目的 回顾分析我医院近9年产妇行剖宫产术治疗的患者的住院病历资料,探索术后出现切口脂肪液化的危险因素。方法 选取我医院2011年1月—2019年8月期间行剖宫产术治疗的产妇患者1 018例,分成术后切口脂肪液化组和甲级愈合组,比较2组间的差异,分析其相关危险因素。结果 1 018例产妇患者中出现切口脂肪液化的为34例,发生率为3.34%(34/1 018);单因素分析结果显示,糖尿病、体质指数超重、7 cm以上切口长度是术后出现切口脂肪液化的相关因素,差异有统计学意义;多因素Logistic回归分析结果显示,糖尿病、体质指数超重、7 cm以上切口长度是术后出现切口脂肪液化的独立危险因素。结论 产妇患者行剖宫产术治疗出现切口脂肪液化率较高;围手术期控制患者血糖,以及孕期控制体质指数、缩小剖宫产手术切口长度可能有效地减少切口脂肪液化发生率。

Objective To retrospectively analyze the medical records of patients undergoing cesarean section in our hospital in recent 9 years, and explore the risk factors of incision fat liquefaction after operation. Methods 1 018 patients undergoing cesarean section in our hospital from January 2011 to August 2019 were divided into two groups: incision fat liquefaction group and grade A healing group. The differences between the two groups were compared and the risk factors were analyzed. Results Among 1 018 parturients, 34 had incision fat liquefaction, and the incidence was 3.34% (34/1018). Univariate analysis showed that diabetes mellitus, overweight body mass index and incision length of more than 7 cm were risk factors for incision fat liquefaction after operation, and the difference was statistically significant. Multivariate logistic regression analysis showed that diabetes mellitus, overweight body mass index and incision length over 7 cm were independent risk factors for incision fat liquefaction. Conclusion The incision fat liquefaction rate is higher in patients undergoing cesarean section. Controlling blood sugar level, body mass index during pregnancy and shortening the length of incision during perioperative period may effectively reduce the incidence of incision fat liquefaction.

目的 探讨影响孕晚期死胎伴胎动减少延迟就诊的临床因素,加强围产期宣教。方法 回顾性分析2017年1月—2019年10月广州市妇女儿童医疗中心住院分娩的孕晚期(孕周≥28周)单胎死胎病例的相关临床资料。结果 在79例死胎中,有59例(74.68%)孕妇感知胎动减少,但只有27人(45.76%)在感知胎动减少后24小时内就诊。妊娠未合并胎儿生长受限可能会导致延迟就诊(P=0.03<0.1)。结论 胎动减少和死胎发生密切相关,但大部分孕妇可能会出现延迟就诊。加强孕期产检,规范孕期宣教,尤其是合并胎儿生长受限等高危妊娠时的孕期严密监测,强调胎动的重要性,在感知胎动减少后强调早期就诊,有助于减少孕晚期死胎风险。

Objective To explore the clinical factors that affect the consultation time of stillbirth after perceptive reduction of fetal movement in the third trimester of pregnancy, and to strengthen the perinatal education. Methods A retrospective analysis of single stillbirth in late pregnancy (gestational weeks≥ 28 weeks) in Guangzhou Women and Children's Medical Center from January 2017 to October 2019 was taken, and the relevant clinical data were summarized and evaluated. Results Out of 79 stillbirth cases, 59 (74.68%) cases had decreased fetal motility. Only 27 pregnant women (45.76%) visited the doctor in 24 hours after they perceived the reduction of fetal movement. Pregnancy without fetal growth restriction may lead to delayed consultation (P=0.03<0.1). Conclusion Perception of decreased fetal movement is closely related to the occurrence of stillbirth, but most pregnant women may have delayed visits. To strengthen the prenatal examination, standardize the propaganda and education during pregnancy, especially the close monitoring of high-risk pregnancy such as fetal growth restriction, emphasize the importance of fetal movement, and emphasize the early consultation after perceiving the reduction of fetal movement, are helpful to reduce the risk of stillbirth in late pregnancy.

