = 0.343,0.340 and 0.352 , P <0.05), but negatively correlated with creatinine index (CHI) and insulin sensitivity index (ISI) (r values were -0.360 and -0.416 respectively, both P values <0. 0 5). Conclusions Serum leptin level in cirrhotic patients may not be related to liver function, but it is involved in the malnutrition and insulin resistance in cirrhosis.