术前血糖控制与糖尿病合并宫颈癌患者围手术期胰岛素抵抗的关系及对预后的影响  

Relationship between preoperative blood glucose control and perioperative insulin resistance in patients with diabetes mellitus complicated by cervical cancer and its effect on prognosis

作　　者：邱红兵 任亚男 李晓明 谢震 QIU Hongbing;REN Yanan;LI Xiaoming;XIE Zhen(Department of Gynecology,Xingtai People’s Hospital,Xingtai 054000,China;Department of Gynecology,Hebei Provincial People’s Hospital,Shijiazhuang 050000,China)

机构地区：[1]邢台市人民医院妇科,河北邢台054000 [2]河北省人民医院妇科,石家庄050000

出　　处：《中国医科大学学报》2025年第4期318-322,共5页Journal of China Medical University

基　　金：国家自然科学基金(81471175);邢台市重点研发计划自筹项目(2022ZC1231)。

摘　　要：目的探讨术前血糖控制与糖尿病(DM)合并宫颈癌(CC)患者围手术期胰岛素抵抗(IR)的关系及对预后的影响。方法选取2022年8月至2024年6月邢台市人民医院接受手术治疗及随访的DM合并CC患者100例,根据IR水平分为IR组(n=61)和非IR组(n=39),根据随访期间是否发生不良事件分为预后不良组(n=34)和预后良好组(n=66)。对各组临床资料进行比较,分析糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血浆葡萄糖(2hPG)与围手术期IR的关系,以及HbA1c、FPG、2hPG、稳态模型评估胰岛素抵抗指数(HOMA-IR)与预后不良风险的相关性。结果与相应对照组比较,IR组和预后不良组术前HbA1c、FPG、2hPG均升高(P<0.05)。logistic回归分析显示,HbA1c、FPG、2hPG水平与围手术期IR发生风险呈正相关(P<0.05);HbA1c、FPG、2hPG、HOMA-IR是DM合并CC预后的危险因素(P<0.05),HOMA-IR的危险性最高(OR=3.261,95%CI:1.737~5.513)。结论DM合并CC患者术前HbA1c、FPG、2hPG水平与围手术期IR风险呈正相关,HOMA-IR、HbA1c、FPG、2hPG是预后不良的独立危险因素。Objective To investigate the relationship between preoperative blood glucose control and perioperative insulin resistance(IR)in patients with diabetes mellitus(DM)complicated by cervical cancer(CC)and its effect on prognosis.Methods A total of 100 patients were categorized into IR(n=61)and non-IR(n=39)groups based on their IR levels.Additionally,patients were classified into poor prognosis(n=34)and good prognosis(n=66)groups according to the occurrence of adverse events during the follow-up period.The clinical data of each group were compared to evaluate the association of glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),and two-hour postprandial plasma glucose(2hPG)with perioperative IR,as well as correlation between HbA1c,FPG,and 2hPG levels and the homeostasis model assessment(HOMA)of IR with the risk of poor prognosis.Results HbA1c,FPG,2hPG,and HOMA-IR were identified as risk factors for the prognosis of patients with DM and CC(P<0.05).Compared with the respective control groups,the IR group and poor prognosis group had higher preoperative levels of HbA1C,FPG,and 2hPG(P<0.05).Conclusion Poor preoperative blood glucose control is positively correlated with the risk of perioperative IR in patients with DM and CC.Moreover,HOMA-IR,HbA1c,FPG,and 2hPG are independent risk factors for poor prognosis in patients with DM and CC.

关 键 词：宫颈癌 糖尿病 胰岛素抵抗 预后 

分 类 号：R737.33[医药卫生—肿瘤]