白血病繼發(fā)糖尿病35例臨床分析

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1、白血病繼發(fā)糖尿病35例臨床分析白血病繼發(fā)糖尿病35例臨床分析中圖分類號：R733.7文獻(xiàn)標(biāo)識碼：A文章編號：1814-8824(2007)-9-0001-02摘要：目的對白血病繼發(fā)糖尿病35例患者進(jìn)行臨床分析，了解白血病繼發(fā)糖尿病的臨床特點。方法進(jìn)行骨髓細(xì)胞學(xué)檢查、血常規(guī)、空腹及餐后2小時血糖、胰島素水平和C肽的測定。結(jié)果化療前出現(xiàn)DM3例，血糖控制理想?；熀蟪霈F(xiàn)DM32例，18例用胰島索治療血糖控制理想，其中7例化療結(jié)束后不用胰島素血糖也正常；5例血糖控制尚可;9例血糖控制差。白血病CR4例(11.4%),PR13例(37.1%),緩解率為48.5%o總的治療效果比

2、我科同期白血病68.8%的完全緩解率明顯降低。死亡19例(54.3%),我科同期白血病死亡率33.8%,p<0.05o死亡患者空腹血糖顯著高于未死亡患者，感染患者空腹血糖顯著高于未感染患者。結(jié)論①白血病繼發(fā)糖尿病以化療后多見，白血病繼發(fā)糖尿病的分類以AML為主。②白血病患者易發(fā)生酮癥和血糖不易控制。③外周血白細(xì)胞數(shù)或骨髓原始細(xì)胞數(shù)越高，糖尿病發(fā)生率越高。④白血病繼發(fā)糖尿病患者完全緩解率明顯降低，死亡率增高，患者預(yù)后不良。關(guān)鍵詞白血病糖尿病ClinicalAnalysisof35CasesDiabetesSecondarytoleukemia?ZhouBai-lang,Q

3、iaoAi-guo.TheCentralHospitalofDazhoibDazhou635000,Sichuan,China?[Abstract]ObjectiveTocomprehendtheclinicalfeaturesofdiabetessecondarytoleukemia,theclinicaldataof35caseswithdiabetessecondarytoleukemiawereanalyzed?MethodTotesttheirbonemarrowcytomorphologicexaminationandbloodroutine,fasting

4、bloodglucoseand2hourpost-mealblood-glucose,theSeruminsulinlevelandC-peptide.ResultTherewere3caseswithDMbeforechems?Theyreceivedeanidealefficiencyofbloodglucose?18withDMafterchems?and18caseshasmadeanidealefficiencyofbloodglucosebyusinginsulintreatment?Theresponseratewas48.5%with4casesCR,1

5、3casesPR.Thetotaltherapeuticefficacywaslowersignificantlythansynchronizationofleukemiainourdepartment?Therewere19deathswithcase-fatalityratioof54.3%whichwashigherthansynchronizationofleukemia(themortalityratewas33.8%).Patientswhodiedhadsignificantlyhigherfastingserumglucosevaluesthanthos

6、ethosepatientswhosurvived?Andinfectedpatientswassignigicantlyhigherthanpatientswithoutinfected.Conclusion?Diabetessecondaryleukemiaoccurreafterchems,andAMLwerethemaincategorizationindiabetessecondaryleukemia?②Iliseasytooccurketonemiaandnoteasytocontrolbloodglucose?③Themorethequantityofpe

7、ripheralbloodleucocyteormarrowmyeloblasts,themorehighlytheincidencerateofdiabetes.4Thecompleteremmissionrateofdiabetessecondarytolwukemia.reducedobviouslyandthedeathrateincreased?Theprognosiswaspoor?[Keywords]Leukemia；Diadebets白血病繼發(fā)糖尿病多數(shù)病人無糖尿病典型的“三多一少”癥狀,確診吋血糖水平升高并不明顯，為提高