摘要
目的分析2型糖尿病合并肺癌患者血糖波动对化疗的影响。方法 80例2型糖尿病合并肺癌患者,根据日内平均血糖波动幅度(mean amplitude of plasma glucose excursion,MAGE)是否高于3.9mmol/L将患者分为正常波动组42例和高波动组38例。观察并比较2组肿瘤标志物、炎症因子水平及不良反应发生情况。结果高波动组MAGE[(5.75±1.28)mmol/L]、日间血糖平均绝对差[(1.45±0.64)mmol/L]、变异系数(1.68±0.73)、最大血糖波动幅度[(6.58±2.34)mmol/L]、空腹血糖[(7.26±1.52)mmol/L]和餐后2h血糖水平[(9.89±2.63)mmol/L]高于正常波动组[(3.79±1.03)mmol/L、(1.13±0.38)mmol/L、1.25±0.79、(4.11±1.52)mmol/L、(6.28±1.07)mmol/L、(7.68±1.65)mmol/L],差异均有统计学意义(P<0.05),高波动组患者癌胚抗原[(16.15±1.34)mg/L]、神经元特异性烯醇化酶[(18.92±4.32)mg/L]、细胞角蛋白19片段[(7.34±2.28)mg/L]、糖类抗原19-9[(77.26±6.67)u/mL]、糖类抗原153[(51.18±5.73)u/mL]、糖类抗原125[(85.19±7.16)u/mL]和鳞状上皮细胞癌抗原[(4.57±1.39)μg/L]、白细胞介素-6[(28.79±6.23)mg/L]、高敏C-反应蛋白[(23.46±3.42)mg/L]、肿瘤坏死因子-α[(56.57±7.56)ng/L]水平高于正常波动组[(12.62±2.32)mg/L、(16.39±3.63)mg/L、(5.27±1.47)mg/L、(55.41±5.21)u/mL、(43.25±5.54)u/mL、(62.23±6.43)u/mL、(2.46±0.75)μg/L、(17.22±3.51)mg/L、(11.64±3.25)mg/L、(39.75±5.64)ng/L](P<0.05),高波动组静脉炎(31.58%),消化道反应(31.58%),口腔溃疡(26.32%),肝、肾功能损害(44.74%)等化疗不良反应发生率高于正常波动组(7.14%、11.90%、4.76%、14.29%)(P<0.05)。结论 2型糖尿病合并肺癌患者高幅度的血糖波动不利于肿瘤标志物水平和炎症细胞因子水平的控制,且可增加化疗不良反应发生率。
Objective To analyze the influence of plasma glucose fluctuation on chemotherapy of lung cancer in patients with type 2 diabetes mellitus (T2DM). Methods According to the mean amplitude of plasma glucose excursion (MAGE) level, 80 patients with T2DM complicated with lung cancer were divided into normal fluctuation group (MAGE〈3. 9 retool/L, n=42) and high fluctuation group (MAGE〉3.9 retool/L, n=38). The tumor markers, inflammatory factors and adverse reactions were observed and compared between two groups. Results The above indexes were significantly higher in high fluctuation group than those in normal fluctuation group (MAGE: ((5. 75± 1.28) mmol/L vs (3. 79 ± 1.03) mmol/L, absolute means of daily difference: (1.45±0. 64) mmol/L vs (1. 13±0. 38) retool/L, coefficient of variation: 1.68±0. 73 vs 1. 25±0. 79, large amplitude of glycemic excursion: (6. 58± 2. 34) mmol/L vs (4. 11 ±1.52) mmol/L, fasting plasma glucose: (7.26±1.52) mmol/L vs (6.28_±1.07) mmol/L, postprandial 2 hours plasma glucose: (9. 89 ± 2. 63) mmol/L vs (7. 68± 1. 65) mmol/L, carcinoembryonic antigen: (16. 15 ± 1. 34) mg/L vs (12.62±2.32) rag/L, neuron-specific enolase: (18.92±4.32) mg/L vs (16.39±3.63) rag/L, cytokeratin 19 fragment: (7.34±2. 28) mg/L vs (5. 27± 1. 47) rag/L, carbohydrate antigen (CA) 19-9: (77.26± 6. 67) u/mL vs (55.41 ± 5.21) u/mL, CA153: (51.18±5. 73) μ/mL vs (43.25!5.54) u/mL, CA125: (85. 19±7. 16) u/mL vs (62. 23± 6.43) u/mL, squamous cell carcinoma antigen: (4.57±1.39) μg/L) vs (2.46±0. 75) μg/L, interleukin-6: (28. 79± 6.23) mg/L vs (17. 22 ± 3. 51) mg/L, high sensitivity C-reactive protein: (23. 46 ± 3. 42) mg/L vs (11. 64± 3.25)mg/L, tumor necrosis factor-cx: (56. 57±7. 56) ng/L vs (39. 75±5. 64) ng/L) (P〈0.05). The incidences of phlebitis (31.58%), digestive tract reaction (31.58%), oral ulcer (26.32%) and liver and kidney damage (44.74%) in high fluctuation group were significantly higher than those in normal fluctuation group (7. 14%, 11. 90%, 4. 76%,14.29%) (P〈0.05). Conclusion The high plasma glucose fluctuation in T2DM patients with lung cancer is not conducive to the control of tumor markers and inflammatory cytokines, and would increase the incidence of adverse reactions.
出处
《中华实用诊断与治疗杂志》
2016年第10期996-998,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
南通市科技厅发展计划支持(2013SA-1023-14)
关键词
2型糖尿病
血糖
肺癌
化疗效果
Type 2 diabetes mellitus
plasma glucose
lung cancer
chemotherapy effect