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目的探讨T2DM患者胃肠道肿瘤相关抗原CA199的变化及与临床指标的相关性和影响因素。方法回顾性收集2007~2014年于我院内分泌科住院的1224例T2DM患者的临床资料,按CA199水平分为阴性组(<37 U/ml)和阳性组(≥37 U/ml)。比较两组一般临床资料。结果 CA199阳性组FPG、HbA_1c、尿微量白蛋白与肌酐比值(UACR)水平高于阴性组[(13.12±4.58)vs(10.22±4.01)mmol/L,(10.84±2.58)%vs(8.78±2.22)%,(38.25±3.15)vs(29.09±1.02)mg/g,P<0.05],微血管并发症发生率增加;而阳性组的血清白蛋白水平低于阴性组[(38.59±5.33)vs(40.13±5.63)g/L,P<0.05]。Pearson相关性分析显示,CA199与FPG、HbA_1c、血清白蛋白有相关性(r=0.251、0.260、-0.082,P<0.05或P<0.01)。多元线性回归分析显示,FPG、HbA_1c是CA199升高的独立危险因素(β=0.793、0.975,P<0.05或P<0.01)。结论 T2DM患者CA199升高与血糖控制不佳及其微血管并发症关系密切。
Objective To investigate the changes of gastrointestinal tumor-associated antigen CA199 in patients with T2DM and the correlation with influencing factors and clinical parameters. Methods The clinical data of 1224 T2DM patients hospitalized in Department of Endocrinology from 2007 to 2014 were retrospectively collected. According to the level of CA199, the patients were divided into negative group (<37 U / ml) and positive group (≥37 U / ml). Comparison of two groups of general clinical data. Results The levels of FPG, HbA_1c, UACR in CA199 positive group were significantly higher than those in the negative group [(13.12 ± 4.58) vs (10.22 ± 4.01) mmol / L, (10.84 ± 2.58)% vs (8.78 ± 2.22 ), (38.25 ± 3.15) vs (29.09 ± 1.02) mg / g, P <0.05]. The incidence of microvascular complication increased while the serum albumin level in the positive group was lower than that in the negative group [(38.59 ± 5.33 vs 40.13 ± 5.63) g / L, P <0.05]. Pearson correlation analysis showed that there was a correlation between CA199 and FPG, HbA_1c and serum albumin (r = 0.251,0.260,0.082, P <0.05 or P <0.01). Multivariate linear regression analysis showed that FPG and HbA_1c were independent risk factors of CA199 (β = 0.793, 0.975, P <0.05 or P <0.01). Conclusion The elevation of CA199 in T2DM patients is closely related to the poor control of blood glucose and microvascular complications.