淋巴瘤化疗继发糖尿病临床分析

Clinical analysis of lymphoma chemotherapy-induced diabetes mellitus

目的:分析淋巴瘤患者化疗继发糖尿病的发生率及相关因素,探索化疗继发糖尿病的危险因素。方法:对207例淋巴瘤化疗患者的年龄、性别、病理分型、临床分期、B症状、4~6个疗程化疗后评估是否完全反应等进行Logistic回归分析。结果:临床资料完整且符合条件的186例患者中,48例(25.8%)化疗后出现继发糖尿病。单因素分析显示,年龄≥40岁、有B症状、首次未完全反应为化疗继发糖尿病的危险因素。Logistic多因素回归分析结果显示,40岁以上患者发生继发糖尿病的风险是40岁以下患者的9.20倍(OR=9.200),有B症状是无B症状的2.90倍(OR=2.903),首次未完全反应是首次完全反应的2.08倍(OR=2.080)。结论:继发糖尿病是淋巴瘤患者化疗期间的重要并发症,发生率为25.8%,年龄≥40岁、有B症状、首次未完全反应为化疗继发糖尿病的独立危险因素。

Objective：To explore the incidence and risk factors of chemotherapy-induced diabetes mellitus（CIDM）in lymphoma patients.Method：A total of 207 patients with lymphoma were enrolled.Potential explanatory variables including age,gender,pathological classification,clinical stage,B symptoms and whether to achieve complete response（CR）after 4to 6cycles of chemotherapy were performed by Logistic regression analysis.Result：Among the 186 patients with complete clinical parameters,48（25.8%）patients developed CIDM.Age≥40years,B symptoms and not achieving CR for the first cycle were significant risk factors associated with CIDM development by univariate analysis.Multivariate analysis revealed that age≥40years（OR=9.200）,B symptoms（OR=2.903）and not achieving CR for the first cycle（OR=2.080）were independently significant association factors.Conclusion：CIDM is a major complication of lymphoma patients during chemotherapy,with the incidence of 25.8%.The results suggest that age≥40years,B symptoms and not achieving CR for the first cycle are independent risk factors of CIDM.