恶性肿瘤化疗患者糖化血红蛋白和空腹血糖的观察

摘要

Objective:To explore the effect of chemotherapy on fasting plasma glucose and glycated hemoglobin of patients with malignant tumors before and after chemotherapy.Methods:There were 49 inpatients with malignant tumor(44 patients had no diabetes before chemotherapy,5 patients were previously diagnosed diabetes before chemotherapy).Their fasting plasma glucose and glycated hemoglobin were detected on schedule before each chemotherapy,clinical materials were collected simultaneously.Some changed regularity on fasting plasma glucose and glycated hemoglobin were found after chemotherapy.Results:Among 44 patients without diabetes,there were 23 patients with elevated fasting plasma glucose (52.3％) and 12 cases with elevated glycated hemoglobin (27.3％) after receiving chemotherapy.10 cases were diagnosed as diabetes (22.7％).Among 5 patients with malignant tumor coordinated with diabetes,there were 4 patients with both elevated fasting plasma glucose and glycated hemoglobin.The average ratio glycated hemoglobin of patients without diabetes and coordinated with diabetes after the first chemotherapy were obviously higher than that of the patients before the first chemotherapy (P =0.0000968,P =0.035).The average ratio glycated hemoglobin of the patients without diabetes before the second,seventh and eighth cycle chemotherapy were apparently higher than that of the patients before the first cycle (P =0.005,P =0.014,P =0.001),the fasting plasma glucose levels of the patients without diabetes before the fourth cycle in chemotherapy was evidently higher than that of the patients before the first chemotherapy(P =0.04).Changes in fasting plasma glucose and glycated hemoglobin of the patients coordinated with diabetes before and after chemotherapy did not differ significantly.Conclusion:Chemotherapy can cause elevated fasting plasma glucose and glycated hemoglobin in part of cancer patients,the use of paired fasting plasma glucose and glycated hemoglobin values can help to identify potential diabetic subjects.%目的:观察化疗对恶性肿瘤患者糖化血红蛋白和空腹血糖的影响.方法:49例恶性肿瘤患者(无糖尿病史者44例,有糖尿病史者5例),检测每周期化疗前及首次化疗后糖化血红蛋白及空腹血糖,对所得数据及相关临床资料进行分析.结果:无糖尿病组化疗后发生高血糖23例(52.3％),糖化血红蛋白升高12例(27.3％),确诊糖尿病10例(22.7％).糖尿病组化疗后发生高血糖及高糖化血红蛋白4例.合并糖尿病组、无糖尿病组首次化疗后糖化血红蛋白水平较化疗前均有升高(P =0.035,P=0.0000968),无糖尿病组第2、7、8次化疗前糖化血红蛋白值较未化疗时显著升高(P=0.005,P=0.014,P=0.001),第4次化疗前空腹血糖较未化疗时显著升高(P=0.04).结论:化疗可导致部分恶性肿瘤患者糖化血红蛋白和空腹血糖升高；空腹血糖联合糖化血红蛋白可以帮助确诊潜在的糖尿病患者.