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良性胰腺疾病患者胰腺实质损失与术后早期高血糖的关系。

Relationship between pancreatic parenchyma loss and early postoperative hyperglycemia in patients with benign pancreatic diseases.

机构信息

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.

出版信息

Abdom Radiol (NY). 2021 Sep;46(9):4210-4217. doi: 10.1007/s00261-021-03061-4. Epub 2021 Apr 4.

Abstract

OBJECTIVE

To evaluate the relationship between pancreatic parenchyma loss and early postoperative hyperglycemia in patients with benign pancreatic diseases.

METHODS

A total of 171 patients with benign pancreatic tumors or chronic pancreatitis, whose preoperative fasting blood glucose (FBG) was normal and who underwent partial pancreatectomy were reviewed. The pancreatic volume was measured by CT imaging before and after the operation. According to their different pancreatic resection volume (PRV), 171 patients were divided into five groups: < 30%, 30%-39%, 40%-49%, 50%-59%, and ≥ 60%. The correlation between the PRV and postoperative FBG was investigated. According to the postoperative FBG value, the patients were divided into a hyperglycemia group (HG) and nonhyperglycemia group (non-HG) to explore the best cutoff value of the PRV between the two groups.

RESULTS

There were significant differences in the postoperative FBG among the five groups (PRV < 30%, 30%-39%, 40%-49%, 50%-59%, and ≥ 60%). The PRV was positively correlated with postoperative FBG in the benign tumor group and chronic pancreatitis group (R = 0.727 and 0.651, respectively). ROC curve analysis showed that the best cutoff value of the PRV between the HG (n = 84) and non-HG (n = 87) was 39.95% with an AUC = 0.898; the sensitivity was 89.29%, and the specificity was 82.76%.

CONCLUSION

There was a linear positive correlation between the postoperative FBG level and PRV. Patients with a PRV ≥ 40% are more likely to develop early postoperative hyperglycemia.

摘要

目的

评估良性胰腺疾病患者胰腺实质丧失与术后早期高血糖之间的关系。

方法

回顾性分析 171 例术前空腹血糖(FBG)正常、接受胰腺部分切除术的良性胰腺肿瘤或慢性胰腺炎患者的临床资料,通过 CT 影像学测量患者术前、术后胰腺体积。根据不同的胰腺切除体积(PRV),将 171 例患者分为五组:<30%、30%-39%、40%-49%、50%-59%和≥60%。分析 PRV 与术后 FBG 的相关性。根据术后 FBG 值,将患者分为高血糖组(HG)和非高血糖组(non-HG),探讨两组间 PRV 的最佳截断值。

结果

五组患者术后 FBG 比较差异有统计学意义(PRV < 30%、30%-39%、40%-49%、50%-59%和≥60%)。良性肿瘤组和慢性胰腺炎组 PRV 与术后 FBG 呈正相关(R=0.727 和 0.651)。ROC 曲线分析显示,HG(n=84)与 non-HG(n=87)之间的最佳 PRV 截断值为 39.95%,AUC=0.898;敏感度为 89.29%,特异度为 82.76%。

结论

术后 FBG 水平与 PRV 呈线性正相关。PRV≥40%的患者更易发生术后早期高血糖。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da73/8346412/e47871211c2e/261_2021_3061_Fig1_HTML.jpg

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