摘要
目的探讨伴有糖尿病的非小细胞肺癌(NSCLC)患者血糖控制情况与急性放射性肺炎发生的关系。方法选取2015年1月至2019年3月该院放疗科45例伴有糖尿病的NSCLC患者为研究对象,据放疗前糖化血红蛋白(HbA1c)水平将其分为血糖控制尚可组和血糖控制不良组,对其进行适形调强放疗同步单药化疗增敏,定期随访观察,比较两组血清炎性因子变化和急性放射性肺炎发生情况。结果糖尿病患者同步放化疗后放射性肺炎发生率高,血糖控制不良组放疗后放射性肺炎总发生率为80.0%,其中2级放射性肺炎发生率为30.0%、3级为10.0%,血糖控制尚可组发生率分别为72.0%、24.0%、4.0%,两组比较差异有统计学意义(P<0.05)。放疗前两组炎性因子水平比较,差异无统计学意义(P>0.05);放疗后炎性因子水平较放疗前升高,但血糖控制不良组炎性因子水平较血糖控制尚可组升高更明显,差异有统计学意义(P<0.05)。结论伴有糖尿病的NSCLC患者放疗后发生放射性肺炎的风险高,尤其是血糖控制不良者,需要对其做好预防。
Objective To investigate the relationship between blood glucose control and acute radiation pneumonitis in non-small cell lung cancer(NSCLC)patients with diabetes mellitus.Methods Selected 45 patients with NSCLC with diabetes from January 2015 to March 2019 in the radiotherapy department as the research object.According to the level of glycated hemoglobin(HbA1c)before radiotherapy,they were divided into the glycemic control group and the poor glycemic control group.They were treated with conformal intensity-modulated radiotherapy and sensitized by single drug chemotherapy,and regular follow-up observation was performed.Compared the changes of serum inflammatory factors and the occurrence of acute radiation pneumonia in the two groups.Results The incidence of radiation pneumonitis was high in the patients with diabetes after concurrent radiotherapy and chemotherapy.The total incidence of radiation pneumonitis after radiotherapy in the poorly glycemic control group was 80.0%,of which grade 2 was 30.0%and grade 3 was 10.0%.The incidence of the glycemic control group was 72.0%,24.0%and 4.0%,respectively,the difference was statistically significant(P<0.05).There was no significant difference in the levels of inflammatory factors between the two groups before radiotherapy(P>0.05).The levels of inflammatory factors after radiotherapy were higher than before radiotherapy,while the levels of inflammatory factors in the poorly controlled blood glucose group changed more obvious,the difference was statistically significant(P<0.05).Conclusion Patients with diabetes have a high risk of radiation pneumonia after radiotherapy,especially those who has poor blood glucose control,which needs to be prevented.
作者
肖韡
洪梅
黄萍
朱诺
刘志远
王延虎
XIAO Wei;HONG Mei;HUANG Ping;ZHU Nuo;LIU Zhiyuan;WANG Yanhu(Department of Radiotherapy,Brain Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu 210029,China)
出处
《重庆医学》
CAS
2020年第16期2675-2678,2682,共5页
Chongqing medicine
基金
江苏省南京市医学科技发展项目(YKK18163)。
关键词
癌
非小细胞肺
糖尿病
血红蛋白A
糖基化
辐射增敏药
辐射性肺炎
carcinoma
non-small-cell lung
diabetes mellitus
hemoglobin a
glycosylated
radiation-sensitizing agents
radiation pneumonitis
