化疗对恶性肿瘤患者的血糖影响的初步观察

目的:探讨化疗对恶性肿瘤患者血糖的影响。方法:取我院2005年3月至2006年12月收治的恶性肿瘤患者155例。回顾性分析其化疗前后的血糖变化情况及相关临床资料。结果:155例患者中,化疗后空腹血糖升高者占13．55%(21/155),其中糖耐量低减8人,占5．16%(8/155);诊断为糖尿病者7人,占4．52%(7/155);一过性血糖增高6人,占3．87%(6/155)。各患者化疗前后血糖值的变化有统计学意义(p＜0．05)。结论:恶性肿瘤患者接受化疗后可引起血糖增高,甚至发生糖耐量低减或2型糖尿病,且多发生于化疗的第3～4周期。     

恶性肿瘤患者化疗前后血糖变化的临床观察

目的:探讨化疗对恶性肿瘤患者血糖的影响。方法:取江苏省溧水县人民医院2008年1月~2011年3月收治的153例恶性肿瘤患者,采取回顾性分析方法对合并2型糖尿病的患者比例,以及化疗前、化疗中、化疗后血糖变化情况进行临床观察。结果:153例患者中,化疗前诊断糖尿病者占9.15%(14/153),未诊断糖尿病者139例,13.67%(19/139)化疗后空腹血糖升高,其中糖耐量异常者11人,占7.91%(11/39),诊病者5人,占3.60%(5/139),一过性血糖升高3人,占2.16%(3/153)。结论:恶性肿瘤患者接受化疗可以引起血糖升高,甚至出现糖耐量异常或2型糖尿病,需进一步分析原因,探索该现象与恶性肿瘤患者治疗效果和预后的关系。     

400例消化系统恶性肿瘤患者血清TSGF检测的临床分析

目的探讨肿瘤特异性生长因子（TSGF）在消化系统恶性肿瘤诊断上的价值及其临床意义。方法用生化比色定量法及TSGF检测试剂盒测定血清中TSGF的含量。结果400例消化系统恶性肿瘤患者血清TS-GF的含量（71．37±11．24u／ml）显著高于正常对照组血清TSGF的含量（59．75±4．45u／ml）（P〈0.01）,阳性检出率达79．80％。另外,在60例进行化疗的患者中,18例有效者化疗后血清TSGF的含量（61．28±6．05u／ml）较化疗前（83．01±4．57u／ml）明显下降（P〈0．01）,6例化疗无效者化疗后血清TSGF的含量（86．51±5．82u／ml）显著高于化疗前（65．76±5．92u／ml）（P〈0．01）。结论TSGF是一种新的、敏感性高的肿瘤标志物,对于消化系统恶性肿瘤的诊断、评价疗效和判断预后,均有临床意义。     

瑞格列奈对老年2型糖尿病胰岛β细胞功能的影响及其安全性观察

目的：评估餐时血糖调节剂瑞格列奈（商品名：诺和龙）对老年2型糖尿病（T2DM）患者胰岛β细胞早时相分泌功能的影响及其用药安全性观察。方法：符合入选的患者,完成临床和实验室检查,根据血糖水平及胰岛素释放结果给予单独瑞格列奈口服治疗12周。结果：与基础值比较,瑞格列奈治疗12周后患者餐后2h血糖（2hPG）及糖化血红蛋白（HbAlc）水平均有显著下降,差异有显著性,P〈0．05;空腹血糖（FBG）有所下降但差异无显著性,P〉0．05。治疗前后比较,患者的空腹胰岛素（FINS）水平并无明显升高,P〉0．05;Ins30、Ins60明显升高,P〈0．05;而且Ins120、Ins180有下降趋势但差异无显著性,P〉0．05。△I30／△G30比值明显升高,P〈0．05,AUCINS未见明显变化,P〉0．05。治疗前后比较患者的甘油三酯（TG）水平下降,P〈0．05,总胆固醇（TC）,低密度脂蛋白胆固醇（LDL-C）水平有所下降同时高密度脂蛋白胆固醇（HDL—C）水平略有上升,但差异无显著性P〉0．05。治疗前后患者的收缩压（SBP）及舒张压（DBP）均未见明显变化,P〉0．05。治疗过程中只有1例患者在早餐与午餐间出现轻微的低血糖的症状,当时测指尖血糖为3．3mmol／L,进食后症状缓解。应用瑞格列奈治疗后患者的肝肾功能均未见明显的异常,P〉0．05。结论：瑞格列奈治疗可部分恢复老年T2DM早期时相胰岛素分泌,是一种有效的并且耐受性好的口服降糖药。     

