乙肝肝硬化合并2型糖尿病患者能量代谢特点及护理
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- 论文作者：时淑云 ; 刘菲菲 ; 李胜利 ; 赵娟 ; 孟庆华
- 年：2016
- 作者机构：首都医科大学附属北京佑安医院肝病重症医学科;
- 论文关键词：肝硬化 ; 2型糖尿病 ; 能量代谢 ; 护理
- 英文论文关键词：Liver cirrhosis ; type 2 diabetes mellitus ; energy metabolism ; nursing
- 会议召开时间：2016-11-25
- 会议录名称：湖南中医药大学学报2016/专集：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集
- 语种：中文
- 分类号：R473.5
- 学会代码：HNZY
- 会议名称：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会
- 会议地点：中国广东珠海
- 主办单位：国际数字医学会、Digital Chinese Medicine
- 学会名称：湖南中医药大学期刊杂志社
- 页数：2
- 文件大小：2073k
- 原文格式：D
- 会议级别：全国
摘要
目的研究乙肝肝硬化合并2型糖尿病患者能量代谢特点及护理干预措施。方法选取首都医科大学附属北京佑安医院2005年5月-2015年12月收治的30例乙肝肝硬化合并2型糖尿病患者、30例乙肝肝硬化患者为研究对象,应用代谢车进行能量代谢指标测定,包括静息能量消耗(REE)、预测REE(p REE)、呼吸商(RQ),并测定空腹血糖。计量资料两组比较采用独立样本t检验。结果乙肝肝硬化合并2型糖尿病组实测REE为(1700.03±377.77)kcal/day,明显高于乙肝肝硬化组(1306.67±294.23)kcal/day,P=0.000。乙肝肝硬化合并2型糖尿病组REE/p REE(%)为(112.77±23.74)%,明显高于乙肝肝硬化组(86.80±18.87)%,P=0.000。乙肝肝硬化合并2型糖尿病组呼吸商低于乙肝肝硬化组,但差异无统计学意义(P=0.098),两组空腹血糖差异具有统计学意义(P=0.000)。结论乙肝肝硬化合并2型糖尿病患者REE升高,呈高代谢状态,合适的护理有助于临床营养干预实施。
Objective: To study the characteristics of energy metabolism and nursing interventions in patients of hepatitis B virus related liver cirrhosis with type 2 diabetes mellitus. Methods:This study included 30 cases of hepatitis B virus related liver cirrhosis with type 2 diabetes mellitus, 30 cases of hepatitis B virus related liver cirrhosis admitted to Beijing You An Hospital affiliated toCapital Medical University from May 2005 to December 2015. Energy metabolism indices were measured with the critical care management system, including resting energy expenditure(REE), predictedresting energy expenditure(p REE), respiratory quotient. Fasting blood glucose was also measured. For continuous data, comparison between two groups was made by independent-samples t test. Results: REE in the liver cirrhosis with type 2 diabetes group was(1700.03±377.77) kcal/day, higher than the liver cirrhosis group [(1306.67±294.23) kcal/day, P= 0.000]. REE as a percentage of the predictedREE [REE/p REE(%)] in the liver cirrhosis with type 2 diabetic group was(112.77±23.74)%, significantly higher than the cirrhosis group [(86.80±18.87)%, P=0.000]. The liver cirrhosis with type 2 diabetes group had a reduced respiratory quotient, the difference was not statistically significant in two groups(P = 0.098).. Fasting blood glucose in the liver cirrhosis with type 2 diabetes group washigher than the cirrhosis group(P = 0.000). Conclusion: Liver cirrhosis patients with type 2 diabetes have an elevated REE, show a hyper metabolic state. Nursing interventions help to improve theefficiency of nutritional intervention.
