辅助化疗对胃肠恶性肿瘤术后的患者血糖、胰岛功能影响的临床研究

发布时间：2018-05-16 22:34

本文选题：胃肠道肿瘤 + 术后辅助化疗　；参考：《青海大学》2017年硕士论文

【摘要】：目的:探讨辅助化疗对胃肠道恶性肿瘤术后的患者血糖水平、胰岛功能的影响。方法:入组病例来源:2015年05月-2016年02月在青海大学附属医院胃肠外科确诊的胃肠道恶性肿瘤患者53例(期间有3例患者终止入组),所有患者均经术后病理确诊。检测患者的空腹血糖、C肽及胰岛素水平,具体检测时间为:化疗前、第一周期化疗后、第四周期化疗后和化疗6月后。将上述检测结果进行整理分析,比较化疗前后患者血糖及胰岛功能的变化。将可能影响患者血糖的临床资料(年龄、体重指数、血压)进行统计分析。结果:1、50例入组患者化疗前的空腹血糖皆正常,化疗后10例患者出现了血糖升高,其中有9例表现为空腹血糖受损(占18%),1例确诊为继发糖尿病(占2%)。化疗前与第一周期化疗后、4周期化疗后以及化疗后6月患者的血糖水平相比差异显著(P0.05),各组间的差异表明化疗次数增加亦会使血糖升高(P0.05)。2、6月后患者的胰岛素、C肽水平,对比化疗前的数据有明显差异(P0.05)。3、应用奥沙利铂联合氟尿嘧啶类的患者中血糖升高的5例(占11.36%);应用“DOF”方案的患者中4例血糖升高(占66.67%)。化疗方案的选择引起血糖异常的差异显著(P0.05)。4、体重指数是患者化疗后血糖异常的影响因素(P0.05);年龄和是否患有高血压并不影响其变化(P0.05)。结论:1、辅助化疗可引起胃肠恶性肿瘤术后的患者血糖、C肽及胰岛素水平的变化,包含多西他赛的化疗方案更易引起患者血糖的升高。2、化疗过程中,体重指数为术后胃肠恶性肿瘤患者辅助化疗后血糖异常的影响因素,超重患者或应控制体重以降低发生风险,年龄及有无高血压病史对其无影响。
[Abstract]:Objective: to investigate the effect of adjuvant chemotherapy on blood glucose and islet function in patients with gastrointestinal cancer after operation. Methods: from May 2015 to February 2016, 53 patients with gastrointestinal malignancy were diagnosed by gastrointestinal surgery in Qinghai University affiliated Hospital. Fasting blood glucose levels of C peptide and insulin were measured before chemotherapy, after the first cycle of chemotherapy, after the fourth cycle of chemotherapy and 6 months after chemotherapy. The changes of blood glucose and islet function were compared before and after chemotherapy. Analyze the clinical data (age, body mass index, blood pressure) that may affect blood sugar. Results fasting blood glucose was normal in 50 patients before chemotherapy, and increased in 10 patients after chemotherapy. Among them, 9 cases showed impaired fasting blood glucose (18%) and 1 case was diagnosed as secondary diabetes mellitus (2%). There were significant differences in blood glucose levels between the patients before and after the first cycle of chemotherapy and after 4 cycles of chemotherapy and 6 months after chemotherapy. The differences among the groups indicated that the increase of chemotherapy frequency also increased the level of plasma glucose (P0.05), and the level of insulin C peptide in patients after 6 months. Compared with the data before chemotherapy, there was a significant difference (P0.05. 3). In the patients with oxaliplatin combined with fluorouracil, 5 patients (11.36%) had elevated blood glucose, and 4 cases (66.67%) of the patients with "DOF" regimen had increased blood glucose. The difference of blood glucose abnormality caused by the choice of chemotherapy regimen was significant (P 0.05). Body mass index (BMI) was the influencing factor of blood glucose abnormality after chemotherapy, and age and hypertension did not affect the change of blood glucose (P 0.05). ConclusionThe adjuvant chemotherapy can cause the changes of blood glucose C peptide and insulin levels in patients with gastrointestinal malignant tumor after operation. The chemotherapy regimen including docetaxel is more likely to cause the increase of blood glucose. Body mass index (BMI) was the influencing factor of blood glucose abnormality after adjuvant chemotherapy in patients with gastrointestinal malignant tumor. Overweight patients should control their body weight to reduce the risk of occurrence. Age and history of hypertension had no effect on it.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735

【相似文献】