氟西汀联合同步放化疗治疗局部晚期非小细胞肺癌的临床观察

目的：观察氟西汀联合同步放化疗治疗局部晚期非小细胞肺癌（none small cells lung carcinoma,NSCLC）的临床疗效及其安全性。方法：选择2010年10月～2011年4月我院收治的III期不能手术的NSCLC患者47例,根据患者的入院顺序,随机分为两组,同步放化疗组（对照组）22例,接受三维适形或调强放疗：肿瘤处方剂量60~66Gy,常规分割：1．8～2．0Gy／次;放疗期间同步两周期“紫杉醇＋顺铂”方案化疗,放疗后再原方案巩固化疗2--3个周期;氟西汀联合治疗组（实验组）25例,从同步放化疗开始起同时服用氟西汀（20-40mg／day）,持续服药半年。随访至1年,观察和评价两组的疗效以及不良反应的发生情况。结果：对照组与实验组的客观有效率分别为77-3％（17／22）和80％（20／25）（P〉0．05）;1年生存率分别为68．2％（15／22）和80％（20／25）（P〉0．05）;1年局控率分别为45．5％（10／22）和76％（19／25）,差异有统计学意义（P〈0．05）。治疗后,实验组患者CD＋／CD8＋比率由1．34±0．23升至1．58±0．22（P〈0．05）,而汉密尔顿抑郁量表（HAMD）总分由13．4±4．8降至9．6±3（P〈0．05）;全组患者主要不良反应为骨髓抑制、消化道反应、放射性食管炎和放射性肺炎,来发生4级不良反应,两组3级不良反应发生率无明显差异（P〉0．05）。结论：对于不能手术的局部晚期NSCLC患者,在同步放化疗的基础上联合氟西汀治疗可以提高肿瘤的1年局控率,促进抗肿瘤免疫,并缓解患者的抑郁情绪,且不加重不良反应。     

地衣芽胞杆菌活菌制剂联合庆大霉素预防伊立替康所致腹泻

目的观察地衣芽胞杆菌活菌制剂（整肠生胶囊）联合庆大霉素预防伊立替康（irinoteean,CPT-11）所致腹泻的疗效。方法31例接受含伊立替康方案化疗的晚期癌症患者,采用自身随机交叉对照的方法,分别于2个治疗周期接受化疗（对照组）、化疗＋整肠生胶囊＋庆大霉素（预防组）,比较腹泻及其他不良反应的差异。结果31例患者在2个治疗周期中,预防组较对照组腹泻发生率有显著降低（腹泻发生率分别为48．4％VS61．3％,P〈0．05;3／4级腹泻发生率分别为9．7％vs16．1％,P〈0．05）,且减少合并用药;同时骨髓抑制、食欲减退、恶心呕吐的发生率也有所降低（P〈0．05）,而2组便秘、肝肾功能异常差异无显著性。结论地衣芽胞杆菌活菌制剂联合庆大霉素能有效预防伊立替康所致腹泻。     

安立泽联合胰岛素治疗单独胰岛素降糖欠佳的高龄2型糖尿病患者临床观察

目的：观察安立泽应用于单独胰岛素治疗血糖控制欠佳的高龄2型糖尿病患者的疗效及安全性。方法：200例高龄2型糖尿病胰岛素降糖欠佳的患者（空腹血糖控制在7．8．13．9mmol／L范围内）,随机分成对照组和治疗组,对照组采用胰岛素加安慰剂治疗80例;治疗组120例,分为A、B、c三组,每组40例,A、B、c三组分别在继续应用胰岛素治疗的基础上加服安立泽4mg／d、5mg／d、6mg／d,疗程三个月。观测治疗组和对照组治疗前后FPG及PPG、HbAlC、BMI和胰岛素用量的改变及治疗的安全性。结果：对照组和治疗组治疗前的各指标无明显差异（P〉0．05）;A、B、c三组在治疗后1个月和3个月FPG、PPG、H1）A1C均有明显的下降（P〈0．05,P〈0．01）,而对照组治疗前后FIG、PPG、HbAlC略有下降,差异不明显（P〉0．05）;A、B、c三组胰岛素的用量及体重指数较治疗前均略有下降,三组间无显著性差异;对照组和治疗组的不良反应发生率无显著差异。结论：对高龄2型糖尿病单用胰岛素治疗血糖控制欠佳的患者,加用安立泽治疗,可使糖尿病相关指标得以良好的控制,减少糖尿病患者每日胰岛素用量,临床毒副作用较小。     

