合并2型糖尿病的上消化道肿瘤患者化疗相关性恶心呕吐的特点

Characteristics of Chemotherapy-Induced Nausea and Vomiting in Patients Undergoing Upper Gastrointestinal Tumors with Type 2 Diabetes Mellitus

目的分析合并2型糖尿病(T2DM)的上消化道肿瘤患者化疗相关性恶心呕吐(CINV)的特点。方法回顾性分析2018年3月至2019年3月郑州大学第一附属医院收治的223例上消化道恶性肿瘤患者的临床资料,将糖耐量正常的110例患者纳入正常糖耐量组,将合并T2DM的113例患者纳入T2DM组。随访患者既往接受含铂方案化疗时CINV的发生情况。结果两组CINV发生率比较,差异无统计学意义(P>0.05)。T2DM组Ⅰ级恶心发生率低于正常糖耐量组,Ⅱ~Ⅲ级恶心发生率高于正常糖耐量组,差异有统计学意义(均P<0.05)。T2DM组Ⅰ级呕吐发生率高于正常糖耐量组,Ⅱ~Ⅳ级呕吐发生率低于正常糖耐量组,差异有统计学意义(均P<0.05)。在化疗后24 h内,T2DM组首次发生CINV的患者比例低于正常糖耐量组,差异有统计学意义(P<0.05)。在化疗结束24 h后,T2DM组首次发生CINV的患者比例高于正常糖耐量组,差异有统计学意义(P<0.05)。T2DM组CINV持续时间长于正常糖耐量组,差异有统计学意义(P<0.05)。结论合并T2DM的上消化道肿瘤患者的CINV易延迟发生,持续时间较长,呕吐程度较轻,但恶心程度多为中重度。

Objective To analyze the characteristics of chemotherapy-induced nausea and vomiting(CINV) in patients undergoing upper gastrointestinal cancer with type 2 diabetes mellitus(T2 DM).Methods The clinical data of 233 patients with upper gastrointestinal malignancies admitted to the First Affiliated Hospital of Zhengzhou University from March 2018 to March 2019 were retrospectively analyzed. A total of 110 patients with normal glucose tolerance were included in normal glucose tolerance group, and 113 patients with T2 DM were included in T2 DM group. Patients were followed up for the occurrence of CINV in the previous platinum-based chemotherapy.Results There was no statistically significant difference in the incidence of CINV between the two groups(P>0.05). Compared with normal glucose tolerance group, the incidence of nausea with grade one was lower and the incidence of nausea with grade two to three was higher in T2 DM group, while the differences were statistically significant(both P<0.05). Compared with normal glucose tolerance group, the incidence of vomiting with grade one was higher and the incidence of vomiting with grade two to four was lower in T2 DM group, while the differences were statistically significant(both P<0.05). Within 24 hours after chemotherapy, the proportion of patients with CINV occurring for the first time in T2 DM group was lower than that in normal glucose tolerance group, and the difference was statistically significant(P<0.05). After 24 hours of chemotherapy, the proportion of patients with CINV for the first time in T2 DM group was higher than that in normal glucose tolerance group, and the difference was statistically significant(P<0.05). The duration of CINV in T2 DM group was longer than that in normal glucose tolerance group, with statistically significant difference(P<0.05).Conclusion CINV in patients undergoing upper gastrointestinal tumors complicated with T2 DM is prone to delay, with a longer duration, and mild vomiting, but moderate to severe nausea.