摘要
【目的】研究及探讨重型β-地中海贫血(β-TM)儿童接受异基因造血干细胞移植(allo-HSCT)后糖稳态的临床特点及其影响因素。【方法】回顾性分析在中山大学孙逸仙纪念医院接受HSCT治疗的41例β-TM儿童患者的随访资料,通过实验室检查评估糖稳态特点并分析相关影响因素。【结果】41.46%(17/41)的患儿在HSCT后发生糖稳态异常,其中82.35%(14/17)表现为胰岛素抵抗,但未发现糖尿病病例。胰岛素释放试验及口服葡萄糖耐量试验(OGTT)结果显示,45.00%(9/20)患者存在胰岛素释放曲线异常,40.00%(8/20)出现葡萄糖高峰延迟。糖稳态异常组的平均移植年龄显著高于正常组[(8.8±3.9)岁vs(6.0±3.1)岁,P=0.015]。【结论】β-TM患儿HSCT后仍有发生糖稳态异常可能,以胰岛素抵抗为主。移植年龄较大(≥7岁)是β-TM患儿HSCT后发生糖稳态异常的危险因素。建议对β-TM患儿HSCT后定期监测糖稳态指标,尤其是高龄移植者。
【Objective】To investigate and explore the characteristics and influencing factors of glucose metabolism in children withβ-thalassemia major(β-TM)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).【Methods】The follow-up data of 41 patients withβ-TM who underwent HSCT at Hematopoietic Stem Cell Transplantation Department of Children´s Medical Center of Sun Yat-sen Memorial Hospital,Sun Yat-sen University were retrospectively analyzed.Their glucose metabolism characteristics were evaluated through laboratory tests and the related influencing factors were analyzed.【Results】In the study,41.46%(17/41)of patients developed abnormal glucose homeostasis after HSCT.Among them,82.35%(14/17)characterized by insulin resistance,but no cases of diabetes mellitus were found.The results of insulin releasing test and oral glucose tolerance test(OGTT)showed that 45.00%(9/20)of patients had abnormal insulin releasing curve and 40.0%(8/20)had delayed serum glucose peak.The average age of HSCT in abnormal glucose homeostasis group was significantly older than that in the normal glucose homeostasis group[(8.8±3.9)years old vs(6.0±3.1)years old,P=0.015].【Conclusions】Patients withβ-TM after HSCT may develop abnormal glucose homeostasis,consists largely of insulin resistance.The elder age of HSCT(≥7 years old)is a risk factor for abnormal glucose homeostasis inβ-TM patients after HSCT.It is recommended to regularly monitor glucose metabolism indicators inβ-TM children after HSCT,especially in elderly transplant recipients.
作者
戴蕙莲
林少汾
张丽娜
欧辉
刘祖霖
徐宏贵
黄科
梁立阳
DAI Huilian;LIN Shaofen;ZHANG Lina;OU Hui;LIU Zulin;XU Honggui;HUANG Ke;LIANG Liyang(Department of Pediatrics,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510000,China)
出处
《中山大学学报(医学科学版)》
北大核心
2025年第6期1071-1078,共8页
Journal of Sun Yat-Sen University:Medical Sciences
基金
市校(院)联合资助项目基础与应用基础研究(202201020298)。
