标题：化疗相关性高血糖对急性淋巴细胞白血病患者生存状况的影响

      作者：王良妥，张湘兰，司徒健瑜，黄远颖
    (阳江市人民医院血液科，广东 阳江 529500)

      卷次： 2016年27卷7期

      【摘要】 目的 探讨急性淋巴细胞白血病(ALL)患者因化疗诱发的高血糖对预后的影响。方法 回顾性分析
我院2010年1月至2015年2月收集的62例ALL患者临床资料，按照是否伴随高血糖分为无高血糖组30例和高血
糖组 32例，比较化疗前后两组患者的临床特征及化疗后生存状况。结果 化疗前，所有患者血糖水平均显示正
常。化疗期间，无高血糖组患者血小板浓度低于50×109/L的发生率为30.00% (9例)，感染发生率为40.00% (12例)；
高血糖组血小板浓度低于50×109/L的发生率为56.25% (18例)，感染的发生率为65.62% (21例)，高血糖组患者血小
板降低和感染发生率显著高于无高血糖组(P<0.05)；无高血糖组的血小板平均浓度为(88.21±7.94)×109/L，明显高于
高血糖组的(52.79±8.73)×109/L，差异有统计学意义(P<0.05)；两组患者在Zubrod评分、白细胞数目、是否出现肝肿大
及核型Ph(+)等方面比较差异均无统计学意义(P>0.05)；高血糖组复发率为28.13% (9例)，无高血糖组患者无复发或
死亡情况发生(P<0.05)；无高血糖组患者的中位生存期为43.61个月，明显长于高血糖组患者的12.81个月，差异有
统计学意义(P<0.05)；高血糖组 5年无疾病生存率为 69.10%，明显低于无高血糖组的 100.00%，差异有统计学意义
(P<0.05)。结论 化疗治疗ALL诱发高血糖症状会增加临床并发症风险，增加患者复发和死亡风险。

      【关键词】 急性淋巴细胞白血病；高血糖；化疗；生存状况；预后

      【中图分类号】 R733.71 【文献标识码】 A 【文章编号】 1003—6350（2016）07—1080—03


Effect of chemotherapy-associated hyperglycemia on the survival of patients with acute lymphoblastic leukemia.
WANG Liang-tuo, ZHANG Xiang-lan, SITU Jian-yu, HUANG Yuan-yin.
Department of Hematology, Yangjiang People's
Hospital, Yangjiang 529500, Guangdong, CHINA

【Abstract】 Objective To investigate the effect of hyperglycemia induced by chemotherapy on prognosis of pa-
tients with acute lymphoblastic leukemia (ALL). Methods The clinical data of 62 patients with ALL collected in our
hospital from Jan. 2010 to Feb. 2015 were retrospectively analyzed. According to the level of blood sugar, the patients were
divided into hyperglycemia group (32 cases) and non-hyperglycemia group (30 cases). The clinical features before and after
chemotherapy and the survival status after chemotherapy were compared between the two groups. Results Before chemo-
therapy, the blood sugar levels of all the patients were in the normal range. During chemotherapy, the incidence of platelet
concentration below 50×109/L and the incidence of infection was 30.00% (9 cases) and 40.00% (12 cases) in the non-hyper-
glycemia group, which were significantly lower than those in the hyperglycemia group of 56.25% (18 cases) and 65.62% (21
cases), P<0.05. The average platelet concentration in the non-hyperglycemia group was (88.21±7.94)×109/L, significantly
higher than (52.79±8.73)×109/L in the hyperglycemia group, P<0.05. The two groups showed no statistically significant
difference in the Zubrod score, number of white blood cells, hepatomegaly and karyotype of pH (+), P>0.05. The recur-
rence rate of hyperglycemia group was 28.13% (9 cases), and no recurrence or death occurred in the non-hyperglycemia
group. The median survival time was 43.61 months in non-hyperglycemia group, which was significantly higher than
that in hyperglycemia patients (12.81 months), with statistically significant difference (P<0.05). The 5-year disease-free
survival rate of hyperglycemia group was 69.10%, which was significantly lower than that of non-hyperglycemia group
(100.00% ), and the difference was statistically significant (P<0.05). Conclusion Chemotherapy in the treatment of
ALL could induce hyperglycemia which results in the increase of recurrence risk and death rate.

      【Key words】 Acute lymphoblastic leukemia; Hyperglycemia; Chemotherapy; Survival; Prognosis
·论 著·
6350.2016.07.017