针对性健康教育对老年2型糖尿病患者糖代谢及生活质量的影响

目的：观察针对性健康教育对老年2型糖尿痛患者的干预效果及对生活质量的影响,为糖尿病的临床护理提供参考。方法：将120例老年2型糖尿病患者随机分为两组,对照组实施常规健康教育,观察组根据患者的文化水平、心理状况、遵医态度、实际需求实施针对性健康教育,护理3个月后观察患者餐后2h血糖（2hPG）、空腹血糖（FPG）、糖化血红蛋白（HbAlc）变化,并采用抑郁自评量表（SDS）、焦虑自评量表（SAS）、生活质量评定表（QOL）对患者的生活质量进行评定。结果：观察组护理后2hPG、FPG、HbAlc分别为（9．3±1．4）mmol／L、（6．9±2．1）mmol／L、（5．1±1.3）％,低于对照组的（11．3±1．8）mmol／L、（8．4±2．6）mmoUL、（6．9±1．5）％（P〈0．05）;观察组完全从医率为65．00％,高于对照组的40．00％（P〈0．01）;观察组护理后总体健康评分为（92．84＋7．19）分,高于对照组的（84．62±6．91）分（P〈0．05）。结论：针对性健康教育有利于提高老年2型糖尿病患者的从医性,提高血糖控制效率,改善患者的身心功能,提高生活质量。     

GK糖尿病大鼠生物学特性观察

目的了解2型糖尿病模型GK大鼠生长曲线、主要脏器重量、糖代谢等生物学特性,评价GK大鼠葡萄糖刺激的胰岛素分泌能力。方法采用51只雄性GK大鼠及15只年龄性别匹配的Wistar大鼠作为研究对象。测定13周龄GK、Wistar大鼠空腹血糖、23周龄GK大鼠空腹及随机血糖。随访GK及Wistar大鼠生长曲线,34～46周龄期间血糖、糖化血红蛋白。46周龄时行腹腔葡萄糖耐量实验（IPGTT）,计算相关参数评价β细胞葡萄糖刺激的胰岛素分泌能力;之后处死大鼠,脏器称重。比较GK及Wistar大鼠间上述各指标差异。结果13周龄GK大鼠空腹血糖4．74±0．41mmol／L,对照Wistar大鼠1．85±0．44mmol／L（P〈0．001）。23周龄GK大鼠空腹血糖7．88±1．96mmol／L,随机血糖9．91±3．52～13．46±4．13mmol／L。7～20及34～45周龄期间GK大鼠体重高于对照Wistar大鼠（P〈0．05）,46周龄时无显著性差异。34～45周龄期间GK大鼠空腹血糖、进食后血糖、HbAlc均高于对照Wistar大鼠（P〈0．05）。IPGTT曲线下面积分析示GK大鼠胰岛素曲线下面积（AUCi）、葡萄糖曲线下面积（AUCg）高于对照Wistar大鼠,胰岛素与葡萄糖曲线下面积比值（AUCi／AUCg）低于对照Wistar大鼠,差异均有显著性（P〈0．05）。GK大鼠肾脏重量高于对照Wistar大鼠（P〈0．05）,余主要脏器重量差异无显著性。结论GK大鼠空腹血糖、进食后血糖、HbAlc水平升高,葡萄糖刺激的胰岛素分泌能力（GSIS）减退,葡萄糖刺激后胰岛素分泌早期相消失,晚期相代偿性增加,具有2型糖尿病特点;体重、血糖等生物学特性稳定。     

