病毒性肝炎合并糖尿病患者终末期肝病影响因素分析

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中图分类号：R587.1；R512.6 文献标志码：A DOI：10.3969/j. issn.1003-1383.2025.04.004

Analysis of influencing factors of end-stage liver disease in patients withviralhepatitiscombinedwith diabetesmellitus

LUO Yan 1 ，SONG Xiaolong'，LI Nana’，MAO Yongkang 1 ， LIU Dafeng 2 ， ZHU Yanfeng 1∙ （1.School of Public Health，Chengdu Medical College，Chengdu 61o5OO，Sichuan，China; 2.Public Health Clinical Center ofChengdu，Chengdu 61oo61，Sichuan，China）

【Abstract】ObjectiveTo explore the influencing factorsof end-stageliverdisease（ESLD）in patients with viral hepatitiscombied with diabetes melltus，and toprovideabasisforthepreventionanddelayof disease progression inESD. MethodsClinicaldataof patientswithviral hepatitiscombinedwithdiabetesmelitusadmittedtoPublic Health Clinical Center of Chengdu from October 27，2O18 to January25，2022 were retrospectivelyanalyzed.Thepatients were divided into casegroupandcontrol groupbasedon whethertheysuffredfromESLD，andlogisticregressionanalysis wasused toidentify risk factors forESLD.ResultsUnivariateanalysisshowedthat gender，age，durationof viral hepatitis，whetherinsulin therapywasreceived，whetherantidiabeticdrugsweretaken，andtheclasificationofviralhepatitis were influencingfactors for ESLD（ P<0.05 ）.Afteradjusting the gender，the results of the multivariate logistic regresson analysis showed that older age （ OR=1.020 95% CI：1.011 - 1.030， P<0.05 ），longer duration of viral hepatitis （ OR=1.035 ，95% CI ： 1. 024 - 1.045， P<0.05 ），and receiving insulin therapy（ OR=1.261 ！ 95% CI：1.040 - 1.528， P<0.05 ）were independent risk factors for ESLD.Taking antidiabetic medications（ OR=0.478 95% CI：0.383-0.596，P<0.05）was a protective factor forESLD.Patients withhepatitisChadalowerrisk of developing thediseasecomparedtothosewithhepatitisB（ OR= 0.715， 95% CI：0.567 -0.901， P<0.05 ）.ConclusionIn patients with viral hepatitis combined with diabetes mellitus， olderage，longerdurationofviralhepatitis，ndinsulintreatmentinhepatitisBpatientsareasociatedwithahigherriskof developing ESLD，while the use of hypoglycemic agents may help delay the progression of liver disease.

【Keywords】viral hepatitis； diabetes melitus；end-stage liver disease（ESLD）；influence factors

终末期肝病（end-stage liver disease，ESLD）是多种肝脏损伤引发的肝病晚期，包括慢加急性肝衰竭、肝硬化失代偿、慢性肝衰竭以及肝细胞癌[1]。（剩余8179字）