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目的了解非霍奇金淋巴瘤合并糖尿病患者使用糖皮质激素后的血糖变化情况,明确糖皮质激素在非霍奇金淋巴瘤合并糖尿病患者应用的安全性。方法回顾性分析2011年1月至2013年6月本院收治的46例非霍奇金淋巴瘤合并2型糖尿病住院患者使用含糖皮质激素化疗方案后血糖变化情况,与同一时间本院收治的单纯糖尿病患者不使用激素时的血糖变化情况进行比较。结果含激素方案化疗后空腹血糖的变化与对照组差异无统计学意义(P>0.05)。相反激素使用后午餐后2 h血糖的变化与对照组比较差异有统计学意义(P<0.01),多数病例需增加降糖药物或胰岛素,2组均未出现糖尿病酮症酸中毒等不良反应。结论 2型糖尿病合并非霍奇金使用含激素方案化疗是相对安全的,但需加强对血糖的监测,特别是餐后2 h血糖,并及时给予增加降糖药物或胰岛素,避免发生糖尿病酮症酸中毒及高渗性昏迷等严重并发症。
Objective To investigate the changes of blood glucose in patients with non-Hodgkin’s lymphoma and diabetes mellitus after glucocorticoids and to clarify the safety of glucocorticoid in patients with non-Hodgkin’s lymphoma and diabetes mellitus. Methods A retrospective analysis of 46 patients with non-Hodgkin’s lymphoma and type 2 diabetes treated with glucocorticoid chemotherapy in our hospital from January 2011 to June 2013 was retrospectively analyzed. Simple diabetic patients without hormones when the blood glucose changes were compared. Results There was no significant difference in fasting blood glucose between patients with and without hormone therapy after chemotherapy (P> 0.05). In contrast, the changes of blood glucose at 2 h after the use of hormones were significantly different from those of the control group (P <0.01). In most cases, hypoglycemic drugs or insulin need to be added. No adverse reactions such as diabetic ketoacidosis were observed in the two groups. Conclusion Type 2 diabetes combined with non-Hodgkin’s use of hormone-containing chemotherapy is relatively safe, but need to strengthen the monitoring of blood glucose, especially 2 h postprandial blood glucose, and timely increase in hypoglycemic drugs or insulin, to avoid diabetic ketosis Acidosis and hypertonic coma and other serious complications.