原发性肝癌患者不同糖代谢异常状态的临床分析

目的探讨原发性肝癌（HCC）患者在不同糖代谢异常状态下的临床特点。方法回顾性分析2003年1月至2007年12月在汕头大学第一、二附属医院住院的698例HCC患者不同糖代谢状态的临床资料。根据糖代谢状态将患者分为4组：糖代谢正常组（472例）、低血糖组（20例）、糖尿病前期组（76例）和糖尿病组（130例）。用方差分析比较各组年龄差异，Kruskal-WallisH检验分析各组血脂代谢等实验室检查的差异。结果纳入本研究698例HCC患者中男性563例，女性135例，平均年龄（55±13）岁。糖尿病前期及糖尿病组患者年龄均高于糖代谢正常组，差异均有统计学意义[分别为（58±13）、（60±13）和（53±15）岁，均P〈0．05]；低血糖症组年龄[（51±14）岁]小于糖尿病组，差异有统计学意义（P〈0．05）。HCC患者糖尿病状态下总胆固醇（TC）水平较糖代谢正常组低，差异有统计学意义[（4．7±1．7）比（4．0±1．7）mmol／L，t=2．266，P〈0．05]。结论HCC合并糖尿病较糖代谢正常组和低血糖症组的年龄大，且HCC合并糖尿病组患者Tc水平较糖代谢正常组低。

Clinical features of glucose metabolism disorders in patients with hepatocellular carcinoma

Objective To investigate the clinical features of various glucose metabolism disorders in patients with hepatocellular carcinoma （HCC）. Methods A retrospective analysis of various glucose metabolism situations in 698 patients with HCC was performed from January 2003 to December 2007 in the Second and the First Affiliated Hospital of Shantou University Medical College. The patients were divided into 4 groups according to glucose metabolism status： normal glucose group （472 cases）, hypoglycemia group （ 20 cases ） , pre-diabetes group （76 cases） and diabetes group （ 130 cases）. Analysis of variance （ANOVA） and Kruskal-Wallis H test were employed to compare differences of age and laboratory chemical indicators among the 4 groups. Results Among 698 HCC patients, 563 were male and 135 were female, with an average age of （55 -＋ 13 ） years. The patients in pre-diabetes and diabetes groups were significantly older than those in normal glucose group （（58 ＋ 13 ）, （60 ＋ 13） and （53 ＋ 15 ） years, respectively; all P 〈 0. 05 ） ; the patients in diabetes group were older than those in hypoglycemia group （ （51 -＋ 14 ） years, P 〈 0. 05 ）. The level of total cholesterol in diabetes group was significantly lower than that in normal glucose group（（4.7＋l.7） vs （4.0_＋1.7） mmol/L, t=2.266, P〈0.05）. Conclusion In patients with HCC, the patients with diabetes mellitus are older than those with normal blood glucose and hypoglycemia, and total cholesterol is lower in patient with diabetes mellitus than that in patients with normal blood glucose.