مقایسه‌ی الگوی شیوع فشار خون بالا و دیابت نوع 2 در بیماران مبتلا به سرطان کولورکتال

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استادیار، گروه اپیدمیولوژی و آمارزیستی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران

2 استادیار، گروه اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

3 معاونت تحقیقات و فناوری، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران

4 استاد، گروه نفرولوژی، دانشکده‌‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: سرطان کولورکتال شایع‌ترین سرطان دستگاه گوارش می‌باشد و 10 درصد مرگ و میر ناشی از سرطان را شامل می‌شود. در ایران، میزان فراوانی سرطان کولورکتال در دهه‌های اخیر افزایش چشمگیری داشته است. تا کنون مطالعه‌ای در ایران به بررسی شیوع فشار خون بالا و دیابت نوع دو و اثر آن‌ها بر بقای بیماران مبتلا به سرطان کولورکتال نپرداخته است. این مطالعه به این منظور انجام گردید.روش‌ها: این مطالعه یک بررسی هم‌گروهی بود که در آن، 1127 بیمار مبتلا به سرطان کولورکتال در مرکز ثبت سرطان وابسته به مرکز تحقیقات گوارش و کبد دانشگاه علوم پزشکی شهید بهشتی در 2570 نفر- سال پیگیری شدند. برای تشخیص دیابت نوع دو، از آزمایش قند خون ناشتا و هموگلوبین گلیکوزیله استفاده گردید. برای تشخیص فشار خون بالا از اندازه‌گیری فشار خون افراد در دو نوبت استفاده گردید. شاخص‌های توصیفی محاسبه و با استفاده از آنالیز بقا، میانه‌ی زمان بقای بیماران از تشخیص بیماری محاسبه و با آزمون Log-rank زمان بقای آن‌ها مقایسه‌ گردید. از نرم‌‌افزار Stata نسخه‌ی 12 برای تجزیه و تحلیل داده‌ها استفاده شد.یافته‌ها: شیوع فشار خون بالا و دیابت نوع دو در بیماران مبتلا به سرطان کولورکتال به ترتیب 38/13 درصد (با فاصله اطمینان 95 درصد: 8/15-1/11) و 69/8 درصد (با فاصله اطمینان 95 درصد: 7/10-0/7) بود. میانه‌ی زمان بقا در این بیماران به ترتیب 52/8 و 9/4 سال بود. بر اساس آزمون Log-rank تفاوت معنی‌داری بین بقای بیماران مبتلا به سرطان کولورکتال که به فشار خون بالا و دیابت نوع دو نیز مبتلا بودند، مشاهده نگردید (818/0 = P).نتیجه‌گیری: شیوع فشار خون بالا، بیشتر از دیابت است و با وجود کاهش بقای بیماران مبتلا به دیابت نوع دو در مقایسه با پرفشاری خون، دو بیماری متابولیک بر میزان بقای بیماران مبتلا به سرطان کولورکتال اثر یکسانی دارند. 

کلیدواژه‌ها

عنوان مقاله [English]

Comparing the Patterns of Hypertension and Type 2 Diabetes Mellitus in Patients with Colorectal Cancer

نویسندگان [English]

  • Hamid Nasri 4
  • Seyyed-Saeed Hashemi-Nazari 2
  • Zahra Molavi-Choobini 3
1 Assistant Professor, Department of Epidemiology and Biostatistics, School of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Assistant Professor, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Research and Technology Deputy, Shahrekord University of Medical Sciences, Shahrekord, Iran
4 Professor, Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Type 2 diabetes mellitus (DM) and hypertension are worldwide epidemic. Colorectal cancer (CRC) is the most prevalent gastrointestinal cancer in Iran. Prevalence of type 2 diabetes mellitus and hypertension in the patients with colorectal cancer had not reported in Iran, before this study.Methods: Overall, 2570 individual-year follow-ups were conducted for 1127 patients with colorectal cancer. For diagnosis of type 2 diabetes mellitus, fasting blood sugar and glycosylated hemoglobin tests were used and for that of hypertension, blood pressure was measured in two turns. The descriptive indices were calculated and the mean and median survivals, from colorectal cancer diagnosis time, were calculated using survival analysis and the comparison among survival times was done through log-rank test. Stata12 software  was used for data analysis.Findings: The prevalences of hypertension and type 2 diabetes mellitus in the patients with colorectal cancer were 13.38% (95% CI: 11.1-15.8) and 8.69% (95% CI: 7.0-10.7), respectively. Median survival time in patients with hypertension and diabetes mellitus were 8.52 and 4.90 years, respectively. According to log-rank test, no significant difference was observed between the survival time of patients with colorectal cancer suffering from hypertension and type 2 diabetes mellitus.Conclusion: The obtained findings in this study indicate that survival time in patients with type 2 diabetes mellitus is less than those with hypertension; but two metabolic diseases have same effect on survival rate of the patients with colorectal cancer.

کلیدواژه‌ها [English]

  • Colorectal Cancer
  • Median survival time
  • Hypertension
  • Type 2 Diabetes Mellitus

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مجله دانشکده پزشکی اصفهان
دوره 32، شماره 302 - شماره پیاپی 302
مهر و آبان 1393
صفحه 1537-1545

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سابقه مقاله

  • تاریخ دریافت: 30 خرداد 1393
  • تاریخ بازنگری: 31 فروردین 1403
  • تاریخ پذیرش: 17 فروردین 1401

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