二甲双胍对糖尿病前期乳腺癌患者化学治疗期间血糖控制疗效和安全性的观察  

Observation on efficacy and safety of metformin in prediabetic patients with breast cancer during chemotherapy

作　　者：周营[1] 蔡杏娟 戈少红 应蓉[1] 裔海鹰 赵纹芸[2] 

机构地区：[1]上海市黄浦区中心医院内分泌科,上海200002 [2]上海市黄浦区中心医院乳腺外科,上海200002

出　　处：《内科理论与实践》2016年第2期75-79,共5页Journal of Internal Medicine Concepts & Practice

基　　金：黄浦区卫生系统新一轮医学重点专科建设计划

摘　　要：目的:观察二甲双胍在乳腺癌合并糖调节受损患者化学治疗(化疗)中血糖控制的疗效和安全性。方法 :手术病理证实为乳腺癌并行初次化疗女性中筛选出糖调节受损患者108例,随机分为治疗组(56例)和对照组(52例)。2组均进行非强化饮食控制,治疗组在化疗期间增加二甲双胍,比较2组化疗前及第6次化疗结束2周后血糖控制的疗效和糖尿病的发生率,并观察不良反应。结果:第6次化疗后,治疗组空腹血糖、餐后血糖、糖化血红蛋白(Hb A1c)、空腹胰岛素、稳态模型评估的胰岛素抵抗指数(HOMA-IR)均低于对照组(均P<0.05)。治疗组糖尿病发生率为34.0%,对照组糖尿病发生率为53.2%(P<0.05)。2组的肝功能、肾功能、低血糖发生率无显著性差异(均P>0.05),治疗组胃肠道不良反应高于对照组(P<0.05)。结论 :二甲双胍可以在乳腺癌合并糖调节受损患者化疗中安全有效地控制血糖,减少糖尿病的发生。Objective To analyze the efficacy and safety of metformin in prediabetic patients with breast cancer during chemotherapy.Methods One hundred and eight female prediabetic patients diagnosed with breast cancer by surgical pathology and undergoing the first cycle of chemotherapy were divided randomly into two groups,56 patients in treatment group and 52 in control group.Both groups received a not fortified controlled diet,and patients in treatment group were given metformin during chemotherapy.After six cycles of chemotherapy the two groups were compared in term of blood glucose control,the incidence of diabetes,and adverse reactions.Results Fasting plasma glucose,postprandial blood glucose,glycated hemoglobin（HbA1c）,fasting insulin and homeostasis model assessment insulin resistance（HOMA-IR） were all lower in treatment group than in control group after six cycles of chemotherapy（all P〈0.05）.Incidence of diabetes in treatment group was 34.0%,while that in control group was 53.2%（P〈0.05）.No significant differences were demonstrated in liver and renal function or the incidence of hypoglycemia between the two groups（P〉0.05）,the incidence of gastrointestinal adverse events was higher in treatment group than in control group（P〈0.05）.Conclusions Metformin can safely and effectively control the blood glucose of prediabetic patients with breast cancer during chemotherapy and reduce the occurrence of diabetes.

关 键 词：二甲双胍 糖尿病前期 乳腺癌 化学治疗 

分 类 号：R587.1[医药卫生—内分泌] R737.9[医药卫生—内科学]