糖化血红蛋白和糖化血清白蛋白联合检测在糖尿病中的筛查价值

目的：探讨糖化血红蛋白和糖化血清白蛋白联合检测在糖尿病中的筛查价值。方法：选取我院2012年3月至2013年7月842例进行糖尿病筛查的个体作为研究对象,通过检测研究对象HbA1c（糖化血红蛋白）、GA（糖化血清白蛋白）水平,分析HbA1c、GA和糖尿病的关系。结果：参加研究的受检者BMI为（24．32＋3．61）kg／m^2,收缩压为（128．11±18．25）mmHg,舒张压为（82．41±11．07）mmHg,空腹血糖（6．05±1．59）mmol／L,餐后2小时血糖（9．97±4．32）mmol／L,糖化血红蛋白（6．17±1.13）％,糖化血清白蛋白（17．82±4．53）％。NGT组、IGR组和DM组三组HbA1c、GA比较不全相等（P〈0．05）,且各组间两两比较也存在差异,差异均具有统计学意义（P〈0．05）;Pearson积差相关分析显示,研究对象HbA1c、GA、FPG（空腹血糖）、2hPG（餐后2小时血糖）这四个指标两两之间均呈正相关（P〈0．05）。结论：HbA1c和GA联合检测在糖尿病筛查中有应用价值,值得在实际工作中应用推广。     

Lactate Dehydrogenase B Is Associated with the Response to Neoadjuvant Chemotherapy in Oral Squamous Cell Carcinoma

Oral squamous cell carcinoma (OSCC) comprises a subset of head and neck squamous cell carcinoma (HNSCC) with poor therapeutic outcomes and high glycolytic dependency. Neoadjuvant chemotherapy regimens of docetaxel, cisplatin and 5-fluorouracil (TPF) are currently accepted as standard regimens for HNSCC patients with a high risk of distant metastatic spread. However, the antitumor outcomes of TPF neoadjuvant chemotherapy in HNSCC remain controversial. This study investigated the role of lactate dehydrogenase B (LDHB), a key glycolytic enzyme catalyzing the inter-conversion between pyruvate and lactate, in determining chemotherapy response and prognosis in OSCC patients. We discovered that a high protein level of LDHB in OSCC patients was associated with a poor response to TPF regimen chemotherapy as well as poor overall survival and disease-free survival. Our in-depth study revealed that high LDHB expression conferred resistance to taxol but not 5-fluorouracil or cisplatin. LDHB deletion sensitized OSCC cell lines to taxol, whereas the introduction of LDHB decreased sensitivity to taxol treatment. Taxol induced a pronounced impact on LDHB-down-regulated OSCC cells in terms of apoptosis, G2/M phase cell cycle arrest and energy metabolism. In conclusion, our study highlighted the critical role of LDHB in OSCC and proposed that LDHB could be used as a biomarker for the stratification of patients for TPF neoadjuvant chemotherapy and the determination of prognosis in OSCC patients.     

Overexpression of miR-329-3p sensitizes osteosarcoma cells to cisplatin through suppression of glucose metabolism by targeting LDHA

Osteosarcoma (OS) is one of the most frequent malignant bone tumor types. Traditional treatments of OS involve standard chemotherapy or combination with radiation before and after surgery. Cisplatin is one of the most effective chemotherapeutic drugs used for treating osteosarcoma. However, patients with advanced tumor stages develop cisplatin resistance, leading to a major clinical challenge. In this study, we investigated the roles of miR-329-3p in cisplatin sensitivity of osteosarcoma cells. We found miR-329-3p was significantly downregulated in osteosarcoma tissues compared with normal bone tissues. Overexpression of miR-329-3p suppressed osteosarcoma cell proliferation. Moreover, we observed low-toxic cisplatin treatments suppressed miR-329-3p but higher concentrations of cisplatin-induced miR-329-3p expression. In addition, miR-329-3p was significantly downregulated in cisplatin-resistant Saos-2 cells which displayed elevated glucose metabolism. Overexpression of miR-329-3p significantly impaired glucose metabolism of Saos-2 cells. Bioinformatics analysis and luciferase assay consistently demonstrated the glycolysis enzyme, lactate dehydrogenase-A (LDHA) was a direct target of miR-329-3p in osteosarcoma cells. Rescue experiments revealed restoration of LDHA in miR-329-3p-overexpressed cisplatin-resistant cells effectively recovered glucose metabolism, resulting in increased cisplatin resistance. This study demonstrates a miR-329-3p-LDHA-glucose metabolism-cisplatin resistance axis in osteosarcoma cells, providing a miRNA-based therapeutic strategy against chemoresistant osteosarcoma.     

