磷脂酰肌醇-3-激酶抑制剂相关高血糖症1例并文献复习

Phosphatidylinositol-3-kinase inhibitor-associated hyperglycemia:a case report and literature review

目的探讨因使用阿培利司(Alpelisib,ALP)导致磷脂酰肌醇-3-激酶抑制剂(Phosphatidylinositol-3-Kinase Inhibitor,PI3Ki)相关高血糖症患者的临床特点。方法回顾分析1例确诊为PI3Ki相关高血糖症患者的临床资料,并复习相关文献。结果本例患者具有雌激素受体阳性(HR+)、人表皮生长因子受体2-阴性(HER2-)、PIK3CA突变乳腺癌病史,接受阿培利司治疗后,出现高血糖伴高胰岛素血症,入院予以二甲双胍、达格列净以及胰岛素治疗后,血糖控制可。结论PI3Ki相关高血糖症是阿培利司治疗最常见的副作用,建议使用阿培利司前行糖尿病危险因素筛查,并于治疗中密切监测血糖,尽早识别,及时干预,避免严重并发症发生。

Objective To investigate the clinical characteristics of phosphatidylinositol-3-kinase inhibitor(PI3Ki)-associated hyperglycemia caused by alpelisib.Methods The clinical data of a patient with PI3Ki-associated hyperglycemia were analyzed retrospectively,and the related literature was reviewed.Results The patient had a history of estrogen receptor positive(HR+),human epidermal growth factor receptor 2-negative(HER2-)and PIK3CA mutated breast cancer,and developed hyperglycemia with hyperinsulinemia after alpelisib treatment.The blood sugar of patients was controlled after metformin,dagliflozin and insulin treatment after admission to hospital.Conclusion PI3Ki-associated hyperglycemia is the most common side effect of alpelisib.It is recommended to screen for the risk factors of diabetes before using alpelisib,and closely monitor the blood glucose during treatment,in order to identify as soon as possible,and intervene in time to avoid serious complications.