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目的观察柔红霉素联合阿糖胞苷化疗对胰岛β细胞功能的影响。方法选择初诊急性非淋巴细胞白血病(ANLL)患者27例,采用标准DA(柔红霉素+阿糖胞苷)化疗方案,化疗2个周期。所有患者化疗前后均行胰岛素释放试验,观察化疗前后患者血糖均值、胰岛素均值、血糖曲线下面积、胰岛素曲线下面积及胰岛β细胞功能指数的变化。结果化疗后,患者血糖曲线各点血糖均值较化疗前有所增高,其中以空腹、0.5 h、1 h增高明显(P<0.05);胰岛素曲线各点胰岛素均值较化疗前有所减少(P<0.05);血糖曲线下面积较化疗前明显增大(P<0.05),胰岛素曲线下面积较化疗前减小(P<0.05),胰岛β细胞功能指数较化疗前降低(P<0.05)。结论柔红霉素联合阿糖胞苷对非糖尿病白血病患者的胰岛β细胞有一定的损伤,有可能导致糖尿病的发生。
Objective To observe the effects of daunorubicine and cytarabine chemotherapy on the function of islet β cells. Methods Twenty-seven patients with newly diagnosed acute non-lymphocytic leukemia (ANLL) were enrolled in this study. The standard DA (daunorubicin + cytarabine) chemotherapy regimen was used for 2 cycles of chemotherapy. All patients underwent insulin release test before and after chemotherapy. The changes of blood glucose, mean insulin, area under the curve of blood glucose, area under the curve of insulin and function index of pancreatic β-cells were observed before and after chemotherapy. Results After the chemotherapy, the mean blood glucose of each point in the curve of blood glucose was higher than that before chemotherapy, which was significantly higher at fasting, 0.5 h and 1 h (P <0.05); the mean of insulin in each point of insulin curve was lower than that before chemotherapy (P < 0.05). The area under the curve of blood glucose was significantly higher than that before chemotherapy (P <0.05), and the area under the curve of insulin was lower than that before chemotherapy (P <0.05). The function index of pancreatic β cells was lower than that before chemotherapy (P <0.05). Conclusion Combination of daunorubicin and cytarabine may damage pancreatic β-cells in patients with non-diabetic leukemia, which may lead to the development of diabetes.