糖尿病患者血清CA19-9水平及其与胰腺疾病的关系  

Relationship between serum level of CA19-9 and pancreatic diseases in diabetic patients

作　　者：张锋[1] 包玉倩[1] 周健[1] 屠印芳[1] 张磊[1] 贾伟平[1] 

机构地区：[1]上海交通大学附属第六人民医院内分泌代谢科,上海市糖尿病临床医学中心,上海市糖尿病重点实验室,上海市糖尿病研究所,上海200233

出　　处：《中国新药与临床杂志》2011年第6期431-435,共5页Chinese Journal of New Drugs and Clinical Remedies

基　　金：上海市市级医院新兴前沿技术联合攻关项目(SHDC12006101)

摘　　要：目的探讨糖尿病患者血清CA19-9水平及其与胰腺疾病的关系。方法选取2007年1月至2008年9月,有完整资料的住院糖尿病患者544例,分为无病变组(糖尿病无胰腺病变)、良性病变组(糖尿病合并胰腺良性疾病)、恶性病变组(糖尿病合并胰腺癌),比较3组间CA19-9水平及临床特征。根据CA19-9水平分组,观察CA19-9水平与胰腺疾病的关系。同时比较不同CA19-9水平无胰腺疾病的糖尿病患者的临床特征,并分析CA19-9水平的影响因素。结果 544例糖尿病患者中,胰腺良、恶性疾病各占1.8%(10/544)。其中良性病变组体重指数、餐后30 min C肽及120 min C肽低于无病变组(P<0.05),恶性病变组年龄大于上述2组(P<0.05)。CA19-9水平升高小于2倍者胰腺良性病变的检出率明显高于CA19-9水平正常者及升高大于2倍者(均P<0.01),而CA19-9水平升高大于2倍者胰腺恶性病变的检出率明显高于其他患者(均P<0.01)。无胰腺病变的糖尿病患者中,伴有CA19-9水平升高者占10.9%(57/524),其年龄、总胆固醇及丙氨酸转氨酶高于CA19-9正常者(P<0.05)。logistic回归分析显示,年龄与CA19-9水平呈独立正相关(β=1.024,P=0.045)。结论糖尿病患者中10%可伴有血清CA19-9水平升高,其中升高超过2倍者应警惕胰腺恶性病变的可能。AIM To investigate the relationship between CA19-9 and pancreatic diseases in diabetic patients. METHODS A total of 544 diabetic inpatients from January 2007 to September 2008 were divided into 3 groups, including non-lesion group （diabetes without pancreatic lesion）, benign lesion group （diabetes with benign pancreatic lesion） and malignant lesion group （diabetes with pancreatic cancer）. Serum levels of CA19-9 and clinical characteristics were compared among the three groups. The relationship between CA19-9 and pancreatic disease was investigated. The clinical characteristics of diabetic patients without pancreatic disease categorized by CA19-9 level were compared. Furthermore, the influential factors for CA19-9 level were analyzed. RESULTS In 544 diabetic patients, the benign and malignant pancreatic lesion each accounted for 1.84% （10/544）. The body mass index, 30 min C-peptide and 120 min C-peptide were lower in benign lesion group than those in non-lesion group （P 〈 0.05） . The age of malignant lesion group was older than that of the other two groups （P 〈 0.05）. The patients with CA19-9 level less than 2-fold increase had higher proportion of benign pancreatic lesion than the patients with normal CA19-9 level and CA19-9 level more than 2-fold increase （both P 〈 0.01 ）. The patients with CA19-9 level more than 2-fold increase had higher proportion of malignant pancreatic lesion than the other patients （both P 〈 0.01）. In the patients with elevated CA19-9 level, who accounted for 10.9% （57/524） of all the diabetic patients without pancreatic lesions, the age, total cholesterol and ALT were higher than those with normal CA19-9 level （P 〈 0.05）. Logistic regression analysis showed that age had an independent positive correlation with CA19-9 level （/3 = 1.024, P = 0.045）. CONCLUSION Ten percent diabetic patients can be detected with elevated serum level of CA19-9. It is alert to malignant pancreatic lesion in the patients with CA19-9 level more than 2-fold inc

关 键 词：糖尿病 CA-19—9抗原 胰腺疾病 

分 类 号：R587[医药卫生—内分泌]