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目的通过了解乳腺癌患者系统化疗后血糖和胰岛功能变化,探讨紫杉类化疗方案治疗对乳腺癌患者血糖的影响。方法对240例接受6个周期化疗的乳腺癌患者,检测化疗前后空腹血糖(FBG)、餐后2h血糖(2h PG)、糖化血红蛋白(Ghb A1c)、空腹胰岛素(FINS)和C肽(FCP)数值,比较评价化疗前后血糖和胰岛功能变化。结果 39例化疗前确诊为糖尿病患者,2h PG和Ghb A1c显著增加,FINS和FCP水平相对于化疗前略有降低,注射胰岛素总量增加(P均<0.05)。201例化疗前非糖尿病患者FBG较化疗前有所变化,但差异无统计学意义(P>0.05),绝大多数患者仍处于正常范围内,8.47%继发糖尿病,且大多发生在第4次化疗后;2h PG、Ghb A1c、FINS和FCP水平相对于化疗前增加(P均<0.05)。结论接受治疗后的乳腺癌患者存在明显的糖代谢紊乱,可能会出现FBG异常,甚至发生糖尿病,并导致原有的糖尿病恶化。
Objective To understand the changes of blood glucose and islet function after systemic chemotherapy in patients with breast cancer to investigate the effects of chemotherapy with taxanes on blood glucose in patients with breast cancer. Methods Fasting plasma glucose (FBG), 2h PG, Ghb A1c, FINS and FCP before and after chemotherapy were measured in 240 patients with breast cancer receiving 6 cycles of chemotherapy. Values, comparative evaluation of changes in blood glucose and islet function before and after chemotherapy. Results 39 patients were diagnosed as diabetic before chemotherapy, PG and Ghb A1c 2h significantly increased, FINS and FCP levels were slightly lower than before chemotherapy, insulin injections increased (P all <0.05). 201 cases of non-diabetic patients before chemotherapy FBG compared with chemotherapy before the change, but the difference was not statistically significant (P> 0.05), the vast majority of patients are still within the normal range, 8.47% of secondary diabetes, and mostly occurred in the fourth After chemotherapy, the levels of PG, Ghb A1c, FINS and FCP increased at 2h after chemotherapy (all P <0.05). CONCLUSIONS: Patients with breast cancer after treatment have obvious disorders of glucose metabolism, abnormalities of FBG may occur, and even diabetes may occur, leading to deterioration of the original diabetes.