目的 了解血脂异常在青少年人群中的分布及影响因素。方法 以江门市棠下中学1 449名学生为研究对象,对其进行问卷调查、InBody人体成分仪检测和实验室检查。结果 血脂异常总检出率是8.3%,高胆固醇(TC)、高甘油三脂(TG)、高低密度脂蛋白胆固醇(LDL-C)和低高密度脂蛋白胆固醇(HDL-C)血症的检出率分别为8.3%、7.8%、10.6%和7.2%,女生血脂异常检出率(26.4%)高于男生(19.8%)(P<0.001);多因素分析显示性别(参照男性,OR=1.39,95%CI=1.08~1.80)和体脂百分比(参照正常组,超重、肥胖和重度肥胖组OR和95%CI分别OR = 1.62 / 2.89 / 4.45,95% CI = 1.13~2.32 / 1.85~4.51 / 2.48~7.96)与血脂异常间存在统计学关联(P<0.05)。结论 性别、体脂百分比是青少年血脂异常的影响因素。相对于青少年男生,青少年女生检出血脂异常的比例更高,体脂百分比高的青少年血脂异常的风险更高。

Objective To study the distribution and influencing factors of dyslipidemia among teenagers. Methods A questionnaire survey,InBody body composition test and laboratory examination were conducted on 1 449 students from the Tangxia Middle School in Jiangmen city as study objects. Results The total detection rate of dyslipidemia was 8.3% and the detection rates of high total cholesterol (TC),triglyceride (TG),high low-density-lipoprotein cholesterol (LDL-C) and low high-density-lipoprotein cholesterol (HDL-C) were 8.3%,7.8%,10.6% and 7.2%,respectively. The detection rate of dyslipidemia among teenage girls (26.4%) was higher than that among teenage boys (19.8%) (P<0.001). Multivariate analysis indicated that gender (with reference to male,OR=1.39,95%CI=1.08-1.80) and body fat percentage (with reference to normal group,for overweight,obesity and severe obesity groups,OR=1.62,2.89,4.45 and 95%CI=1.13-2.32,1.85-4.51,2.48-7.96,respectively) were statistically related to dyslipidemia (P<0.05). Conclusion Gender and body fat percentage are the influencing factors of dyslipidemia among teenagers. Compared with teenage boys,the teenage girls have a higher detection percentage of dyslipidemia. Teenagers with higher percentage of body fat show a higher risk of dyslipidemia.

目的 探讨非酒精性脂肪肝患者昼夜节律特点并分析昼夜节律与非酒精性脂肪肝的相关性。方法 选取2017年12月—2018年12月我院门诊部及住院部非酒精性脂肪肝患者60例作为观察组,对照组抽取门诊体检正常人群60例。通过使用本院自制个人一般资料调查表、睡眠节律清晨型与夜晚型量表(MEQ)以及智能手环检测两组纳入对象的昼夜节律(饮食方式、饮食时间、活动节律、体重指数、睡眠节律等)。对比分析两组患者昼夜节律特点并分析其与非酒精性脂肪肝的相关性。结果 非酒精性脂肪肝患者在BMI、睡眠绝对夜晚型、睡眠中度夜晚型、日均运动量小于30 min、睡眠时间紊乱、睡眠时长以及深度睡眠时间等方面与对照组患者比较差异有统计学意义(P＜0.05);以非酒精性脂肪肝为应变量,以昼夜节律为自变量进行回归分析发现性别、年龄、工作性质、BMI、睡眠节律、身体锻炼、睡眠时长、深度睡眠时长与非酒精性脂肪肝呈现正相关且差异有统计学意义(OR＞1,P＜0.01)。结论 非酒精性脂肪肝患者昼夜节律一般存在失眠熬夜、睡眠时间不规律、少运动、身形丰满等特点,引发非酒精性脂肪肝相关因素包括BMI、睡眠节律、运动节律、职业性质、年龄、性别、睡眠质量等,临床上可尝试对非酒精性脂肪肝患者进行昼夜节律干预治疗,改善预后。

