脂质代谢指标预测结直肠癌合并糖尿病患者术后吻合口瘘的临床研究

Clinical study of lipid metabolism index predicting anastomotic fistula in patients with colorectal cancer complicated with diabetes

目的探讨结直肠癌合并2型糖尿病患者血脂水平与术后吻合口瘘的相关性。方法收集2020年1月至2022年1月就诊于重庆医科大学附属第一医院胃肠外科的结直肠癌合并2型糖尿病患者39例,分为吻合口瘘组(n=13)和非吻合口瘘组(n=26)。收集两组患者的脂类代谢指标,包括血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)进行分析。结果吻合口瘘组的TG水平明显高于非吻合口瘘组,且差异有统计学意义(P<0.05)。ROC曲线分析显示TG的诊断临界为1.25,曲线下面积(AUC)为0.93,敏感度为92.3%,特异度为95.0%。血清TC、LDL-C、HDL-C水平两组间差异无统计学意义(P>0.05)。结论TG早期预测结直肠癌合并2型糖尿病患者术后吻合口瘘有一定准确性。若TG值大于1.25,提示患者术后吻合口瘘发生率高,可指导下一步临床干预。

Objective To investigate the correlation between blood lipid level and postoperative anastomotic fistula in patients with colorectal cancer complicated with type 2 diabetes.Methods Clinical and pathological data of 39 patients with colorectal cancer complicated with type 2 diabetes admitted to the Department of Gastrointestinal Surgery,the First Affiliated Hospital of Chongqing Medical University from January 2020 to January 2022 were collected and divided into anastomotic fistula group(n=13)and non-anastomotic fistula group(n=26).Lipid metabolism indexes,including serum total cholesterol,triglyceride,low density lipoprotein cholesterol and high density lipoprotein cholesterol,were collected for analysis.Results The triglyceride(TG)value of anastomotic fistula group was significantly higher than that of non-anastomotic fistula group(P<0.05),and the difference was statistically significant.ROC curve analysis showed that the diagnostic threshold of TG was 1.25,the area under the curve(AUC)was 0.93,the sensitivity was 92.3%,and the specificity was 95.0%.There was no significant difference in serum total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)between the two groups.Conclusion TG value has certain clinical value for early prediction and diagnosis of anastomotic fistula in patients with colorectal cancer complicated with type 2 diabetes mellitus.If TG value is greater than 1.25,it indicates that the incidence of postoperative anastomotic fistula is high,which can guide the next clinical intervention.