胰岛素瘤切除术后对血清激素、癌胚抗原水平及胰岛功能的影响

Effects of insulinoma resection on islet function, serum hormone and CEA levels

探究了胰岛素瘤切除术前后患者血清激素、癌胚抗原(carcinoembryonic antigen,CEA)及胰岛功能指标水平变化,发现术后1 d患者胰岛β细胞功能指数(homeostasis model assessment-β,HOMA-β)、胰岛素敏感性指数(insulin sensitivity index,ISI)降低,胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)及血糖水平升高,CEA水平先增后降,差异有统计学意义(P<0.05);与术后5 d相比,术后10 d及15 d患者HOMA-β、ISI水平升高,HOMA-IR水平降低;术后15 d胰岛素水平为(14.16±3.06)μU/L,但显著低于术前(32.07±5.75)μU/L,血糖水平降至(4.62±0.31)mmol/L,显著高于术前(2.12±0.59)mmol/L,术后1 d患者CEA水平高于术前,随后逐渐降低,差异有统计学意义(P>0.05)。CEA水平与各指标显著相关。胰岛功能指标、血清激素及CEA水平术后短时间内可引起胰岛素水平的异常降低和血糖水平的急剧升高,可作为预后指标。

Changes in serum hormones, carcinoembryonic antigen(CEA) and islet function index levels before and after insulinoma resection are explored. It is found that from day 1 to day 5 after the operation, the patients’ homeostasis model assessment-β(HOMA-β) and insulin sensitivity index(ISI) decrease, insulin resistance index(homeostasis model assessment of insulin resistance, HOMA-IR) and blood glucose levels increase, and CEA level increases first and then decreases. The difference is statistically significant(P<0.05). Compared with day 5 after the operation, patients’ HOMA-β and ISI levels increase and HOMA-IR levels decrease from day 10 to day 15 after the operation;insulin levels are 14.16±3.06 μU/L, but significantly lower than those before the operation, the blood glucose level drops to 4.62±0.31 mmol/L, which is significantly higher than 2.12±0.59 mmol/L before the operation. There is no significant change in CEA index and the difference is not statistically significant(P>0.05). There is significant correlation between CEA level and various indicators. Pancreatic islet function indicators, serum hormones and CEA levels can cause an abnormal decrease in insulin levels and a sharp increase in blood glucose levels within a short period of time after surgery, which can be used as prognostic indicators.