PAXX is a novel target to overcome resistance to doxorubicin and cisplatin in osteosarcoma

Osteosarcoma (OS) is the most common primary malignant bone tumor diagnosed in children and adolescents. Unfortunately, OS patients with metastatic or recurrent disease are highly resistant to front line chemotherapy that significantly limits the long-term survival rate. Since majority of chemotherapeutic agents used in OS work by generating DNA damages, enhanced DNA repair pathways are generally associated with chemoresistance in OS treatment. However, the exact mechanisms of chemoresistance in OS are not fully understood. Our study found that paralogue of XRCC4 and XLF (PAXX), which was identified recently as a novel factor of non-homologous end joining (NHEJ), is upregulated in chemoresistant OS cells. Importantly, PAXX deficiency re-sensitizes chemoresistant OS cells to doxorubicin and cisplatin. Mechanistically, chemoresistance to doxorubicin or cisplatin results in enhanced PAXX-Ku70 interaction and elevated NHEJ efficiency. We also identified a small molecule M11 that interrupts PAXX-Ku70 interaction and re-sensitizes chemoresistant OS cells to doxorubicin and cisplatin. Thus, our data provide evidence that PAXX could serve as a novel target to overcome chemoresistance in OS treatment.     

Clinical Analysis of 152 Cases of Multiple Primary Malignant Tumors in 15,398 Patients with Malignant Tumors

ObjectivesIn this study, the etiology, clinical characteristics, and prognosis of multiple primary malignant tumors (MPMTs) were investigated. Furthermore, we analyzed the treatment factors associated with MPMTs.MethodsFrom 15,398 patients with malignant tumors presenting to The First Hospital of Jilin University, China, between January 2010 and December 2013, we identified and analyzed patients with MPMTs. Data were obtained retrospectively from the hospital database.ResultsThe prevalence of MPMTs in this study was 0.99% (152/15398): 51 cases were synchronous MPMTs, and 101 cases were metachronous MPMTs. The mean time between the first and second primary cancer was 43.1 months. In this population, MPMTs were observed more frequently in patients with head and neck tumors (5.65%) and urinary tumors (4.19%); the prevalence of MPMTs in these patients was over 4-fold greater than the prevalence of MPMTs in all patients (0.99%). There were no cases of MPMTs in 132 cases of nervous system tumors and 404 cases of multiple myeloma. Nearly 50% (45.4%) of patients with MPMTs did not receive chemotherapy or radiotherapy before the second primary cancer was diagnosed. Eighty-five patients with MPMTs were followed for more than 2 years, and the 2-year cumulative survival rate was 40.8%.ConclusionsIn this study, the prevalence of MPMTs was 0.99% (152/15398), which is consistent with the Chinese literature. Patients with head and neck tumors or urinary tumors are at greater risk of developing MPMTs. In addition to radiotherapy or chemotherapy, this study suggests that other factors may contribute to MPMTs.     

On the Status and Comparison of Glucose Intolerance in Female Breast Cancer Patients at Initial Diagnosis and during Chemotherapy through an Oral Glucose Tolerance Test

Aims

This study is to estimate the status and comparison of glucose intolerance in female breast cancer patients at initial diagnosis and during chemotherapy through an oral glucose tolerance test (OGTT), as well as to learn the effect of chemotherapy on the glucose metabolism of breast cancer patients.

Methods

All the 79 breast cancer patients at initial diagnosis, with the mean age of 53.2 years, and 96 breast cancer patients before the 5th or 6th cycle of chemotherapy, with the mean age of 51.5 years, participated in the study from December 2012 to October 2013. After an overnight fast, participants underwent OGTT test, and fasting and 2-hour glucose levels were measured to identify undiagnosed diabetes and prediabetes (i.e., impaired fasting glucose or impaired glucose tolerance) in them. Previously diagnosed diabetes among the female breast cancer patients was determined on the self-report and the medical record.

Results

The overall incidences of total normal glucose tolerance, prediabetes, diabetes in female breast cancer patients at initial diagnosis and during chemotherapy were 24.1% and 38.5% (p<0.05), 50.6% and 28.1% (p<0.05), and 25.3% and 33.3% (p>0.05), respectively, and the differences of normal glucose tolerance and prediabetes instead of diabetes between the two groups were statistically significant. About 84% of the total diabetes and prediabetes in the female breast cancer patients at initial diagnosis and 79.7% of those during chemotherapy need to be diagnosed with OGTT.

Conclusions

Breast cancer patients have high incidences of diabetes and prediabetes. After chemotherapy even with steroids, some breast cancer patients with abnormal glucose metabolism may even become normal. Isolated hyperglycemia 2 hours after glucose loading is common, and OGTT should be made for breast cancer patients at initial diagnosis and during chemotherapy.     

