肺癌合并2型糖尿病患者的临床特征及影响因素分析

The Analysis of Clinical characteristics and influencing factors of lung cancer patients with type 2 diabetes mellitus

目的分析新疆石河子地区肺癌合并2型糖尿病(T2DM)患者的临床特征,进一步探讨分析肺癌合并T2DM的影响因素。方法1.纳入本院2016年到2019年肺癌患者为研究对象。根据既往有无T2DM病史或OGTT试验结果分为三组:肺癌合并T2DM组(A组),肺癌组(B组),健康对照组(C组);2.采用化学发光法测定血清糖类抗原(CA-199)等肿瘤标志物,全自动生化分析仪测定血清中糖脂等指标,分析临床特征,进行组间比较,探讨影响因素。软件SPSS 20.0处理数据,并进行方差分析;影响因素采用Logistic回归分析;假设检验水准=0.05,P<0.05差异有统计学意义(双侧检验)。结果1.基线资料比较显示:B组242例(男/女为143/99),年龄63.94±11.68岁;A组60例(男/女为34/26),年龄67.32±9.56岁;C组305例(男/女为135/170),年龄52.99±11.05岁;与C组相比,A组及B组男性患者较多,年龄更高;2.三组基线资料比较结果显示:三组在年龄、性别上存在统计学差异(P<0.05)。协方差分析消除影响因素后:与C组相比,B组TG、TC、HDL-c、LDL-c降低。A组TG升高,TC、HDL-c、LDL-c降低;与C组相比,A组及B组FPG均升高,A组更高;与C组相比,A组及B组CEA、CA12-5升高,B组更高。A组及B组CA19-9、CA72-4升高,A组更高;3.Logistic回归分析后结果显示:年龄、FPG、TG是肺癌合并T2DM发生的独立危险因素(OR=1.035、1.697、1.505)。结论肺癌合并T2DM患者以老年男性常见。对于老年男性T2DM患者,尤其是合并血脂异常的情况下,应及早监测血糖,以防治肺癌合并T2DM的发生和发展。

Objective To analyze the clinical characteristics of patients with lung cancer complicated with type 2 diabetes mellitus(T2 DM)in Shihezi,Xinjiang,and further to explore the influencing factors of lung cancer complicated with T2 DM.Methods(1)Lung cancer patients from 2016 to 2019 were included in the study.According to the previous history of T2 DM or the results of OGTT test,the patients were divided into three groups:lung cancer group(group A),lung cancer combined with T2 DM group(group B),and healthy control group(group C).(2)Tumor markers such as serum carbohydrate antigen(CA-199)were determined by chemiluminescence method,indicators such as serum glucose and lipid were determined by automatic biochemical analyzer,clinical characteristics were analyzed,and intergroup comparison was conducted to explore influencing factors.SPSS 20.0 were used to process data and analyze variance.The influencing factors were analyzed by Logistic regression.Test level was assumed to be 0.05,and P<0.05 showed statistically significant difference(bilateral test).Results(1)Comparison of baseline data showed that 242 patients(143/99 male/female)in group A were 63.94±11.68 years old.In group B,60 patients(34/26 male/female)were aged 67.32±9.56 years.In group C,305 patients(male/female:135/170)were aged 52.99±11.05 years.Compared with group C,groups A and B had more male patients with higher age.(2)The comparison of baseline data among the three groups showed that there were statistical differences in age and gender among the three groups(P<0.05).After covariance analysis eliminated the influencing factors,TG,TC,HDL-c and LDL-c decreased in group A compared with group C.TG in group B increased,while TC,HDL-c and LDL-c decreased.Compared with group C,FPG increased in group A and group B,and was higher in group B.Compared with group C,CEA and ca12-5 in group A and group B were increased,while group A was higher.CA19-9 and CA72-4 were increased in group A and group B,while those in group B were higher.(3)Logistic regression analysis showed that age,FPG and TG were independent risk factors of lung cancer complicated with T2 DM(OR=1.035,1.697 and 1.505).Conclusions Lung cancer patients with T2 DM are common in elderly men,so for elderly male lung cancer patients,especially those with abnormal blood lipids,early monitoring of blood glucose should be conducted to prevent the occurrence and development of lung cancer patients with T2 DM.