儿童类固醇性糖尿病2例报道

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目的:分析儿童类固醇性糖尿病的临床特点,提高对该病的认识。方法:回顾性分析山西省儿童医院收治的2例类固醇糖尿病患儿临床表现、体征、实验室检查结果。结果:2例儿童类固醇性糖尿病均无多饮、多尿及体质量减轻等糖尿病典型临床表现,均以餐后血糖明显升高为主要临床表现。1例患儿于糖皮质激素治疗2个月后发生,激素总量1 700 mg,胰岛素治疗7周后血糖恢复正常;另1例患儿于激素治疗20 d后发生,激素总量1 000 mg,激素减量12周后,血糖恢复正常。结论:大剂量长疗程使用糖皮质激素易引起类固醇糖尿病,激素减量可能使血糖恢复正常,胰岛素为治疗类固醇糖尿病的首选药物。 Objective: To analyze the clinical characteristics of children with steroid-induced diabetes and improve their understanding of the disease. Methods: Two children with steroid diabetes admitted to Shanxi Children’s Hospital were retrospectively analyzed for clinical manifestations, signs and laboratory findings. Results: There was no typical clinical manifestations of diabetes in 2 children with steroid-induced diabetes mellitus such as polyhydramnios, polyuria, and weight loss. Both of them showed the postprandial hyperglycemia as the main clinical manifestation. One patient developed glucocorticoid therapy two months later, with a total hormone dose of 1 700 mg and normal blood glucose levels returned to normal after 7 weeks of insulin therapy. Another patient developed hormone 20 mg after hormone therapy After 12 weeks of hormone reduction, blood glucose returned to normal. CONCLUSIONS: High dose and long course of treatment with glucocorticoids can cause steroid diabetes. Hormone reductions may make blood sugar return to normal. Insulin is the drug of choice for the treatment of steroid diabetes.
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