肝源性糖尿病45例临床分析

目的探讨肝源性糖尿病的临床特点及治疗。方法观察45例肝硬化合并肝源性糖尿病患者的临床表现,检测治疗前、治疗后的血糖情况并进行比较分析。结果肝源性糖尿病患者以肝病表现为主,血糖波动较大,以餐后2h血糖升高为主;而Child-pugh分级C级患者的血糖明显高于A、B级患者,有并发症的患者血糖明显高于无并发症的患者。结论肝硬化患者易发生糖代谢紊乱,血糖水平与肝功能情况密切相关,经早期积极治疗,血糖基本可降至理想范围并稳定。     

The protective role of selenium on the toxicity of cisplatin-contained chemotherapy regimen in cancer patients

The effect of selenium (Se) in reducing the toxicity of cisplatin in cancer patients was studied. Forty-one patients were randomized into group A (20 patients with Se administration in first cycle of chemotherapy as study cases and without Se in second cycle of chemotherapy as control) and group B (21 patients without Se in first cycle of chemotherapy and with Se in second cycle of chemotherapy). The 400 μg per day of Se as Seleno-Kappacarrageenan were administered from 4 before to 4 d after chemotherapy for study cases. The serum Se increased from 70.4±22.86 to 157.04±60.23 ng/mL (P<0.001) in patients received Se. The cisplatin dosage was iv administration in 60–80 mg/m² on the first day. The results showed that the peripheral WBC counts on day 14 after initiation of chemotherapy in study cases was significantly higher than the controls (3.35±2.01 vs 2.31±1.38 [×10⁹L])/L,p<0.05). On the other hand, the consumption of GCSF for the cases was significantly less than the controls (110.1±82.2 vs 723.6±192.6 IU,p<0.05). The volumes of blood transfusion for the study group were also significantly less than the controls (0 vs 62±38mL,p<0.05). The nephrotoxicity of cisplatin was measured by urine enzymes (NAG, GGT, AAP, LAP, and ALP) were determined prior to and at 2, 24, 48, and 72h after initiation of chemotherapy. The urine enzymes NAG, GGT, AAP, and ALP after chemotherapy for cases were significantly lower than the controls. No toxicity of Seleno-Kappacarrageenan was noted. The above results suggest that the Se can be used as an agent for reducing the nephrotoxicity and bone marrow suppression induced by cisplatin.     

Anatamo-pathological aspects of malignant ovarian tumors in children. Apropos of 16 cases

The authors present 16 cases of malignant ovarian tumors in childhood, censed in Pasteur Institute - Tunis. These tumors are scarce, and present in the literature only 3% of the malignant tumors in childhood. In this series, germ cell tumors are the most frequent and present 81.25% of these cases, of which 43.75% of dysgerminoma. Gonadal stromal tumors are more scarce (6.25%). The prognosis of these tumors was transformed by the radiation therapy in dysgerminoma, and the chemotherapy in the other germ cell tumors. These tumors must be diagnosed and treated early.     

首发未用药精神分裂症患者糖代谢异常的情况及相关影响因素分析

目的:分析首发未用药精神分裂症患者伴发糖代谢异常的情况及相关影响因素。方法:选择80例首发未用药的精神分裂症患者作为病例组及同期进行体检的80例健康人作为对照组,根据口服OGTT试验将病例组分为糖代谢正常者和糖代谢异常者,收集病例组及对照组一般资料、及血糖相关指标进行分析。结果:病例组糖代谢异常发生率为38.75%,明显高于对照组(26.25%)(P0.05);病例组糖化血红蛋白、胰岛素抵抗指数(IR)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、皮质醇水平均明显高于对照(P0.05),而TSH水平明显低于对照组(P0.05);病例组中,糖代谢异常者皮质醇、FT3、FT4、IR、BMI、腰臀比明显高于糖代谢正常者(P0.05),TSH水平明显低于糖代谢正常者(P0.05);病例组中,糖代谢异常者餐后血糖7.8的比例随用药时间延长明显增高(P0.05)。结论:首发未经治疗的精神分裂症患者中糖代谢异常的构成比较健康人明显增高,属于2型糖尿病的高危人群。无抗精神病药物影响的前提下,肥胖、IR、皮质醇增高、FT4增高、TSH降低可能为精神分裂症患者发生糖代谢异常的危险因素。首发未经治疗的精神分裂症患者应用抗精神病药物治疗后餐后血糖会明显升高。