糖代谢紊乱与头颈部鳞癌放射性皮炎相关性研究

Study on the correlation between glucose metabolic disorders and radiodermatitis of the patients with squamous cell carcinoma in the head and neck

目的:探讨糖代谢紊乱与头颈部鳞癌放射性皮炎的相关性。方法:对1043例头颈部鳞癌患者治疗前后分别检测空腹和餐后2h血糖,观察放射性皮炎程度,并分析其与血糖水平的相关性。结果:空腹血糖、餐后2h血糖与放射性皮炎程度呈正相关;糖代谢紊乱和非糖代谢紊乱患者3级以上放射性皮炎发生率分别为16.67%和11.05%,两组差异有统计学意义(P<0.05);放疗前后空腹血糖受损、糖耐量低减和总糖代谢紊乱发生率有极显著性差异(P<0.01)。结论:头颈部鳞癌放疗可诱发和加重糖代谢紊乱,合并糖代谢紊乱者放射性皮炎发生率高、程度重,影响预后,应加强放射野皮肤的保护,并严格控制血糖。

Objective： To explore the correlation between glucose metabolic disorders and radiodermatitis of the patients with squamous cell carcinoma in the head and neck. Methods ： The patients＇ fasting blood - glucose and postprandial blood glucose after 2 hrs. were assayed before and after the treatment, observing the degree of radiodermatitis of the patients so as to analyze the correlation between glucose metabolic disorders and radiodermatitis. Results： The positive correlation was found between fasting, postprandial blood - glucose and degree of radiodermatitis ; the incidence of radiodermatitis above degree Ⅲ in the patients with glucose metabolic disorders and non glucose metabolic disorders was respectively 11.67% and 11.05%, the difference between the two groups was significant （P 〈0.05} ; there were significant differences in the comparison of loss of fasting blood - glucose, impaired glucose tolerance and the total glucose metablic disorders before and after the treatment （P 〈 0. 01 ）. Conclusion： Radiotherapy can induce or worsen the glucose metabolic disorders and the incidence of radiodermatitis is higher in the patients with combined glucose metabolic disorders and therefore it affects prognosis. Protection of the skin exposed to radiotherapy and control of blood glucose are necessary.