5-氟尿嘧啶化疗方案治疗胃肠道恶性肿瘤继发糖尿病临床分析

目的观察以5-氟尿嘧啶（5-fluorouracil，5FU）为基础化疗对胃肠道恶性肿瘤患者血糖的影响。方法回顾性分析作者医院2006—01／201212月收治的357例胃肠道恶性肿瘤患者化疗前后的血糖变化情况及相关临床资料。结果化疗期间出现继发性糖尿病8例（8／304，2．63％），化疗后出现继发性糖尿病21例（21／304，6．91％），2例血糖控制不好因糖尿病并发症而分别于化疗后5月和7月死亡（2／29，6．90％）；32例出现糖尿量异常（32／304，10．5％），其中化疗期间出现11例（13／304，4．28％），化疗后出现19例（19／304，6．25Voo），经过饮食控制及物理治疗5例空腹血糖水平恢复到正常水平（5／32，15．60％）。结论对于胃肠道恶性肿瘤患者应用以5一FU为基础的化疗与继发性糖尿病或糖尿量异常之间存在着一定的相关性。

Clinical Analysis of Secondary Diabetes Associated with 5-FU Based Chemotherapy Regimens in Non-diabetic Patients with Gastrointestinal Malignant Tumor

Objective To observe the chemotherapy on the basis of 5-fluorouraeil （5 FU） on the blood glucose of patients with gastrointestinal malignant tumors. Methods The changes of the blood glucose and the correlated clinical materials of 357 patients with gastrointestinal tract malignant tumor treated in our hospital from January 2006 to Decem- ber 2012 before and after chemotherapy were retrospectively analyzed. Results Eight cases （8/304, 2. 63%） during chemotherapy, 21 cases （21/304, 6. 91 G） after chemotherapy had secondary diabetes, and 2 cases （2/29, 6. 90 ~/00 ） with poor blood glucose control and diabetes complications died at 5 and 7 months after chemotherapy. Thirty-two cases （32/304,10. 5O/oo） had abnormal glucosuria levels, among whom 13 cases （13/304,4. 28o/oo） had the abnormality during chemotherapy 19 cases （19/304,6. 25%） after chemotherapy, and 5 cases （5/32,15.60%） had normal fasting blood glu- cose levels after diet control and physical therapy. Conclusion For patients with gastrointestinal malignant tumor, the ap- plication of 5 FU based chemotherapy has certain correlation with secondary diabetes or abnormal glucosuria.