中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
33期
2562-2565
,共4页
范文哲%张应强%王于%姚学华%杨建勇%李家平
範文哲%張應彊%王于%姚學華%楊建勇%李傢平
범문철%장응강%왕우%요학화%양건용%리가평
肝肿瘤%放射学,介入性%糖尿病
肝腫瘤%放射學,介入性%糖尿病
간종류%방사학,개입성%당뇨병
Liver neoplasms%Radiology,interventional%Diabetes mellitus
目的 探讨经肝动脉化疗栓塞(TACE)治疗肝细胞癌(HCC)诱发患者肝源性糖尿病(HD)的临床危险因素.方法 收集2005年11月至2011年12月中山大学附属第一医院48例HCC行TACE后出现HD的患者作为研究组,同期48例HCC行TACE后而无HD的患者为对照组.采用病例-对照研究的方法,对各个研究因素采用逐步引入剔除法,建立logistic回归模型进行各因素系统分析.结果 多因素logistic回归分析显示,HCC患者TACE后发生HD的独立危险因素包括糖尿病家族史(OR=3.464,95％ CI1.100～110.909,P=0.034)、HBV DNA＞1×105 IU/ml(OR=5.420,95％ CI1.235～23.792,P=0.025)、肝功能Child-Pugh C级(OR=7.653,95％ CI 1.385～42.301,P =0.020)、肿瘤最大径＞10 em(OR=5.347,95％ CI1.499 ～ 19.067,P=0.010)、首次栓塞面积＞70％(OR =9.031,95％ CI 1.782～ 48.537,P=0.008)、TACE＞3次(OR =3.726,95％ CI1.151 ～12.065,P=0.028).结论 糖尿病家族史、HBV DNA＞1×105 IU/ml、肝功能Child-Pugh C级、最大肿瘤＞10 cm、首次栓塞面积＞70％、TACE＞3次是HCC患者TACE后易发HD的独立危险因素,有助于早期诊断与治疗.
目的 探討經肝動脈化療栓塞(TACE)治療肝細胞癌(HCC)誘髮患者肝源性糖尿病(HD)的臨床危險因素.方法 收集2005年11月至2011年12月中山大學附屬第一醫院48例HCC行TACE後齣現HD的患者作為研究組,同期48例HCC行TACE後而無HD的患者為對照組.採用病例-對照研究的方法,對各箇研究因素採用逐步引入剔除法,建立logistic迴歸模型進行各因素繫統分析.結果 多因素logistic迴歸分析顯示,HCC患者TACE後髮生HD的獨立危險因素包括糖尿病傢族史(OR=3.464,95％ CI1.100～110.909,P=0.034)、HBV DNA＞1×105 IU/ml(OR=5.420,95％ CI1.235～23.792,P=0.025)、肝功能Child-Pugh C級(OR=7.653,95％ CI 1.385～42.301,P =0.020)、腫瘤最大徑＞10 em(OR=5.347,95％ CI1.499 ～ 19.067,P=0.010)、首次栓塞麵積＞70％(OR =9.031,95％ CI 1.782～ 48.537,P=0.008)、TACE＞3次(OR =3.726,95％ CI1.151 ～12.065,P=0.028).結論 糖尿病傢族史、HBV DNA＞1×105 IU/ml、肝功能Child-Pugh C級、最大腫瘤＞10 cm、首次栓塞麵積＞70％、TACE＞3次是HCC患者TACE後易髮HD的獨立危險因素,有助于早期診斷與治療.
목적 탐토경간동맥화료전새(TACE)치료간세포암(HCC)유발환자간원성당뇨병(HD)적림상위험인소.방법 수집2005년11월지2011년12월중산대학부속제일의원48례HCC행TACE후출현HD적환자작위연구조,동기48례HCC행TACE후이무HD적환자위대조조.채용병례-대조연구적방법,대각개연구인소채용축보인입척제법,건립logistic회귀모형진행각인소계통분석.결과 다인소logistic회귀분석현시,HCC환자TACE후발생HD적독립위험인소포괄당뇨병가족사(OR=3.464,95％ CI1.100～110.909,P=0.034)、HBV DNA＞1×105 IU/ml(OR=5.420,95％ CI1.235～23.792,P=0.025)、간공능Child-Pugh C급(OR=7.653,95％ CI 1.385～42.301,P =0.020)、종류최대경＞10 em(OR=5.347,95％ CI1.499 ～ 19.067,P=0.010)、수차전새면적＞70％(OR =9.031,95％ CI 1.782～ 48.537,P=0.008)、TACE＞3차(OR =3.726,95％ CI1.151 ～12.065,P=0.028).결론 당뇨병가족사、HBV DNA＞1×105 IU/ml、간공능Child-Pugh C급、최대종류＞10 cm、수차전새면적＞70％、TACE＞3차시HCC환자TACE후역발HD적독립위험인소,유조우조기진단여치료.
Objective To investigate related clinical factors of hepatocellular carcinoma (HCC) patients received transcatheter arterial chemoembolization (TACE) complicated with hepatogenous diabetes (HD).Methods Forty eight cases of HCC line after TACE combined HD patients as the case group,and another forty eight cases of HCC line after TACE without HD patients as control group.A case-control study was retrospectively analyzed among two groups.A logistic regression modelwas established.Results Multivariates analysis showed that family history of diabetes (OR =3.464,95％ CI 1.100-10.909,P =0.034),HBV DNA ＞ 1 × 105 IU/ml (OR =5.420,95％ CI 1.235-23.792,P =0.025),liver function Child-Pugh C (OR =7.653,95％ CI 1.385-42.301,P =0.020),major larger tumors ＞ 10 em (OR =5.347,95％ CI 1.499-19.067,P =0.010),the initial embolism area ＞ 70％ (OR =9.031,95％ CI 1.782-48.537,P =0.008),TACE ＞ 3 times (OR =3.726,95％ CI 1.151-12.065,P =0.028) were independent risk factors of HD in patients with HCC after TACE.Conclusion Family history of diabetes,HBV DNA ＞ 1 × 105 IU/ml,Child-Pugh C,major tumors size ＞ 10 cm,the initial embolism area ＞ 70％,TACE ＞ 3 times were independent risk factors of HD in HCC patients after TACE.As for factors to these patients,the blood glucose was monitored promptly in order to early diagnosis and treatment.
