化疗药物对乳腺癌患者糖代谢的影响

目的:探讨化疗药物对乳腺癌患者糖代谢的影响。方法:选择250例女性乳腺癌患者,术后采用紫杉类为主化疗的患者156例,采用长春瑞滨为主化疗的患者94例。对2组化疗前后的血糖水平及相关临床资料进行回顾性分析。结果:250例化疗前空腹血糖均正常,化疗前与6个周期化疗后空腹血糖相比差异有统计学意义(P<0.05)。化疗后空腹血糖升高42例(16.8%),其中明确诊断糖尿病9例,占同期化疗者的3.6%(9/250)。以紫杉类为主化疗的患者156例,发生血糖异常25例(16.03%),占同期化疗者的10.00%(25/250);以长春瑞滨为主化疗的患者94例,发生血糖异常17例(18.09%),占同期化疗者的6.80%(17/250)。在确诊为糖尿病的9例患者中接受以紫杉类为主化疗方案者6例,糖尿病的发生率为3.85%(6/156),以长春瑞滨为主化疗方案者3例,糖尿病的发生率为3.19%(3/94),差异无统计学意义(P>0.05)。2组患者空腹血糖均值随化疗周期变化差异无统计学意义(P>0.05)。结论:乳腺癌患者接受化疗可以引起血糖升高,甚至发生糖尿病,以紫杉类为主的化疗方案与以长春瑞滨为主的化疗方案对患者血糖无明显影响。

Study on chemotherapy-induced glucose metabolic disorders in patients with breast cancer

Objective: To determine the infuence of chemotherapy on glucose metabolism in patients with breast cancer.Methods: We selected 250 female with breast cancer who accepted postoperative adjuvant chemotherapy of paclitaxel and vinorelbine from January 2005 to December 2006 and analyzed the cases retrospectively,according to the blood glucose assay and associated clinical materials before and after chemotherapy.Results: The blood glucose after chemotherapy was more increasing than that before chemotherapy(P<0.05).Fouty-two(16.8%) cases had elevated fasting blood glucose level after chemotherapy.Among them,9 cases(3.6%) were diagnosed as diabetes mellitus.Paclitaxel based chemotherapy and vinorelbine based chemotherapy were the same in menopause,cardiovascular disease,age and body mass index(P>0.05).Paclitaxel based chemotherapy did not seem to have more opportunity to induce the incidence of diabetes mellitus than that vinorelbine based chemotherapy(P>0.05).The two regimens both could elevate fasting blood glucose level of the patients,but there were not different(P>0.05).Conclusion: Chemotherapy induced disorders of glucose metabolism,even diabetes mellitus,but paclitaxel based chemotherapy did not seem to have more opportunity to induce the incidence of diabetes mellitus than that vinorelbine based chemotherapy.