Objective To explore the characteristics of circadian rhythm in patients with nonalcoholic fatty liver disease(NAFLD) and to analyze the correlation between circadian rhythm and NAFLD. Methods From December 2017 to December 2018,60 patients with NAFLD in outpatient department and inpatient department of our hospital were selected as observation group,while 60 normal people were selected as control group.The circadian rhythm (dietary pattern,dietary time,activity rhythm,body mass index,sleep rhythm) of the subjects in the two groups were measured by self-made personal data questionnaire,MEQ and smart bracelet.The circadian rhythm characteristics of two groups were compared and the correlation between circadian rhythm and NAFLD was analyzed. Results There were significant differences in BMI,absolute night sleep,moderate night sleep,daily average exercise less than 30 minutes,sleep disturbance,sleep duration and deep sleep time between the patients with NAFLD and the control group (P<0.05). NAFLD was used as dependent variable and circadian rhythm as independent variable. Logistic regression analysis showed that gender,age,nature of work,BMI,sleep rhythm,physical exercise,sleep duration and deep sleep time were positively correlated with fatty liver (OR>1,P<0.01). Conclusion The circadian rhythm of NAFLD patients generally has the characteristics of insomnia,staying up late,irregular sleep time,less exercise and plump figure.The related factors causing NAFLD include BMI,sleep rhythm,motor rhythm,occupational nature,age,gender and sleep quality.In clinic,circadian rhythm intervention therapy may improve the prognosis of patients with NAFLD.

目的 分析医院登革热阳性病例特别是重症患者的临床和实验室和流行病学特征可为登革热的早期诊断和预防控制提供依据。方法 收集2010年—2017年期间944例就诊于广州市第一人民医院并经实验室确诊的登革热患者。根据疾病的严重程度将入选患者分为3组,比较各组之间的临床和生物学变量,并使用多元回归分析了严重登革热的危险因素的影响。结果 本研究通过对7年间944例登革热患者进行回顾性分析发现登革热病例以轻症为主,77.5%的患者有基础疾病,主要为糖尿病(15.4%)和高血压患者(34%)。大部分患者就诊时表现为高热(39.05±0.67)℃,登革病毒IgM和(或)IgG阳性,白细胞及血小板减少明显及肝、肾功能异常。重症患者AST和LDH值相比轻症者升高。冠心病和肿瘤疾病的患者发生重症的比例更高。流行趋势分析显示7年间登革热出现1次爆发(2014年)。每年9～10月为登革热高发季节。登革热发病率在男女间无统计学差异。男性和女性的高发年龄分别71～80岁和51～60岁。10岁以下发病率最小,50～80岁年龄段发病率最高。结论 广州市第一人民医院登革热患者以老年人为主,基础性疾病患者是登革热高危人群。登革热患者具有高热、登革病原检测阳性、血象和肝肾功能异常的特征;临床医生在9～10月高发季节加强对高热患者的登革病原检查有利于登革热早期诊断和防治。

Objective The Guangzhou area is a high-risk area for dengue fever. This study aim to provide a basis for the early diagnosis and prevention of dengue fever by analyzing the clinical and laboratory characteristics and epidemiological analysis of dengue patients in Guangzhou,especially in critically ill patients. Methods A total of 944 patients with dengue fever diagnosed at the First People's Hospital of Guangzhou from 2010 to 2017 were collected. The enrolled patients were divided into 3 groups according to the severity of the disease,the clinical and biological variables between the groups were compared,and multiple regression analysis was used to analyze the effects of risk factors for severe dengue. Results This study retrospectively analyzed the clinical manifestations and laboratory tests of 944 patients with dengue fever in the past 7 years,showing that dengue fever cases in Guangzhou are mainly mild. 77.5% of them have underlying diseases,mainly diabetes (15.4%) and hypertension (34%). Most patients developed high fever (39.05±0.67)℃ at the time of seeing doctors,positive for dengue virus IgM and/or IgG,decreased white blood cells and thrombocytopenia,and abnormal liver and kidney function. AST and LDH values were significantly elevated in critically ill patients compared with mild cases. Patients with coronary heart disease and neoplastic disease have a higher proportion of severe cases. Epidemiological analysis of dengue virus showed an outbreak of dengue fever in 7 years (2014). September-October is the season of high incidence of dengue fever. The incidence of dengue fever was not statistically different between men and women. The high-incidence ages of men and women are 71～80 years old and 51～60 years old,respectively. The incidence rate is the lowest under the age of 10,and the highest in the 50～80 age group. Conclusion Dengue fever patients in Guangzhou are dominated by the elderly,and patients with underlying diseases are at high risk of dengue fever. Dengue fever patients have high fever,positive dengue pathogen detection,blood and liver and kidney dysfunction characteristics. Strengthening the dengue pathogen examination for hyperthermia patients during the high season of September-October is conducive to the early diagnosis and prevention of dengue fever.

