患儿急性淋巴细胞白血病的诱导治疗期间高血糖的危险因素和临床影响
Yassin Y Taher1, Leslie Lehmann2, Manal Zamzam3
1Pediatric Oncology Department, Children's Cancer Hospital Egypt (CCHE-5737), Cairo, Egypt.
International journal of cancer
|August 13, 2025
概括
高血糖 (高血糖) 在诱导治疗期间影响了近一半的儿科急性淋巴细胞白血病 (ALL) 患者. 这种并发症增加了侵入性真菌感染和败血症相关死亡的风险.
科学领域:
- 儿科瘤学 儿科瘤学
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
背景情况:
- 在成人急性淋巴细胞白血病 (ALL) 诱导治疗期间的高血糖与不良结果有关.
- 在诱导疗法期间,高血糖症对儿科ALL患者的影响尚不清楚.
研究的目的:
- 在诱导过程中确定儿科ALL患者高血糖的发病率.
- 在这个人群中识别与高血糖相关的危险因素.
- 评估高血糖症对侵入性真菌感染和败血症相关死亡率的影响.
主要方法:
- 在2016年至2019年期间治疗的1711名儿科ALL患者的回顾性分析.
- 根据随机血糖水平,患者被分为明显高血糖症 (≥200 mg/dL),轻度高血糖症 (140-199 mg/dL) 和高血糖症.
- 使用多变量分析来确定风险因素和评估结果.
主要成果:
- 高血糖症发生在45.2%的儿科ALL患者中 (15.4%明显,29.8%轻度).
- 风险因素包括女性性别,年龄≥10岁,肥胖,家族糖尿病史,初始白细胞数量高和唐氏综合征.
- 过度高血糖症与侵袭性真菌感染率 (26.1%) 和与败血症相关的死亡率 (15.2%) 与轻度高血糖症和euglycemia组相比显著更高.
结论:
- 高血糖是儿童ALL的诱导治疗期间常见和显著的并发症.
- 它与侵入性感染的风险增加和与败血症相关的死亡率有关.
- 建议及早识别高风险患者,监测血糖,并预防感染,以改善结果.
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