环孢素诱发血糖升高

Cyclosporine-caused blood glucose elevation

1例27岁女性患者因白细胞减少症和血小板减少症给予口服司坦唑醇（2 mg，3次/d）、再造升血片（4片，3次/d ），皮下注射非格司亭（150μg，1次/d ）、重组人白细胞介素11（2 mg，1次/d）、重组人促红素（10000 U，3次/周），静脉滴注头孢美唑（2 g，2次/d），以及成分输血等治疗。用药前空腹血糖5.3 mmol/L。18 d后诊断为再生障碍性贫血，加用环孢素125 mg，2次/d口服。加药第28天，患者空腹血糖升至9.8 mmol/L，予饮食控制。第36天，空腹血糖8.2 mmol/L。第45天，空腹血糖达10.7 mmol/L，餐后2 h血糖为18.7 mmol/L，将环孢素剂量改为100 mg，2次/d，并加用二甲双胍500 mg，2次/d口服，且严格执行糖尿病饮食。第47天，空腹血糖7.3 mmol/L；第55天，空腹血糖5.4 mmol/L，餐后2 h血糖11.3 mmol/L。

A 27-year-old female patient received oral stanozolol 2 mg thrice daily and 4 Zaizao Shengxue tablets（再造升血片）thrice daily,subcutaneous injection of filgrastim 150 μg once daily, recombinant human interleukin-11 2 mg once daily,and recombinant human erythropoietin 10 000 U thrice weekly,and an intravenous infusion of cefmetazole 2 g twice daily combined with supportive treatment of blood component transfusion for leukopenia and thrombopenia. Her fasting blood glucose was 5. 3 mmol/L before the medication. Eighteen days later,aplastic anemia was diagnosed and oral cyclosporine 125 mg twice daily was added to the regimen. On day 28 of adding cyclosporine,the level of fasting plasma glucose increased to 9. 8 mmol/L and the patient＆#39;s diet restricted. On day 36,the level of fasting plasma glucose was 8. 2 mmol/L. On day 45,the level of fasting plasma glucose and 2-hour post-meal blood glucose were respectively 10. 7 mmol/L and 18. 7 mmol/L. The dose of cyclosporine was adjusted to 100 mg twice daily and diabetic diet was given strictly. On day 47,the level of fasting plasma glucose was 7. 3 mmol/L and on day 55,the level of fasting plasma glucose was 5. 4 mmol/L and the 2-hour post-meal blood glucose was 11. 3 mmol/L.