目的 探究高龄患者植入静脉输液港并发感染相关影响因素分析。方法 随机抽取我院2015年5月—2018年8月期间收入高龄患者总计72例,对并发感染患者数量进行统计,采取Logistic回归方程进行计算,分析高龄患者植入静脉输液港并发感染相关因素。结果 共计纳入植入静脉输液港并发感染患者总计72例,其中并发感染患者为23例,占比31.94%,对比两组一般资料,发现两组患者在穿刺部位、疾病种类、使用时间及频率、是否有糖尿病史、体质量上存在差异,数据对比差异有统计学意义(P＜0.05),将上述有差异资料带入Logistic回归方程计算,发现穿刺部位、疾病种类、使用时间及频率、是否有糖尿病史、体质量均为导致高龄患者植入静脉输液港并发感染影响因素。结论 对高龄患者而言,植入静脉输液港并发感染各项因素中,包括穿刺部位、疾病种类、使用时间及频率、是否有糖尿病史、体质量,患者需加强关注,可控制输液港相关感染。

Objective To explore the influencing factors of infection in elderly patients with intravenous infusion port. Methods 72 elderly patients from May 2015 to August 2018 were randomly selected in our hospital. After counting the number of patients with complicated infection,the relative factors of infection in elderly patients were analyzed by using the Logistic regression equation. Results A total of 72 patients were included in the intravenous infusion port with concurrent infection,of which 23 were accompanied with infection,accounting for 31.94%.By comparing the general data,two groups in puncture sites,types of diseases,application times and frequencies,histories of diabetes and body masses had statistically difference(P<0.05). It was found all the above factors were the concomitant factors leading to the implantation of intravenous infusion port in elderly patients by putting the difference data into the Logistic regression equation. Conclusion To control infusion port related infection,the elderly patients should focus more on the infection factors of the implantation in intravenous infusion port which included puncture sites,types of diseases,application times and frequencies,histories of diabetes and body masses.

目的 随着治疗水平和疗效的不断提高,急性白血病患者的生存质量越来越受到广泛的关注,本研究旨在探讨急性白血病(AML)患者化疗后生活质量及其相关因素。方法 采用癌症患者生存质量测定量表(European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30)中文版、患者一般状况调查问卷,对268例按照AML患者治疗后1年生活质量进行调查,并将EORTC-QLQ-C30各领域评分与患者的特征进行相关性分析。结果 AML患者年龄、FAB分型、是否恢复工作、ECOG评分、婚姻状态、生存质量评分比较上,差异有统计学意义(P>0.05);不同年龄组AML患者PF、RF、EF、SF、QL、FI评分比较上,差异有统计学意义(P<0.05);不同分型AML患者患者RF、EF、SF、QL、DY、SL、FI评分比较上,差异有统计学意义(P<0.05),恢复工作的AML患者PF、RF、SF、QL评分高于未恢复工作的AML患者,恢复工作的AML患者FA、DY、FI评分则低于未恢复工作的AML患者(P<0.05),结婚AML患者PF、RF、SF、QL评分高于未结婚患者,结婚AML患者FA评分低于未结婚患者(P<0.05);逐步多元回归分析发现,年龄、分型、ECOG评分、婚姻状况与AML生存质量有关。结论 高龄、非M3型、ECOG评分高、未婚是AML生存质量差危险因素,可能作为改善AML患者生活质量预期指标。