Objective: To study the characteristics of energy metabolism and nursing interventions in patients of hepatitis B virus related liver cirrhosis with type 2 diabetes mellitus. Methods:This study included 30 cases of hepatitis B virus related liver cirrhosis with type 2 diabetes mellitus, 30 cases of hepatitis B virus related liver cirrhosis admitted to Beijing You An Hospital affiliated toCapital Medical University from May 2005 to December 2015. Energy metabolism indices were measured with the critical care management system, including resting energy expenditure(REE), predictedresting energy expenditure(p REE), respiratory quotient. Fasting blood glucose was also measured. For continuous data, comparison between two groups was made by independent-samples t test. Results: REE in the liver cirrhosis with type 2 diabetes group was(1700.03±377.77) kcal/day, higher than the liver cirrhosis group [(1306.67±294.23) kcal/day, P= 0.000]. REE as a percentage of the predictedREE [REE/p REE(%)] in the liver cirrhosis with type 2 diabetic group was(112.77±23.74)%, significantly higher than the cirrhosis group [(86.80±18.87)%, P=0.000]. The liver cirrhosis with type 2 diabetes group had a reduced respiratory quotient, the difference was not statistically significant in two groups(P = 0.098).. Fasting blood glucose in the liver cirrhosis with type 2 diabetes group washigher than the cirrhosis group(P = 0.000). Conclusion: Liver cirrhosis patients with type 2 diabetes have an elevated REE, show a hyper metabolic state. Nursing interventions help to improve theefficiency of nutritional intervention.
引文
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[3]Meng QH,Wang JH,Yu HW,et al.Resting energy expenditure and substrate metabolism in Chinese patients with acute or chronic hepatitis B or liver cirrhosis[J].Intern Med,2010,49:2085-2091.
[4]中华医学会传染病与寄生虫病学分会,肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志,2000,8:324-329.
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[6]杜佩玉.肝硬化合并肝源性糖尿病的护理体会[J].实用临床医药杂志,2014,18:170-171+173.
[7]赵娟,李娟,于红卫,等.乙型肝炎肝硬化合并2型糖尿病病人能量代谢特点的研究[J].肠外与肠内营养,2015,22:6-9.
[8]Plauth M,CabréE,Campillo B,et al.ESPEN Guidelines on Parenteral Nutrition:hepatology[J].Clin Nutr,2009,28:436-444.
[9]于红卫,赵娟,王克菲,等.睡前加餐对不同Child-Pugh分级肝硬化患者能量代谢的影响研究[J].传染病信息,2012,25:216-219.
[10]Koreeda C,Seki T,Okazaki K,et al.Effects of late evening snack including branched-chain amino acid on the function of hepatic parenchymal cells in patients with liver cirrhosis[J].Hepatol Res,2011,41:417-422.基金项目:国家卫计委2014重点建设专科项目(WJWYA-2014-001),北京市卫计委科技成果和适宜技术推广项目(编号:TG-2014-01)。
[2]赵长青,顾宏图,邢枫,等.乙型肝炎肝硬化合并糖尿病的临床特点[J].临床肝胆病杂志,2012,28:450-455.
[3]Meng QH,Wang JH,Yu HW,et al.Resting energy expenditure and substrate metabolism in Chinese patients with acute or chronic hepatitis B or liver cirrhosis[J].Intern Med,2010,49:2085-2091.
[4]中华医学会传染病与寄生虫病学分会,肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志,2000,8:324-329.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2010年版)[J].中国糖尿病杂志,2012,20:S1-S37.
[6]杜佩玉.肝硬化合并肝源性糖尿病的护理体会[J].实用临床医药杂志,2014,18:170-171+173.
[7]赵娟,李娟,于红卫,等.乙型肝炎肝硬化合并2型糖尿病病人能量代谢特点的研究[J].肠外与肠内营养,2015,22:6-9.
[8]Plauth M,CabréE,Campillo B,et al.ESPEN Guidelines on Parenteral Nutrition:hepatology[J].Clin Nutr,2009,28:436-444.
[9]于红卫,赵娟,王克菲,等.睡前加餐对不同Child-Pugh分级肝硬化患者能量代谢的影响研究[J].传染病信息,2012,25:216-219.
[10]Koreeda C,Seki T,Okazaki K,et al.Effects of late evening snack including branched-chain amino acid on the function of hepatic parenchymal cells in patients with liver cirrhosis[J].Hepatol Res,2011,41:417-422.基金项目:国家卫计委2014重点建设专科项目(WJWYA-2014-001),北京市卫计委科技成果和适宜技术推广项目(编号:TG-2014-01)。