肝细胞癌患者低血糖发生率和影响因素研究

目的 探讨原发性肝细胞癌患者的低血糖发生情况及相关风险因素。方法 收集2020年4月—2021年6月于我院肿瘤介入病区诊断为原发性肝细胞癌的232例住院患者（伴或不伴糖尿病）的临床诊疗及检验资料,采用多因素Logistic回归分析进行筛选和确定与低血糖的发生具有显著相关性的影响因素。结果 肝细胞癌患者低血糖发生率为28.9%（67/232）;Child-Pugh分级C级、甲胎蛋白值是肝细胞癌患者发生低血糖的影响因素,糖化血红蛋白值是保护因素。与Child-Pugh分级为A级的患者相比,C级患者发生低血糖的OR增加8.050倍;肝细胞癌患者糖化血红蛋白每增加1%,低血糖发生风险减少0.496倍。结论 肝细胞癌伴低血糖症的发生与Child-Pugh分级、糖化血红蛋白因素有关,本研究结果提示在对此类患者进行低血糖发生风险预估时应综合考虑此2种因素,适时对诊疗方案和护理计划进行调整,以减少低血糖事件的发生。

Incidence and Risk Factors of Hypoglycemia in Patients with Hepatocellular Carcinoma

Objective To explore the incidence and risk factors of hypoglycemia in patients with hepatocellular carcinoma (HCC). Methods We collected and analyzed the clinical data of 232 patients with HCC in our cancer center from April 2020 to June 2021. Multivariate logistic regression analysis was performed to identify the risk factors associated with hypoglycemia. Results The incidence of hypoglycemia in patients with HCC was 28.9% (67/232). Child-Pugh grade C and alpha-fetoprotein (AFP) level were the influencing factors for hypoglycemia in patients with HCC, and the glycated hemoglobin (HbA1c) was a protective factor. Compared with patients with Child-Pugh class A, the OR of hypoglycemia in class C patients increased by 8.050 times; for every 1% increase in glycosylated hemoglobin in patients with hepatocellular carcinoma, the risk of hypoglycemia decreased by 0.496 times. Conclusion Child-Pugh stage and HbA1c are associated with hypoglycemia in patients with HCC. Our study suggests that these factors should be comprehensively considered when estimating the risk of hypoglycemia in these patients, and the diagnosis, treatment, and nursing plan should be adjusted in time to reduce the incidence of hypoglycemia.