Objective With the continuous improvement of treatment level and efficacy, the quality of life of patients with acute myeloid leukemia (AML) has attracted more and more extensive attention. This study aimed to explore the quality of life and related factors of patients with acute leukemia (AML) after chemotherapy. Methods The Chinese version of the quality of life scale for cancer patients(European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30, and the general situation questionnaire were was used to investigate quality of life for 268 AML patients one year after treatment.And then the correlation between the EORTC-QLQ-C30 scores in various fields and the characteristics of patients were analyzed. Results There were statistical differences in the scores of age, AML types, work(yes or no),ECOG scores, and marital status in patients (P<0.05).The differences of PF, RF, EF, SF, QL, FI score of AL in different age groups were statistically significant (P<0.05), The PF, RF, EF, SF, QL and FI scores of AML patients in different age groups were statistical different (P<0.05).The scores of PF, RF, SF and QL in AML patients who returned to work were higher than those in AML patients who did not returned to work,while FA, DY and FI scores were the opposite(P<0.05).The PF, RF, SF and QL scores of married AML patients were higher than those of unmarried AML patients,while FA scores were the opposite(P<0.05).Age, classification, ECOG score, marital status were found to be associated with quality of life of AML patients by stepwise multiple regression analysis (P<0.05). Conclusion Old age, non-M3 type, high ECOG score, and unmarried are risk factors for poor quality of life for AML, which may serve as expected indicators for improving the quality of life of patients with acute leukemia.

目的 探讨特发性肺纤维化(IPF)患者和结缔组织病相关性纤维化间质性肺疾病(CTD-fILD)患者急性加重(AE)的短期内死亡的危险因素。方法 回顾性分析2017年10月—2019年9月在深圳大学和广州医科大学附属第一医院住院的25例 AE-CTD-fILD和26例AE-IPF患者临床信息,Kaplan-Merier法对两组患者进行生存分析,Cox回顾分析年龄、性别、吸烟、白细胞总数、C反应蛋白、红细胞沉降率及肿瘤指标在急性加重患者死亡中的作用。结果 与AE-CTD-fILD比较,AE-IPF患者组男性比例、年龄、吸烟比例较高,红细胞沉降率较低(24/26 vs 10/25,P<0.001;63.77±9.97 vs 58.00±10.32,P=0.048;16/26 vs 9/25,P=0.02;28.07±29.45 vs 64.35±40.34,P=0.002 );90天内,26例AE-IPF患者11例死亡,25例AE-CTD-fILD患者5例死亡,死亡率无明显差异(42.3% vs 20%,P=0.073);Cox回归分析显示,白细胞计数是AE-IPF和AE-CTD-fILD患者的死亡危险因素(HR=1.305,P=0.001;HR=1.529,P=0.009);CA15-3是AE-IPF患者死亡危险因素(HR=1.015,P=0.005)。结论 急性加重IPF和CTD-fILD患者短期内死亡风险相似,白细胞计数及外周CA15-3水平可能是肺纤维化急性加重患者短期内死亡的危险因素。

Objective To explore the risk factors for acute exacerbation (AE) in patients with idiopathic pulmonary fibrosis (IPF) and connective tissue disease associated with fibrotic interstitial lung disease (CTD-fILD). Methods We retrospectively reviewed 25 patients with AE-CTD-fILD and 26 patients with AE-IPF, and Kaplan-Merier was used to analyze the survival of the two groups of patients. The impact of age,gender, smoking,WBC,CRP,ESR and tumor markers on acute exacerbation death were performed by Cox regression analysis. Results The AE-IPF patients had a higher proportion of men,age and smoking,and a lower ESR compared with AE-CTD-fILD patients(24/26 vs 10/25,P<0.001;63.77±9.97 vs 58.00±10.32,P=0.048;16/26 vs 9/25,P=0.02;28.07±29.45 vs 64.35±40.34,P=0.002 ). 11 cases of 26 patients with AE-IPF and 5 cases of 25 patients with AE-CTD-fILD died within 90 days, Log-rank tests showed patients with CTD-fILD had similar mortality rate compared with IPF patients after AE(42.3% vs 20%,P=0.073). The WBC count was negatively correlated with survival and the independent predictors for patients with AE-IPF and AE-CTD-fILD after adjusting for other clinical variates in Cox regression models(HR=1.305,P=0.001;HR=1.529,P=0.009). CA15-3 may be a risk factor for death of AE-IPF patients(HR=1.015,P=0.005). Conclusion AE-CTD-fILD and AE-IPF were associated with similar poor short-term survival, WBC count and plasma CA15-3 may be the independent survival predictors respectively for patients with acute exacerbation of pulmonary fibrosis in short term.

