化疗药物对头颈部鳞癌患者血糖代谢的影响  

Study on Chemotherapy-Induced Glucose Metabolic Disorders in Patients with Head and Neck Squamous Cell Cancer

作　　者：罗铭[1] 甘华侠[2] 任军[1] 刘宜敏[1] 

机构地区：[1]中山大学附属第二医院肿瘤科,广东广州510120 [2]南昌大学第一附属医院内分泌科,江西南昌330006

出　　处：《实用临床医学（江西）》2006年第9期7-9,共3页Practical Clinical Medicine

摘　　要：目的：探讨化疗药物对头颈部鳞癌患者血糖代谢的影响。方法：收集2000年1月-2005年12月收治的320例放化综合治疗及282例单纯放疗的头颈部鳞癌患者的血糖检验报告及相关临床资料，并对其进行回顾性分析。结果：320例放化综合治疗患者中，化疗前合并糖尿病6例，其余化疗前血糖水平正常。化疗后空腹血糖升高42例，占13．12％。42例中明确诊断为糖尿病11例，糖耐量减低14例，一过性血糖升高18例，分别占同期接受化疗的思者的3．43％、4．37％和5．62％。其中，接受以紫杉醇类药物为主的化疗患者123例，发生血糖异常24例，占同类化疗19．51％（24／123），占同期化疗7．50％（24／320）；接受以铂类药物为主的化疗患者197例．发生血糖异常18例，占同类化疗9．13％（18／197），占同期化疗5．60％（18／320）。以紫杉醇类为主化疗与以铂类为主化疗引起的血糖异常的发生率相比较，差异有显著性（P〈O．05）。而接受单纯放疗的282例患者中放疗前有12例糖尿病患者，放疗后没有新增病例。结论：头颈部恶性肿瘤患者接受化疗后可能会出现血糖异常，甚至发生糖耐量低减或糖尿病，以紫杉醇类为主的化疗方案治疗中这种情况更加常见。Objective：To determine the effect of chemotherapy on glucose metabolism in patients with head and neck squamous cell cancer. Methods：The blood glucose assay and associated clinical materials of 282 cases accepted radiotherapy and 320 cases accepted chemo-radiotherapy for malignant head and neck tumor from January 2000 to December 2005 were analyzed retrospectively. Results：Fouty-two cases（13. 12%）had elevated fasting blood glucose level after chemotherapy among the patients accepting combined therapy, 11 cases（3.43%）were diagnosed as diabetes mellitus, 14 cases（4.37 %）were diagnosed as impaired glucose tolerance. Paclitaxel based chemotherapy seemed to have more opportunity to induce disorders of glucose metabolism than that in cisplatin based chemotherapy（P〈0.05）. Radiotherapy alone had no any effect on the glucose metabolism. Conclusion：Chemotherapy may induce disorders of glucose metabolism, including impaired glucose tolerance and diabetes mellitus,especially in receiving paclitaxel chemotherapy.

关 键 词：头颈肿瘤 抗肿瘤药 紫杉醇 血糖 

分 类 号：R73[医药卫生—肿瘤]