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目的探讨小剂量甲泼尼龙在恶性肿瘤合并糖尿病患者中的应用价值。方法选取2013年6月至2015年6月辽宁省沈阳市第四人民医院收治的消化系统恶性肿瘤合并糖尿病患者80例作为研究对象,将其按照随机数字表法分为观察组与对照组,各40例。观察组患者于化疗周期开始前3 d给予甲泼尼龙每天40 mg,此后于每次化疗时给予甲泼尼龙40 mg静脉滴注;对照组患者则使用0.9%氯化钠注射液作为空白对照。比较两组患者治疗后化疗相关并发症发生情况、血糖控制情况及不良反应发生情况。结果观察组患者肝肾功能受损、血液系统抑制、胃肠道反应以及脱发发生率均显著低于对照组,差异均有统计学意义(均P<0.05);干预后,观察组患者空腹血糖、餐后2 h血糖及糖化血红蛋白水平均明显低于对照组,差异均有统计学意义(均P<0.05)。结论针对消化道恶性肿瘤合并糖尿病患者,使用小剂量甲泼尼龙,能显著减少化疗期间不良反应发生,并能有效调节血糖水平,降低糖尿病相关并发症发生率。
Objective To investigate the value of low-dose methylprednisolone in patients with malignant tumor complicated by diabetes. Methods Eighty patients with digestive system malignant neoplasm with diabetes mellitus admitted to the Fourth People’s Hospital of Shenyang, Liaoning Province from June 2013 to June 2015 were selected as study subjects and divided into observation group and control group according to random number table 40 cases. Patients in the observation group were treated with methylprednisolone 40 mg daily 3 days before the start of the chemotherapy cycle. After that, 40 mg of methylprednisolone was given intravenously every time of chemotherapy, while 0.9% sodium chloride injection was used as the control in the control group. The incidence of chemotherapy-related complications, glycemic control and adverse reactions were compared between the two groups after treatment. Results The observation group had impaired liver and renal function, blood system inhibition, gastrointestinal reaction and the incidence of alopecia were significantly lower than the control group, the differences were statistically significant (all P <0.05); after intervention, the fasting blood glucose , 2 h postprandial blood glucose and glycosylated hemoglobin levels were significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusion For patients with gastrointestinal malignant tumor complicated with diabetes, the use of small doses of methylprednisolone can significantly reduce adverse reactions during chemotherapy, and can effectively regulate blood glucose levels and reduce the incidence of complications related to diabetes.