目的 探讨超声引导下射频消融术治疗肝癌的资料,评价其术后局部复发的影响因素,为临床应用提供参考依据。方法 回顾性分析2010年7月—2012年7月我院进行超声引导下射频消融治疗肝癌80例患者的临床资料,通过统计学软件,明确射频消融术的疗效,通过单因素分析中的χ²检验和logistic线性回归分析等方法分析射频消融治疗肝癌局部复发的主要危险因素。结果 80例肝癌患者行超声引导下射频消融术治疗的次数共为94次,12例肝癌患者接受RFA治疗的次数≥2次,94次肝癌射频消融术处理病灶共为101个,完全消融共为68例(85.0%),不完全消融12例(15.0%);所研究病例瘤体个数按≤3 cm、3～5 cm、>5 cm分组总数分别为55、34、12,其完全消融率分别为89.09%、79.41%、66.67%;运用多因素统计分析,结果显示肝硬化、肝炎史以及血管癌栓形成是影响肝癌患者射频消融术后局部复发的独立因素。结论 RFA治疗肝癌是一种疗效满意的局部微创治疗手段,肝硬化、肝炎史、血管癌栓形成是影响肝癌患者术后局部复发的独立高危因素。

Objective To provide reference for clinical application, we investigated the data of ultrasound-guided radiofrequency ablation RFA in the treatment of hepatocellular carcinoma and evaluated the influencing factors of local recurrence after operation. Methods The clinical data of 80 patients with hepatocellular carcinoma treated with ultrasound-guided radiofrequency ablation from July 2010 to July 2012 in our hospital were analyzed retrospectively. The efficacy of radiofrequency ablation was determined by statistical software analysis. We analyzed the main risk factors of local recurrence of hepatocellular carcinoma treated with radiofrequency ablation by χ² test and logistic linear regression analysis in univariate analysis. Results The frequency of ultrasound-guided radiofrequency ablation in 80 patients with hepatocellular carcinoma was 94 times and a total of 101 lesions were treated. Among them, 12 patients with hepatocellular carcinoma were treated with RFA more than 2 times. In 80 patients with hepatocellular carcinoma treated with RFA, 68 cases (85.0%)underwent complete ablation and 12 cases (15.0%)underwent incomplete ablation. The treated lesions were divided into 55, 34 and 12 lesions respectively, according to the size of≤ 3cm, 3 ≤ 5cm,>5cm. And the complete ablation rates were 89.09%, 79.41% and 66.67% respectively. Multivariate statistical analysis showed that liver cirrhosis, hepatitis history and vascular tumor thrombus formation were independent factors for the local recurrence of patients with hepatocellular carcinoma after radiofrequency ablation. Conclusion RFA treatment of hepatocellular carcinoma is a local minimally invasive treatment with satisfactory efficacy. Cirrhosis, hepatitis history and vascular tumor thrombosis are independent high risk factors for the local recurrence of patients with hepatocellular carcinoma.

