中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2015年
10期
513-518
,共6页
乳腺癌%糖尿病%化疗%血糖浓度%他莫昔芬
乳腺癌%糖尿病%化療%血糖濃度%他莫昔芬
유선암%당뇨병%화료%혈당농도%타막석분
breast cancer%diabetes%chemotherapy%blood glucose%tamoxifen
目的：通过分析乳腺癌患者在化疗期间诱发高血糖的临床特征，了解血糖监测的重要性。方法：分析2011年1月至12月就诊于天津医科大学肿瘤医院229例非糖尿病乳腺癌患者的临床特征。化疗期间分为99例血糖浓度<7 mmol/L组和130例血糖浓度≥7 mmol/L组，按随访结束时血糖水平分为130例正常组、61例糖耐量受损（IGT）组及38例糖尿病组，165例内分泌治疗组进一步分为76例他莫昔芬（TAM）组及89例芳香化酶抑制剂（AI）组。结果：化疗期间的血糖波动水平在不同年龄、身体质量指数（BMI）、组织学分级、肿瘤特征及新辅助化疗的患者间差异均无统计学意义。截至随访结束共有15例患者死亡，正常组、IGT组及糖尿病组分别为1例（6.7%）、5例（33.3%）和9例（60.0%），三组之间差异具有统计学意义（P<0.01）；患者是否接受内分泌治疗在随访结束时其血糖水平间的差异无统计学意义（P=0.79），而TAM组、AI组中血糖恢复至正常水平分别为52、40例，组间差异具有统计学意义（P=0.04）。结论：患者化疗期间的血糖水平越高，随访结束时血糖水平异常的可能性越大，且异常血糖状态会造成乳腺癌患者的不良预后，因此监测血糖意义重大。
目的：通過分析乳腺癌患者在化療期間誘髮高血糖的臨床特徵，瞭解血糖鑑測的重要性。方法：分析2011年1月至12月就診于天津醫科大學腫瘤醫院229例非糖尿病乳腺癌患者的臨床特徵。化療期間分為99例血糖濃度<7 mmol/L組和130例血糖濃度≥7 mmol/L組，按隨訪結束時血糖水平分為130例正常組、61例糖耐量受損（IGT）組及38例糖尿病組，165例內分泌治療組進一步分為76例他莫昔芬（TAM）組及89例芳香化酶抑製劑（AI）組。結果：化療期間的血糖波動水平在不同年齡、身體質量指數（BMI）、組織學分級、腫瘤特徵及新輔助化療的患者間差異均無統計學意義。截至隨訪結束共有15例患者死亡，正常組、IGT組及糖尿病組分彆為1例（6.7%）、5例（33.3%）和9例（60.0%），三組之間差異具有統計學意義（P<0.01）；患者是否接受內分泌治療在隨訪結束時其血糖水平間的差異無統計學意義（P=0.79），而TAM組、AI組中血糖恢複至正常水平分彆為52、40例，組間差異具有統計學意義（P=0.04）。結論：患者化療期間的血糖水平越高，隨訪結束時血糖水平異常的可能性越大，且異常血糖狀態會造成乳腺癌患者的不良預後，因此鑑測血糖意義重大。
목적：통과분석유선암환자재화료기간유발고혈당적림상특정，료해혈당감측적중요성。방법：분석2011년1월지12월취진우천진의과대학종류의원229례비당뇨병유선암환자적림상특정。화료기간분위99례혈당농도<7 mmol/L조화130례혈당농도≥7 mmol/L조，안수방결속시혈당수평분위130례정상조、61례당내량수손（IGT）조급38례당뇨병조，165례내분비치료조진일보분위76례타막석분（TAM）조급89례방향화매억제제（AI）조。결과：화료기간적혈당파동수평재불동년령、신체질량지수（BMI）、조직학분급、종류특정급신보조화료적환자간차이균무통계학의의。절지수방결속공유15례환자사망，정상조、IGT조급당뇨병조분별위1례（6.7%）、5례（33.3%）화9례（60.0%），삼조지간차이구유통계학의의（P<0.01）；환자시부접수내분비치료재수방결속시기혈당수평간적차이무통계학의의（P=0.79），이TAM조、AI조중혈당회복지정상수평분별위52、40례，조간차이구유통계학의의（P=0.04）。결론：환자화료기간적혈당수평월고，수방결속시혈당수평이상적가능성월대，차이상혈당상태회조성유선암환자적불량예후，인차감측혈당의의중대。
Objective:To analyze the clinical characteristics of breast cancer patients who had hyperglycemia reactions due to che-motherapy and evaluate the significance of monitoring glucose. Methods:A total of 229 patients who had hyperglycemia during their chemotherapy sessions were included in the investigation. In particular, the participants of this study were selected based on the follow-ing criteria:those who did not have any diabetes-related diagnoses before the study period and those who had complete clinical data. At the onset of the study, the patients were divided into two groups based on the level of their blood glucose during chemotherapy (<7 mmol/L group and ≥7 mmol/L group). Subsequently, the patients were further divided into the following three groups based on the blood glucose level:normal, impaired glucose tolerance, and diabetes groups. The normal glucose group had 130 patients. Meanwhile, 61 and 38 patients belonged to the impaired glucose tolerance and diabetes groups, respectively. A total of 165 patients treated with hor-mone therapy were further distributed into tamoxifen (TAM)-(76 patients) and arimedex (AI)-(89 patients) treated groups. Results:No significant association was observed between the patients' level of blood glucose during the chemotherapy period and their clinical characteristics, including age, body mass index, histology grade, tumor characteristics, and neoadjuvant chemotherapy. A total of 15 pa-tients died during the study period. In particular, 1 (6.7%), 5 (33.3%), and 9 patients (60.0%) who belonged to the normal glucose, im-paired glucose tolerance, and diabetes groups, respectively, died with a significant difference of P<0.01. We determined that hormone therapy was not significantly associated with the patients' succeeding blood glucose levels (P=0.79). After further classification, 52 and 40 patients in the TAM-and AI-treated groups had normal level of blood glucose, with a significant difference of P=0.04. Conclusion:The patients' blood glucose level during chemotherapy influenced their glucose level in the succeeding period. Hyperglycemia may eventually predict poor prognosis. This study suggests that extensive blood glucose screening and prevention strategies among breast cancer patients may be warranted.
