白血病继发糖尿病35例临床分析

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1、白血病继发糖尿病35例临床分析白血病继发糖尿病35例临床分析中图分类号：R733.7文献标识码：A文章编号：1814-8824(2007)-9-0001-02摘要：目的对白血病继发糖尿病35例患者进行临床分析，了解白血病继发糖尿病的临床特点。方法进行骨髓细胞学检查、血常规、空腹及餐后2小时血糖、胰岛素水平和C肽的测定。结果化疗前出现DM3例，血糖控制理想。化疗后出现DM32例，18例用胰岛索治疗血糖控制理想，其中7例化疗结束后不用胰岛素血糖也正常；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%),缓解率为48.5%o总的治疗效果比

2、我科同期白血病68.8%的完全缓解率明显降低。死亡19例(54.3%),我科同期白血病死亡率33.8%,p<0.05o死亡患者空腹血糖显著高于未死亡患者，感染患者空腹血糖显著高于未感染患者。结论①白血病继发糖尿病以化疗后多见，白血病继发糖尿病的分类以AML为主。②白血病患者易发生酮症和血糖不易控制。③外周血白细胞数或骨髓原始细胞数越高，糖尿病发生率越高。④白血病继发糖尿病患者完全缓解率明显降低，死亡率增高，患者预后不良。关键词白血病糖尿病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白血病继发糖尿病多数病人无糖尿病典型的“三多一少”症状,确诊吋血糖水平升高并不明显，为提高