目的 分析石河子地区2型糖尿病(T2DM)合并消化道恶性肿瘤患者的临床特征,探讨T2DM合并消化道恶性肿瘤的影响因素。方法 ①纳入我院2015年至今消化道恶性肿瘤患者为研究对象。根据OGTT结果或既往有无T2DM病史分为三组:健康对照组(A组),消化道恶性肿瘤组(B组),T2DM合并消化道恶性肿瘤组(C组)。②全自动生化分析仪测定血清中糖脂代谢指标,化学发光法测定血清甲胎蛋白(AFP)等肿瘤标志物,分析其临床特征,进行组间比较,并探讨其影响因素。采用SPSS 22.0软件处理数据,并进行方差分析;影响因素采用Logistic回归分析;假设检验水准α＝0.05,双侧检验P<0.05差异有统计学意义。结果 ①基线资料比较显示:A组310例(男女比138/172),年龄(52.96±10.98)岁;B组513例(男女比343/170),胃癌患者居多(26.90%),年龄(62.26±12.34)岁;C组134例(男女比80/54),肝癌患者较多(26.12%),年龄(66.78±10.47)岁;与A组相比,B组与C组男性患者较多,年龄较大。②组间基线资料比较显示:三组的性别、年龄存在统计学差异(P<0.001)。③协方差分析消除影响因素后:与A组相比,B组及C组的TG、 TC、HDL-c降低(P<0.001);FPG、AFP、CEA、CA12-5、CA15-3、CA19-9、CA72-4升高(P<0.01)。④Logistic回归分析后结果显示:FPG为消化道恶性肿瘤发生的独立危险因素(OR=1.204);年龄是消化道恶性肿瘤及T2DM合并消化道恶性肿瘤发生的危险因素(OR=1.072,1.105),HDL-c为消化道恶性肿瘤及T2DM合并消化道恶性肿瘤发生的保护因素(OR=0.200,0.111);结论 老年男性T2DM患者易发生消化道恶性肿瘤。因此,对于高龄男性T2DM患者,尤其是HDL-c降低的情况下,应进行相关筛查,以早期防治消化道恶性肿瘤的发生发展。

Objective To analyze the clinical characteristics of patients with type 2 diabetes mellitus (T2DM)complicated with gastrointestinal malignancy in Shihezi area, and investigate the influencing factors of T2DM complicated with gastrointestinal malignancy. Methods ①Patients with malignant tumors of the digestive tract in our hospital from 2015 to the present have been included in the study. They were divided into three groups based on OGTT results or previous history of T2DM: healthy control group (group A), gastrointestinal malignant tumor group (group B), and T2DM combined gastrointestinal malignant tumor group (group C). ②Automatic biochemical analyzer measured serum glucose and lipid metabolism indicators, chemiluminescence method was used to measure serum alpha-fetoprotein (AFP)and other tumor markers, to analyze its clinical characteristics, make a comparaison between groups, and explore its influencing factors. The data was processed with SPSS 22.0 software and analysis of variance was performed; the influencing factors were analyzed by logistic reg-ression; hypothesis test level = 0.05, and the two-sided test P <0.05 was statistically significant. Results ①Comparison of baseline data showed that 310 cases (male/female 138/172)in group A were (52.96±10.98)years old. In group B, 513 patients (male/female 343/170)were diagnosed with gastric cancer (26.90%), aged (62.26±12.34)years. There were 134 cases in group C (male/female 80/54), with more liver cancer patients (26.12%), and the age was (66.78±10.47)years. Compared with group A, group B and group C had more male patients and were older. ②Comparison of baseline data among groups showed there were statistical differences in gender and age among the three groups (P<0.001). ③After covariance analysis eliminated influencing factors: compared with group A, TG, TC and HDL-c were decreased in group B and group C (P<0.001). FPG, AFP, CEA, CA12-5, CA15-3, CA19-9, and CA72-4 increased (P<0.01). ④Logistic regression analysis results: FPG was an independent risk factor for gastrointestinal malignancy (OR=1.204). Age wss a risk factor for gastrointestinal malignancy and T2DM complicated with gastrointestinal malignancy (OR=1.072, 1.105), HDL-c was the protective factor (OR=0.200, 0.111). Conclusion Elderly male T2DM patients are prone to gastrointestinal malignancies. Therefore, for elderly men with T2DM, especially when HDL-c is reduced, relevant screening should be performed to prevent and control the occurrence and development of gastrointestinal malignant tumors in the early stage.