化疗对恶性肿瘤合并2型糖尿病患者胰岛B细胞功能影响及治疗分析.docVIP

化疗对恶性肿瘤合并2型糖尿病患者胰岛B细胞功能影响及治疗分析 　 作者：刘晓辉，刘太锋，白小军，汪齐 【摘要】 目的 探讨恶性肿瘤合并2型糖尿病患者接受化疗后胰岛B细胞功能的变化，化疗过程中罗格列酮对胰岛B细胞功能的影响及治疗意义。方法 筛选2007年3月—2008年12月收住我院及鄂尔多斯市中心医院的32例恶性肿瘤合并2型糖尿病患者，分为A、B两组，B组选用罗格列酮口服降糖治疗，A组选用其他降糖药物及胰岛素。化疗前后按时检测C肽释放试验中各时间点的C肽水平，分析化疗后胰岛B细胞功能的变化规律及罗格列酮对其的影响。结果 2组患者化疗后C肽释放水平均呈不同程度降低（P＜0.05），A组较B组降低明显（P＜0.05）；B组患者较A组胰岛B细胞功能恢复快（P＜0.05），恢复率高（P＜0.01）。结论 恶性肿瘤合并2型糖尿病患者化疗后胰岛B细胞功能显著下降，随着时间的推移渐有不同程度的恢复；罗格列酮在化疗过程中对胰岛B细胞功能具有保护作用。 【关键词】 恶性肿瘤；2型糖尿病；化疗；胰岛B细胞；罗格列酮 　　Abstract:Objective To investigate the effect of chemotherapy on islet B cell function in patients with malignant tumor plus type 2 diabetes mellitus and the effect of rosiglitazone on islet B cell function during chemotherapy as well as the therapeutic significance.Methods 32 inpatients afflicted with malignant tumor coordinated with type 2 diabetes mellitus admitted from March 2007 to December 2008 in our hospitals were screened out and divided into two groups: A and B. Rosiglitazone was used in the antidiabetic treatment in group B, and other hypoglycemic medications were used in group A. The C peptide levels at different time points of the CPRT were determined on schedule before and after chemotherapy to analyze the change regularity of islet B cell function and the effect of rosiglitazone on islet B cell function following chemotherapy.Results Following chemotherapy, C peptide levels in both groups decreased to a certain degree (Plt;0.05), and C peptide level in group A was significantly lower than that in group B (Plt;0.05). Compared with group A, the islet B cell function in group B restored more rapidly (Plt;0.05) and had higher recovery percentage (Plt;0.01).Conclusions In patients with malignant tumor plus type 2 diabetes mellitus, their islet B cell function was significantly reduced after chemotherapy and restored gradually with time. Rosiglitazone could preserve islet B cell function during chemotherapy. 　　Key words： malignant tumor; type 2 diabetes mellitus; chemotherapy; islet B cell function; rosig