柔红霉素联合阿糖胞苷化疗影响胰岛β细胞功能的研究

Effect of daunorubicin combined with cytarabine chemotherapy on the functions of islet β-cells

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 effect of daunorubicin and cytarabine chemotherapy on islet β-cell dysfunction. Methods 27 patients with acute non-lymphocyte leukemia （ANLL） were selected and accepted standard DA （daunorubicin ＋ Cytarabine） chemotherapy for two cycles. Before and after the chemotherapy, an insulin release test, the blood sugar average value, insulin average value, area under the blood sugar curve, area under the insulin curve and exponential functions of islet β-cells were determined. Results After chemotherapy, blood glucose curve points increased at each time point, especially at points of an empty stomach, half an hour and 1 hour （ P 〈 0. 05 ） ; the area under the blood sugar curve aggrandized significantly （ P 〈 0. 05 ） ; the area under the insulin curve was obviously reduced （ P 〈 0.05 ） ; and the exponential of β-cell functions decreased. Conclusion Daunorubicin and cytarabine do certain damage to the functions of islet β-cells in patients who suffer from leucocythemia without diabetes, and may cause diabetes.