2型糖尿病患者血清CA19-9、CA125水平及其相关因素分析  

Change of serum CA19-9,CA125 levels and its related factors in patients with type 2 diabetes mellitus

作　　者：陈晶波[1] 陈频[1] 胡艳艳[2] 杨露[1] 陈瑾[1] 黄勤[1] 

机构地区：[1]第二军医大学附属长海医院内分泌科,上海200433 [2]同济大学附属第十人民医院内分泌科,上海200072

出　　处：《重庆医科大学学报》2015年第7期970-974,共5页Journal of Chongqing Medical University

基　　金：国家自然科学基金面上资助项目(编号:30871198);上海市自然科学基金项目(编号:12ZR1438100)

摘　　要：目的:观察分析2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清糖类抗原19-9(carbohydrate antigen19-9,CA19-9)、糖类抗原125(carbohydrate antigen125,CA125)水平及其影响因素。方法:选取117例T2DM患者和132例健康体检者,计量资料采用t检验、非参数检验,计数资料采用χ2检验,比较糖、脂、蛋白指标及血清CA19-9、CA125水平。T2DM患者再按糖化血红蛋白(haemoglobin A1c,Hb A1c)水平、并发症情况分组比较CA19-9和CA125水平;观察治疗前后CA19-9或CA125异常升高T2DM患者糖类抗原水平变化。结果:(1)与正常人群相比,T2DM患者糖脂组份和CA19-9、CA125水平均明显升高,白蛋白水平明显降低(均P<0.05);(2)与Hb A1c≤7.5%T2DM患者(n=34)比,Hb A1c>7.5%T2DM患者(n=83)的糖代谢指标及CA19-9、CA125水平均明显升高(均P<0.01);(3)与无并发症者(n=50)和伴慢性并发症者(n=51)相比,伴急性并发症者(n=16)糖代谢指标及CA19-9、CA125水平均明显升高(均P<0.05);(4)与入院时相比,治疗后CA19-9或CA125异常升高T2DM患者糖类抗原均显著降低(均P<0.05);(5)相关分析显示,T2DM患者中血糖(r值分别为0.353、0.269,P值均<0.01)、Hb A1c(r值分别为0.320、0.325,P值均<0.01)、糖化血清白蛋白(r值分别为0.307、0.324,P值均<0.01)、总胆固醇(r值分别为0.215、0.359,P值均<0.05)与CA19-9、CA125升高呈正相关,白蛋白(r值分别为-0.296、0.359,P值均<0.05)与CA19-9、CA125升高呈负相关。结论:T2DM患者不仅存在糖脂代谢紊乱,也存在蛋白代谢异常;血糖控制越差时,CA19-9或CA125水平升高更明显;血糖控制好转后,CA19-9或CA125水平将明显降低;糖脂蛋白代谢紊乱可能是影响CA19-9或CA125升高的因素。Objective：To investigate the association between serum CA19-9,CA125 levels and its related factors in T2 DM patients.Methods：Totally 117 T2 DM patients and 132 healthy subjects who had medical checkups were recruited to compare metabolic indices including blood glucose,lipids and protein as well as serum CA19-9 and CA125 levels. The change in CA19-9 and CA125 levels before and after treatment was observed. Results ：（ 1） Statistically significant differences were found between normal controls and T2 DM patients in serum CA19-9,CA125 levels and metabolic components including glucose,lipids and protein（all P0.05）.（2）There were statistical differences in serum glucose,CA19-9 and CA125 levels in T2 DM patients with a Hb A1c7.5% when compared with those with a Hb A1c≤7.5%（all P0.05）.（3）When compared with patients with no complication and those with chronic complications,T2 DM patients with acute complications had statistically different serum levels of glucose,CA19-9 and CA125（all P0.05）.（4）Carbohydrate antigens of T2 DM patients with abnormal CA19-9 or CA125 were significantly lower after treatment than before treatment（all P 0.05）.（5）Correlation analysis revealed that glucose,Hb A1 c and total cholesterol were positively correlated with CA19-9,CA125 levels in T2 DM patients. Serum albumin was negative correlated with CA19-9 and CA125 levels in T2 DM patients.Conclusion：T2DM patients exists not only glucose and lipid metabolism disorders,but also disorders of protein metabolism. More evident increase in CA19-9 and CA125 levels will arise if the T2 DM patient has poorer glycemic control. With the improvement of glycemic control,CA19-9 and CA125 levels will decrease.The change in serum and CA125 levels in T2 DM patients is likely to be associated with disorders of glucose,lipid and protein metabolism.

关 键 词：CA19-9 CA125 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]