海南86例2型糖尿病合并消化系統(tǒng)惡性腫瘤臨床特點(diǎn)分析

王樂(lè)樂(lè)　陳小盼

[摘要] 目的 探討海南地區(qū)2型糖尿病合并消化系統(tǒng)惡性腫瘤患者臨床特點(diǎn)，提高疾病預(yù)防與治療的認(rèn)識(shí)。 方法 回顧性收集海南醫(yī)學(xué)院第一附屬醫(yī)院2015年1月—2019年6月期間2型糖尿病合并消化系統(tǒng)惡性腫瘤86例和單純2型糖尿病100例患者的臨床資料，分別作為病例組和對(duì)照組。結(jié)果 ①病例組中，男性73例，女性13例，男性發(fā)病率84.88%（73/86），女性發(fā)病率15.12%（13/86），男性腫瘤發(fā)病率明顯高于女性。男性以肝癌高發(fā)占32.6%。②兩組患者年齡、性別、糖尿病病程、舒張壓、糖尿病家族史、TC、TG、LDL、HGB、HbA1c、WBC、RBC、NE、LYM水平差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者吸煙、飲酒、高血壓病史、收縮壓、合并心腦血管疾病、BMI、FPG、HDL、PLT水平差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。③多因素logistic分析顯示：糖尿病家族史、NE與T2DM合并消化系統(tǒng)惡性腫瘤存在顯著正相關(guān)關(guān)系，是T2DM合并消化系統(tǒng)惡性腫瘤的獨(dú)立危險(xiǎn)因素（OR=24.085，3.562，P<0.05）。 結(jié)論 2型糖尿病合并消化系統(tǒng)惡性腫瘤患者以男性為主，年齡在43～85歲之間，其中以肝癌高發(fā)，依次為結(jié)直腸癌、胃癌;糖尿病家族史、NE是T2DM合并惡性腫瘤的獨(dú)立危險(xiǎn)因素。

[關(guān)鍵詞] 2型糖尿病;消化系統(tǒng);惡性腫瘤;臨床特點(diǎn);回顧性分析

[中圖分類(lèi)號(hào)] R587.2? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1672-4062（2020）02（b）-0030-04

[Abstract] Objective To explore the clinical characteristics of patients with type 2 diabetes mellitus and digestive system malignancies in Hainan， and to improve the understanding of disease prevention and treatment. Methods The clinical data of 86 patients with type 2 diabetes and digestive system malignant tumors and 100 patients with simple type 2 diabetes were collected retrospectively from January 2015 to June 2019 in the First Affiliated Hospital of Hainan Medical College， which were used as case groups and control group. Results 1.In the case group， there were 73 males and 13 females. The incidence of males was 84.88% （73/86）， the incidence of females was 15.12% （13/86）， and the incidence of male tumors was significantly higher than that of females. The prevalence of liver cancer in men accounted for 32.6%. 2.There were significant differences in age， gender， duration of diabetes， diastolic pressure， family history of diabetes， TC， TG， LDL， HGB， HbA1c， WBC， RBC， NE， and LYM in the two groups（P<0.05）. There were no significant differences in smoking， drinking， history of hypertension， systolic blood pressure， combined cardiovascular and cerebrovascular disease， BMI， FPG， HDL， and PLT levels in the two groups（P>0.05）. 3.Multivariate logistic analysis showed that there was a significant positive correlation between family history of diabetes， NE， and T2DM combined digestive system malignancies， which were independent risk factors for T2DM combined digestive system malignant tumors（OR=24.085，3.562， P<0.05）. Conclusion Type 2 diabetes patients with digestive system malignant tumors are predominantly male， aged between 43 and 85 years old， with liver cancer being the highest incidence， followed by colorectal cancer and gastric cancer; family history of diabetes and NE are independent of T2DM with malignant tumors of risk factors.

[Key words] Type 2 diabetes; Digestive system; Malignant tumor; Clinical characteristics; Retrospective analysis

2型糖尿病和消化系統(tǒng)惡性腫瘤兩大慢性疾病，嚴(yán)重影響公民健康和生活質(zhì)量，給個(gè)人、社會(huì)均帶來(lái)重大經(jīng)濟(jì)負(fù)擔(dān)[1]。研究顯示，性別[2]、BMI[3-4]、糖尿病家族史[5]、吸煙[6-7]、種族[7]等是2型糖尿病合并惡性腫瘤的危險(xiǎn)因素，2型糖尿病會(huì)增加結(jié)腸癌、胰腺癌、肝癌[8-10]、食管癌[11]等消化系統(tǒng)惡性腫瘤的發(fā)生。但兩者之間存在的潛在聯(lián)系尚不完全清楚。該文通過(guò)回顧性收集了2015年1月—2019年6月海南醫(yī)學(xué)院第一附屬醫(yī)院86例T2DM合并消化系統(tǒng)惡性腫瘤患者的臨床資料，探討海南地區(qū)2型糖尿病合并消化系統(tǒng)惡性腫瘤的臨床特點(diǎn)，以期能夠提高對(duì)海南地區(qū)2型糖尿病合并消化系統(tǒng)惡性腫瘤患者疾病預(yù)防與治療的認(rèn)識(shí)，現(xiàn)報(bào)道如下。……