抗氧化参数水平对合并糖尿病的非小细胞肺癌患者术后肺功能的预测价值

Predictive Value of Antioxidant Parametersfor Postoperative Pulmonary Function in Non-small Cell Lung Cancer Patients Complicated with Diabetes Mellitus

目的抗氧化参数水平对合并糖尿病的非小细胞肺癌(NSCLC)患者术后肺功能的预测价值。方法纳入接受手术治疗的I期NSCLC患者共234例,其中合并糖尿病者为126例及无糖尿病者为108例。接受手术治疗前所有患者均进行抗氧化参数水平的检测及常规肺功能,术后3个月复测肺功能。结果合并糖尿病的肺癌组术前、术后的肺功能指标:VC%pred、FVC%pred、FEV_1%pred、FEV_1/FVC%、DLCO%pred、DLCO/VA水平均低于肺癌组。合并糖尿病的肺癌组术前、术后FEV_1%pred有明显差异。合并糖尿病的肺癌组术前抗氧化参数(谷胱甘肽过氧化物酶GSH-Px、超氧化物歧化酶SOD)水平要低于无糖尿病组。GSH-Px<21"mol/L、SOD<200 U/m L可以做为判断糖尿病合并NSCLC组术后FEV_1%pred是否下降超过20%的依据。结论结合术前抗氧化参数水平,可更好评估合并糖尿病的I期NSCLC患者术后肺功能明显下降的风险,因而能更准确全面地评估患者的手术耐受力。

Objective To investigate the predictive value of antioxidant parameters for postoperative pulmonary function in non-small cell lung cancer( NSCLC) patients complicated with diabetes mellitus. Methods A total of 234 patients with stage I NSCLC,having received surgical treatment,were include,among which 126 patients were complicated with diabetes mellitus( NSCLC complicated with diabetes mellitus group) while the other 108 patients were not( NSCLC group). All patients received determination of antioxidant parameters and pulmonary function before surgery,with a callback for reexamination of pulmonary function 3 months after surgery. Results Pulmonary function indicators,e.g. VC%pred,FVC%pred,FEV1%pred,FEV1/FVC%,DLCO%pred and DLCO/VA,of patients in NSCLC complicated with diabetes mellitus group were lower than those of patients in NSCLC group,either before or after surgery. There was statistically significant difference between pre-operative FEV1% pred and post-operative FEV1%pred in NSCLC complicated with diabetes mellitus group. Antioxidant parameters,e.g. glutathione peroxidase( GSH-Px) and superoxide dismutase( SOD),of NSCLC complicated with diabetes mellitus group were lower than NSCLC group before surgery. GSH-Px<21 μmol/L and SOD<200 U/m L can be used as the basis to determine whether NSCLC diabetics would suffer a decrease in FEV1% pred by more than 20% after surgery. Conclusion Risk for post-operative pulmonary function decline in stage Ⅰ NSCLC patients complicated with diabetes mellitus can be well evaluated under the help of pre-operative antioxidant parameters,with which we can estimate the surgical tolerance of patients more accurately and comprehensively.