【摘要】 目的探讨2型糖尿病合并结直肠癌患者肿瘤治疗前后体质量变化对血糖的影响。方法选取2013年4月—2014年10月在广西壮族自治区人民医院住院的2型糖尿病合并结直肠癌患者122例,根据患者血糖情况调整降糖治疗方案,治疗用药均为胰岛素,在血糖达标后,根据患者肿瘤的病理、部位、分期及高危情况等选择不同的治疗方式:手术、放疗和化疗。肿瘤治疗结束4周后,根据血糖情况调整糖尿病治疗方案,使血糖控制达标。比较肿瘤治疗前后患者体质量、体质指数(BMI)、胰岛素用量;对体质量变化和胰岛素用量变化进行相关分析。结果肿瘤治疗前后,患者空腹血糖和餐后2 h血糖均达标,治疗前后患者空腹血糖、餐后2 h血糖比较,差异均无统计学意义(t=1.370、1.153,P>0.05)。肿瘤治疗后94.3%(115/122)的患者体质量下降;治疗前,患者体质量为(66.5±8.7)kg,BMI为(25.4±2.4)kg/m2;治疗后,患者体质量为(60.6±7.4)kg,BMI为(23.2±2.1)kg/m2。治疗后患者体质量、BMI均低于治疗前(t=5.738、6.580,P<0.01)。肿瘤治疗后95.1%(116/122)的患者胰岛素用量减少;治疗前,患者胰岛素用量为(24.7±8.0)U,治疗后胰岛素用量为(14.1±9.1)U,治疗后胰岛素用量低于治疗前(t=9.626,P<0.01)。Pearson直线相关分析结果显示,随着患者体质量减少幅度增大,胰岛素用量减少幅度也增加,两者呈正相关关系(r=0.921,P<0.01)。结论 2型糖尿病合并结直肠癌患者经过肿瘤治疗后体质量减轻对血糖有明显影响,因此在治疗期间需定期监测血糖,及时调整降糖治疗方案,避免低血糖发生。更多还原

【Abstract】 Objective To investigate the effect of weight changes after oncotherapy on blood glucose of patients with type 2 diabetes mellitus and colorectal cancer.Methods We enrolled 122 patients with type 2 diabetes mellitus and colorectal cancer who were admitted into People’s Hospital of Guangxi Zhuang Autonomous Region from April 2013 to October 2014.The hypoglycemic therapy was adjusted according to the blood glucose of patients.All the patients were administrated with insulins.After blood glucose reaching standard,different oncotherapy methods,including operation,radiotherapy and chemotherapy,were undertaken for different patients according to the pathology,position,staging and critical condition of their tumors.Four weeks after oncotherapy,diabetes treatment method was adjusted according to blood glucose,in order to make blood glucose reach standard.Comparison was made between the body mass,BMI and insulin dosage before oncotherapy and those after oncotherapy,and correlation analysis was made between weight changes and insulin dosage changes.Results Before and after oncotherapy,fasting glucose and 2 h PBG all reached standard,and there was no difference between the fasting glucose and 2 h PBG before oncotherapy and those after oncotherapy(t = 1.370,1.153; P > 0.05).After oncotherapy,94.3%(115 /122) of the patients saw decrease in body weight; before oncotherapy,the average body weight was(66.5 ± 8.7) kg and the average BMI was(25.4 ± 2.4) kg / m2; after oncotherapy,the average body weight was(60.6 ± 7.4) kg and the average BMI was(23.2 ± 2.1) kg / m2.After oncotherapy,the patients had lower body weight and BMI than those before oncotherapy(t = 5.738,6.580; P < 0.01).After oncotherapy,95.1%(116 /122) of the patients reduced insulin dosage;the insulin dosage was(24.7 ± 8.0) U before oncotherapy,higher(t = 9.626,P < 0.01) than that after oncotherapy which was(14.1 ± 9.1) U.Pearson linear correlation analysis showed that decreasing extent of body weight was positively associated with decreasing extent of insulin dosage(r = 0.921,P < 0.01).Conclusion The loss of weight after oncotherapy brings enormous influence on the blood glucose of patients with type 2 diabetes mellitus and colorectal cancer.Therefore,during oncotherapy,blood glucose should be monitored regularly and the hypoglycemic therapy should be adjusted accordingly to avoid hypoglycemia.更多还原