2型糖尿病患者血清Ca199水平升高相关因素分析

发布时间：2018-03-22 12:23

本文选题：2型糖尿病　切入点：血清Ca19-9升高　出处：《大理大学》2016年硕士论文　论文类型：学位论文

【摘要】：【目的】分析2型糖尿病合并血清Ca19-9水平升高患者相关临床指标的特点及血清Ca199水平升高与其他临床指标的相关性。【方法】选取2015年1月至2015年12月在云南省第四人民医院住院的2型糖尿病合并血清Ca19-9升高患者132例为阳性组(或观察组)和同期住院的2型糖尿病不合并血清Ca199升高患者121例为阴性组(或对照组)。收集两组患者的一般信息,如性别、年龄、民族、糖尿病病史、体重指数等。收集两组患者实验室检查相关指标如糖化血红蛋白、空腹C肽、餐后2小时C肽、空腹血糖、餐后2小时血糖、果糖胺、血尿酸、C反应蛋白、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、尿酮体、高密度脂蛋白胆固醇、血清白蛋白、血清Ca199等。记录两组患者眼底检查糖尿病视网膜病变情况、记录颈部血管彩超颈动脉中膜厚度。比较两组间以上指标(一般信息、生化检查及辅助检查)是否有统计学差异,然后以其他临床指标作为自变量,以血清肿瘤标志物Ca199水平是否异常作为因变量,进行非条件logistic回归分析,观察血清Ca199水平与其他临床指标的相关性。【结果】1、观察组与对照组间年龄、性别、病程、血压、体重指数、空腹血糖、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、尿酸、酮体等无统计学差异(P0.05)。两组间餐后2小时血糖、空腹C肽、餐后2小时C肽、糖化血红蛋白、C反应蛋白、果糖胺、血清白蛋白、总胆固醇等有统计学差异(P0.05)。2、血清肿瘤标记物Ca19-9水平与其他临床变量的相关性分析,结果显示,血清肿瘤标记物Ca19-9浓度与餐后2小时血糖、C反应蛋白、果糖胺、总胆固醇、低密度脂蛋白胆固醇呈正相关,与空腹C肽、血清白蛋白呈负相关。进一步非条件Logistic逐步回归分析示,FMN、ALB是血清肿瘤标记物Ca19-9浓度的独立影响因素。【结论】2型糖尿病患者血清Ca19-9浓度升高与餐后2小时血糖、C反应蛋白、果糖胺、总胆固醇、低密度脂蛋白胆固醇呈正相关,与空腹C肽、血清白蛋白呈负相关。2型糖尿病患者血清Ca19-9浓度升高与长期血糖、血脂控制欠佳有关。临床工作中对血清Ca19-9升高的2型糖尿病患者因更加警惕糖尿病并发症(如糖尿病视网膜病变等)的发生发展。应待血糖、血脂、血压稳定后动态观察肿瘤标记物Ca19-9浓度的变化,若血清Ca199水平持续升高,因及时行进一步相关检查,排除2型糖尿病合并肿瘤的可能。这样既不漏诊、误诊,在保证生命健康的同时也不浪费医疗资源,减轻病人经济及心理负担。
[Abstract]:[objective] to analyze the clinical characteristics of patients with type 2 diabetes mellitus complicated with elevated serum Ca19-9 level and the correlation between the elevation of serum Ca199 level and other clinical indexes. [methods] from January 2015 to December 2015 in Yunnan Province. There were 132 patients with type 2 diabetes mellitus with elevated serum Ca19-9 in the fourth people's hospital and 121 patients with type 2 diabetes mellitus without elevated serum Ca199 in the same period. General information on patients in the group, For example, sex, age, nationality, history of diabetes, body mass index, and so on. The related indexes such as glycosylated hemoglobin, fasting C-peptide, 2-hour postprandial C-peptide, fasting blood glucose, 2-hour postprandial blood glucose, fructosamine were collected. Serum uric acid C-reactive protein, total cholesterol, triglyceride, low density lipoprotein cholesterol, urine ketone body, high density lipoprotein cholesterol, serum albumin, serum Ca199 and so on. The carotid intima-media thickness was recorded by color Doppler ultrasound. Whether there were statistical differences between the two groups (general information, biochemical examination and auxiliary examination) was compared, and other clinical parameters were used as independent variables. The correlation between serum Ca199 level and other clinical indexes was observed by non-conditional logistic regression analysis. [results] 1. Age, sex, course of disease, blood pressure, blood pressure, age, sex, course of disease, and blood pressure were observed between the observation group and the control group. Body mass index, fasting blood glucose, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, uric acid and ketone body were not significantly different between the two groups (P 0.05). There were significant differences in glycosylated hemoglobin C reactive protein, fructosamine, serum albumin, total cholesterol and so on. The correlation between serum tumor marker Ca19-9 and other clinical variables was analyzed. Serum tumor marker Ca19-9 was positively correlated with serum glucose C-reactive protein, fructosamine, total cholesterol, low density lipoprotein cholesterol and fasting C-peptide. Serum albumin was negatively correlated. Further unconditioned Logistic stepwise regression analysis showed that Ca19-9 level was an independent factor of serum tumor marker. [conclusion] the elevated serum Ca19-9 level and 2 hours postprandial blood glucose and C-reactive protein in patients with type 2 diabetes mellitus were found to be independent factors of serum tumor marker Ca19-9 concentration. Fructose amine, total cholesterol, low density lipoprotein cholesterol were positively correlated with fasting C-peptide and serum albumin. 2. The increase of serum Ca19-9 and long-term blood glucose were negatively correlated with the level of fructosamine, total cholesterol and low density lipoprotein cholesterol. In clinical work, type 2 diabetes patients with elevated serum Ca19-9 are more alert to the occurrence and development of diabetic complications (such as diabetic retinopathy). After stable blood pressure, the change of tumor marker Ca19-9 concentration was observed dynamically. If the serum Ca199 level continued to increase, the possibility of type 2 diabetes mellitus complicated with tumor could be excluded by further relevant examination in time, so that the diagnosis would not be missed and misdiagnosed. In order to ensure the health of life and not waste medical resources, reduce the economic and psychological burden of patients.
【学位授予单位】：大理大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R587.1

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