2型糖尿病和血小板计数在原发性肝癌患者中的关系研究

Association Between Type-2 Diabetes Mellitus and Platelet Count in Patients with Primary Liver Cancers

目的探讨2型糖尿病和血小板计数在原发性肝癌患者中的关系。方法采用横断面研究,按照诊断标准、纳入和排除标准,研究纳入2003年1月至2012年4月在中日友好医院住院且以＂原发性肝癌＂作为主要诊断的患者375例。分析入选患者的人口统计学、临床、生化、代谢等资料,二元非条件Logistic回归分析研究2型糖尿病和血小板计数在原发性肝癌患者中的关系。结果 375例患者中,63例（16.8%）合并2型糖尿病,患者的平均白细胞计数（4.13±2.49）×10~9/L,血红蛋白定量（132.5±23.8）g/L,血小板计数的中位数和四分位数间距130/（85~189）×10~9/L,国际标准化比值（1.20±0.27）。两组比较的结果提示,血小板计数[113/（64~157）×10~9/L vs.139/（89~192）×10~9/L,P=0.020]在两组人群中差异存在统计学意义。多因素分析的结果显示,在控制年龄、乙肝感染、血红蛋白定量和INR等情况下,血小板计数不是原发性肝癌合并2型糖尿病患者的独立相关因素,OR值为0.999,95%CI：0.995~1.003（P=0.505）。结论原发性肝癌合并2型糖尿病患者的血小板计数明显低于肝癌不合并糖尿病患者,Logistic回归分析归因于其他因素的作用。

Objective To determine the association between type-2 diabetes mellitus（DM） and platelet count in patients with primary liver cancers（PLC）. Methods We included 375 patients with a hospital discharge diagnosis of PLC treated in the China-Japan FriendshipHospital from January 2003 to April 2012 in this investigation, according to the diagnostic criteria, inclusion and exclusion criteria. The demographic, clinical, biochemical and metabolic data were analyzed; and the multivariate logistic regression model was used to determine the association between DM and platelet count in PLC patients. Results Of the total 375 patients, 63（16.8%） cases were diagnosed with DM, the mean neutrophil count was（4.13±2.49）×10~9/L, the mean hemoglobin was（132.5±23.8）g/L, the median/interquartile range of platelet count was 130/（85-189）×10~9/L and the mean international normalized ratio（INR） level was（1.20±0.27）. A statistical difference was found by univariate analysis for the platelet count [113/（64-157）×10~9/L vs. 139/（89-192）×10~9/L, P=0.020], however, no statistical difference（OR=0.999, 95%CI： 0.995-1.003, P=0.505） was found by the multivariate analysis, after controlling the age, HBV infection, hemoglobin and INR. Conclusion PLC patients with type-2 DM have obviously decreased platelet count, compared with those without DM, which is modified by other factors.