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目的 总结胰腺癌合并糖尿病的临床特点 ,以提高早期胰腺癌的诊断率。方法 回顾性分析我院 10年来胰腺癌合并糖尿病患者的临床特点 ,分析其一般情况、合并症、糖尿病家族史、肿瘤指标、糖耐量和诊治过程 ,并与单纯 2型糖尿病患者比较。结果 胰腺癌合并糖尿病血糖水平和胰岛素水平与 2型糖尿病相似 ,有高胰岛素血症 ,但又有独特的临床特点 :①发病年龄相对较大 ,常大于 6 0岁 ,女性多见 ;②基本无DM家族史 ;③无三多症状 ,但短期内体重下降较明显 ;④起病时常有腹痛或腹部不适感 ;⑤合并高血压和冠心病 ,尤其是高脂血症相对少见 ;⑥肿瘤指标CA19 9和CEA常有异常。胰腺癌所致的糖尿病常在胰腺癌早期即可出现。结论 胰腺癌所致糖尿病有一定的发病特点 ,借助此特点 ,有望提高早期胰腺癌的诊断率。
Objective To summarize the clinical features of pancreatic cancer complicated with diabetes in order to improve the diagnosis rate of early pancreatic cancer. Methods The clinical features of patients with pancreatic cancer complicated with diabetes mellitus in our hospital over the past 10 years were analyzed retrospectively. The general conditions, comorbidities, family history of diabetes, tumor markers, glucose tolerance and diagnosis and treatment were analyzed. Compared with those with type 2 diabetes mellitus alone. Results Compared with type 2 diabetes, pancreatic cancer complicated with type 2 diabetes mellitus had hyperinsulinemia, but had unique clinical features: ① The age of onset was relatively large, often larger than 60 years old; DM family history; ③ no more than three symptoms, but short-term weight loss significantly more; ④ onset often abdominal pain or abdominal discomfort; ⑤ hypertension and coronary heart disease, especially hyperlipidemia is relatively rare; ⑥ tumor markers CA19 9 and CEA often abnormal. Diabetes caused by pancreatic cancer often appear early in pancreatic cancer. Conclusion The diabetes caused by pancreatic cancer has a certain incidence characteristics, with this feature, is expected to improve the diagnosis of early pancreatic cancer.