卵巢癌患者化疗后糖代谢异常与其临床结局相关性的研究

发布时间：2018-04-01 15:11

  本文选题：卵巢上皮性癌　切入点：化疗　出处：《青岛大学》2017年硕士论文

【摘要】：目的:回顾性分析我院142例卵巢癌患者化疗前后血糖变化的临床特征,探讨卵巢癌化疗后影响血糖变化的因素与其临床结局的相关性。方法:对我院2008年1月至2015年8月收治的142例卵巢癌术后患者做回顾性分析,收集化疗前后的血糖数据,分析患者化疗前后血糖变化,从中筛选出糖代谢紊乱患者,分析其临床特征等方面的资料,对卵巢癌患者术后血糖代谢紊乱的发病率、病因以及相关危险因素进行系统的分析,进而研究化疗后血糖变化的规律以及影响因素与临床结局的关系。结果:(1)142例患者均在我院行手术治疗且达到满意肿瘤细胞减灭术,均经病理确诊为卵巢上皮性癌,年龄为34.5~72岁,中位年龄52.5岁。年龄段主要集中在46~65为主,共97例(97/142)约占68.31%,其中46~55岁,共46例,约占32.39%,56~65岁共51例,约占35.92%。142例患者平均随诊32.5个月(16个月~50个月)。(2)142例患者化疗前空腹血糖正常,化疗后(6个疗程)空腹血糖异常升高37例,占总例数26.06%(37/142),其中空腹血糖调节受损患者28例,占总例数19.72%(28/142),确诊糖尿病患者9例,占总例数6.34%(9/142)。出现空腹血糖升高的患者CTCAE分级主要集中在1级至3级,其中1级30例,构成比约81.08%。(3)对血糖正常组与异常组的高血压病史情况进行x2检验,p0.05,差异有统计学意义。(4)BMI23者有42例(29.58%),化疗时血糖升高者有8例,比例为19.05%。而BMI≥23者有100例(70.42%),化疗时血糖升高者有29例,比例为29.00%。血糖升高组与正常组的BMI其差异存在统计学意义(p0.05)。(5)未绝经患者有43例,占比为30.28%。化疗期间血糖升高者有8例,比例为18.60%。绝经患者有96例,占比为67.61%。化疗时血糖升高者有29例,比例为29.29%。统计结果表明差异有显著性意义。(6)142例卵巢癌患者中,平均随诊32.5个月(16个月~50个月),在随诊期间出现肿瘤复发者共45例,占比为31.69%。其中血糖升高者有27例,占血糖异常组的60%,血糖正常组复发18例,占总复发例数的40%,统计结果表明血糖升高者术后复发率明显高于血糖正常者。结论:高龄、高血压、高BMI、已绝经的卵巢癌患者化疗后容易出现空腹血糖异常,且多发生在化疗后第四个周期,控制血糖能改善临床结局。
[Abstract]:Objective: to retrospectively analyze the clinical characteristics of blood glucose changes in 142 patients with ovarian cancer before and after chemotherapy. Methods: 142 patients with ovarian cancer treated from January 2008 to August 2015 were retrospectively analyzed and their blood glucose data were collected before and after chemotherapy. To analyze the changes of blood glucose before and after chemotherapy, to screen out the patients with glucose metabolism disorder, to analyze its clinical characteristics, and to analyze systematically the incidence, etiology and related risk factors of blood glucose metabolism disorder after operation in patients with ovarian cancer. The changes of blood glucose after chemotherapy and the relationship between the influencing factors and the clinical outcome were studied. Results all of the 142 patients underwent surgical treatment in our hospital and achieved satisfactory tumor cell reduction. All of them were pathologically diagnosed as ovarian epithelial carcinoma, aged 34.5 or 72 years. The median age was 52.5 years old. The main age group was 460.65 (97 / 97 / 142) accounting for 68.31, 46 of which were 4655 years old, accounting for 51.51 cases were about 32.390.5665 years old, about 35.922.142 patients were followed up for an average of 32.5 months (16 months ~ 50 months), 2142 patients had normal fasting blood glucose before chemotherapy. After 6 courses of chemotherapy, 37 cases of abnormal increase of fasting blood glucose were found, accounting for 26.06% and 37% of 142 cases. Among them, 28 cases were impaired in fasting blood glucose regulation, accounting for 19.72% of the total number of cases, and 9 cases were diagnosed with diabetes mellitus. The CTCAE grade of patients with increased fasting blood glucose was mainly in grades 1 to 3, of which 30 were grade 1. The constitution ratio was about 81.088.The history of hypertension in normal group and abnormal group was tested by x2 test (p0.05). The difference was statistically significant. There were 42 cases with BMI23 and 8 cases with elevated blood sugar during chemotherapy. The ratio was 19.05.There were 43 cases (30.28%) of unmenopausal patients with BMI 鈮，

本文编号：1696061