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血糖波动联合炎症及免疫因素对糖尿病合并尖锐湿疣患者治疗后复发的影响

王莹 涂胜

王莹, 涂胜. 血糖波动联合炎症及免疫因素对糖尿病合并尖锐湿疣患者治疗后复发的影响[J]. 中华全科医学, 2024, 22(9): 1518-1521. doi: 10.16766/j.cnki.issn.1674-4152.003672
引用本文: 王莹, 涂胜. 血糖波动联合炎症及免疫因素对糖尿病合并尖锐湿疣患者治疗后复发的影响[J]. 中华全科医学, 2024, 22(9): 1518-1521. doi: 10.16766/j.cnki.issn.1674-4152.003672
WANG Ying, TU Sheng. Influence of blood glucose fluctuation, inflammation and immune factors on recurrence of condyloma acuminatum in patients with diabetes[J]. Chinese Journal of General Practice, 2024, 22(9): 1518-1521. doi: 10.16766/j.cnki.issn.1674-4152.003672
Citation: WANG Ying, TU Sheng. Influence of blood glucose fluctuation, inflammation and immune factors on recurrence of condyloma acuminatum in patients with diabetes[J]. Chinese Journal of General Practice, 2024, 22(9): 1518-1521. doi: 10.16766/j.cnki.issn.1674-4152.003672

血糖波动联合炎症及免疫因素对糖尿病合并尖锐湿疣患者治疗后复发的影响

doi: 10.16766/j.cnki.issn.1674-4152.003672
基金项目: 

安徽高校自然科学研究重点项目 KJ2020A0336

亳州市人民医院2023科研项目 by2023029

详细信息
    通讯作者:

    涂胜,E-mail:tusheng77@163.com

  • 中图分类号: R587.1 R752.53

Influence of blood glucose fluctuation, inflammation and immune factors on recurrence of condyloma acuminatum in patients with diabetes

  • 摘要:   目的  探讨糖尿病合并尖锐湿疣(DMCA)患者CO2激光及咪喹莫特(CO2-Ⅰ)治疗后血糖波动联合白介素-6(IL-6)及血清肿瘤坏死因子-α(TNF-α)与复发的相关性。  方法  纳入2020年8月—2022年12月期间在亳州市人民医院实施CO2-Ⅰ治疗的136例DMCA患者进行研究,所有患者均在治疗后持续72 h监测血糖水平并计算平均血糖波动幅度(MAGE)。出院后对患者跟踪随访6个月,统计患者短期复发情况,依据治疗后复发情况将患者分为复发组(34例)与非复发组(102例),并分析糖尿病合并CA患者CO2-Ⅰ治疗后血糖波动对短期复发的影响。  结果  经统计,136例DMCA患者复发34例,占25.00%,未复发患者共102例,占75.00%。复发组的MAGE、IL-6和TNF-α水平均高于非复发组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,MAGE值高(≥3.9 mmol/L,OR=1.527,P<0.001)、肛门和(或)生殖器区域糜烂(OR=2.786,P=0.016)、TNF-α水平高(≥6.39 μg/L,OR=1.746,P=0.001)、IL-6水平低(<5.26 pg/mL,OR=1.725,P=0.001)均为复发的危险因素。  结论  DMCA患者CO2-Ⅰ治疗后MAGE、TNF-α越高、IL-6越低,肛门和(或)生殖器区域糜烂,短期复发风险越大,具有一定的临床意义,可能为预后提供评估依据。

     

  • 表  1  2组MDCA患者基线资料及实验室指标比较

    Table  1.   Comparison of baseline characteristics and laboratory indicators between the two groups of MDCA patients

    项目 复发组(n=34) 非复发组(n=102) 统计量 P
    性别[例(%)] 0.411a 0.840
      男性 21(61.76) 61(59.80)
      女性 13(38.24) 41(40.20)
    年龄(x±s,岁) 41.32±6.48 39.07±7.64 1.545b 0.125
    糖尿病病程(x±s,年) 5.79±1.89 5.93±1.38 0.456b 0.649
    CA病程(x±s,月) 5.79±1.81 6.28±2.77 0.964b 0.337
    疣体数量(x±s,个) 5.88±1.55 5.76±1.62 0.370b 0.712
    吸烟[例(%)] 1.813a 0.178
      是 12(35.29) 24(23.53)
      否 22(64.71) 78(76.47)
    饮酒[例(%)] 1.454a 0.228
      是 10(29.41) 22(21.57)
      否 24(70.59) 80(78.43)
    HPV感染类型[例(%)] 1.070a 0.586
      高危型 8(23.53) 31(30.39)
      低危型 17(50.00) 41(40.20)
      高-低危混合感染型 9(26.47) 30(29.41)
    性伴侣感染HPV[例(%)] 0.046a 0.830
      是 11(32.35) 31(30.39)
      否 23(66.65) 71(69.61)
    性生活中使用安全套[例(%)]
      是 22(64.71) 43(42.16) 0.066a 0.797
      否 12(35.29) 59(57.84)
    肛门和(或)生殖器区域糜烂[例(%)] 5.857a 0.016
      是 10(29.41) 12(11.76)
      否 24(70.59) 90(88.24)
    TC(x±s,mmol/L) 5.89±1.39 5.67±1.31 0.875b 0.383
    TG(x±s,%) 2.89±0.62 2.95±0.72 1.437b 0.663
    HDL-C(x±s,mmol/L) 1.28±0.22 1.25±0.28 0.578b 0.564
    LDL-C(x±s,pg/mL) 3.52±0.67 3.58±0.71 0.433b 0.666
    TSH(x±s,μIU/mL) 3.08±0.51 3.13±0.59 0.440b 0.661
    糖化血红蛋白(x±s,%) 7.58±1.66 7.21±1.69 1.113b 0.268
    注:a为χ2值,bt值。
    下载: 导出CSV

    表  2  2组MDCA患者血糖波动及IL-6、TNF-α比较(x±s)

    Table  2.   Comparison of blood glucose fluctuation, IL-6 and TNF-α in two groups of MDCA patients(x±s)

    组别 例数 MAGE(mmol/L) IL-6(pg/mL) TNF-α(μg/L)
    复发组 34 5.89±1.50 4.37±1.14 6.59±1.92
    非复发组 102 3.10±0.67 5.71±1.26 5.43±1.67
    t 14.903 5.718 3.400
    P <0.001 0.002 0.001
    下载: 导出CSV

    表  3  DMCA患者CO2-Ⅰ治疗后复发的影响因素分析

    Table  3.   Analysis of factors affecting recurrence in DMCA patients after CO2-Ⅰ treatment

    变量 B SE Waldχ2 P OR 95% CI
    肛门和(或)生殖器区域糜烂(是) 1.025 0.847 9.652 0.016 2.786 0.711~16.376
    MAGE≥3.9 mmol/L 0.423 0.317 13.457 0.001 1.527 1.149~2.495
    TNF-α≥6.39 μg/L 0.558 0.164 9.458 0.001 1.746 6.393~8.347
    IL-6<5.26 pg/mL 0.545 0.338 8.326 0.002 1.725 1.267~4.903
    注:赋值情况如下,性生活中使用安全套,是=0,否=1;肛门和(或)生殖器区域糜烂,是=0,否=1;MAGE<3.9 mmol/L=0,≥3.9 mmol/L=1;TNF-α<6.39 μg/L=0,≥6.39 μg/L=1;IL-6<5.26 pg/mL=0,≥5.26 pg/mL=1。
    下载: 导出CSV
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