胰岛素抵抗在前列腺癌治疗前后动态变化的临床观察

目的:探讨胰岛素抵抗程度在前列腺癌治疗过程中动态变化及胰岛素抵抗程度与前列腺癌预后的关系。方法:选择前列腺癌惠者50名。平均年龄72岁。将前列腺癌患者根据治疗方法分为前列腺癌根治术组、手术去势组、药物去势组;根据有无复发转移分为复发转移组、无复发转移组。采用己糖激酶法测定空腹葡萄糖,放免法测定空腹胰岛素(Fasting serum insulin FINS)水平。运用HOMA模型中的胰岛素抵抗计算公式计算胰岛素抵抗指数(insulin resistance index IRI)。组间比较采用配对t检验。结果:前列腺癌患者在手术后的胰岛素抵抗指数明显下降,与手术前胰岛素抵抗指数存在统计学差异(P<0.05)。前列腺癌根治组的IRI值和手术去势组与药物去势组都存在统计学差异(P<0.05),但手术去势组和药物去势组两组之间不存在统计学差异(P>0.05)。前列腺癌治疗后无复发转移组的IRI值明显低于复发转移组,两组间IRI存在统计学差异(P<0.05)。结论:前列腺癌患者胰岛素抵抗程度与肿瘤治疗经过、效果有关。胰岛素抵抗指数有助于前列腺癌患者判断治疗效果,判断预后。

The Clinical Research on the Dynamic Change of Insulin Resistance during the Therapy of Prostate Cancer

Objective:To study the dynamic change of insulin resistance(IR)during the therapy of prostate cancer(Pca)and the re- lationship between IR and the prognosis of Pea.Methods:50 Pca patients were divided into three groups by therapeutic methods,and di- vided into two groups by the recurrence and the transfer of the cancer.The fasting blood glucose (FBG)was determined by hexokinase assay.IR was determined in all cases by radio-immunity method.Insulin resistance index (IRI) was calculated according to the formula in HOMA model.Results:IRI of Pca patients significantly decreased after the castration or radical prostatectomy.IRI of the radical prostatectomy group were statistically different from the castration group,but it was not obvious between the operation castration group and the medication castration group.IRI of the treatment group without the recurrence was significantly lower than the group with the re- currence.Conclusion:IRI was closely related to the treatment course and curative effect.1RI is helpful for Pea patients to estimate the cu- rative effect and the prognosis during the early diagnosis.