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目的探讨糖尿病患者血清CA19-9水平及其与胰腺疾病的关系。方法选取2007年1月至2008年9月,有完整资料的住院糖尿病患者544例,分为无病变组(糖尿病无胰腺病变)、良性病变组(糖尿病合并胰腺良性疾病)、恶性病变组(糖尿病合并胰腺癌),比较3组间CA19-9水平及临床特征。根据CA19-9水平分组,观察CA19-9水平与胰腺疾病的关系。同时比较不同CA19-9水平无胰腺疾病的糖尿病患者的临床特征,并分析CA19-9水平的影响因素。结果 544例糖尿病患者中,胰腺良、恶性疾病各占1.8%(10/544)。其中良性病变组体重指数、餐后30 min C肽及120 min C肽低于无病变组(P<0.05),恶性病变组年龄大于上述2组(P<0.05)。CA19-9水平升高小于2倍者胰腺良性病变的检出率明显高于CA19-9水平正常者及升高大于2倍者(均P<0.01),而CA19-9水平升高大于2倍者胰腺恶性病变的检出率明显高于其他患者(均P<0.01)。无胰腺病变的糖尿病患者中,伴有CA19-9水平升高者占10.9%(57/524),其年龄、总胆固醇及丙氨酸转氨酶高于CA19-9正常者(P<0.05)。logistic回归分析显示,年龄与CA19-9水平呈独立正相关(β=1.024,P=0.045)。结论糖尿病患者中10%可伴有血清CA19-9水平升高,其中升高超过2倍者应警惕胰腺恶性病变的可能。
Objective To investigate the serum CA19-9 level in patients with diabetes and its relationship with pancreatic diseases. Methods From January 2007 to September 2008, 544 hospitalized diabetic patients with complete data were divided into three groups: non-lesion group (diabetes without pancreatic lesion), benign lesion group (diabetes with benign pancreatic disease), malignant group (diabetic group Combined with pancreatic cancer), comparing the level of CA19-9 between the three groups and clinical features. According to the level of CA19-9 grouping, observe the relationship between the level of CA19-9 and pancreatic diseases. At the same time, the clinical characteristics of diabetic patients with different CA19-9 levels without pancreatic disease were compared and the influencing factors of CA19-9 levels were analyzed. Results Among 544 diabetic patients, benign and malignant pancreatic diseases accounted for 1.8% (10/544) respectively. The body mass index of benign lesion group, 30 min postprandial C peptide and 120 min C peptide were lower than those in non-lesion group (P <0.05). The malignant lesion group was older than the above two groups (P <0.05). The detection rate of benign pancreatic lesions with CA19-9 level less than 2 times was significantly higher than those with CA19-9 levels or more than 2 times (all P <0.01), while CA19-9 level was more than 2 times The detection rate of pancreatic malignant lesions was significantly higher than other patients (all P <0.01). Among the diabetic patients without pancreatic lesions, the patients with elevated CA19-9 levels accounted for 10.9% (57/524), and their age, total cholesterol and alanine aminotransferase were higher than those with CA19-9 (P <0.05). Logistic regression analysis showed that there was a positive correlation between age and CA19-9 (β = 1.024, P = 0.045). Conclusion 10% diabetic patients may be associated with elevated levels of serum CA19-9, of which more than 2 times higher should be alert to the possibility of malignant pancreatic lesions.