去铁胺联合去铁酮对重型地中海贫血患儿血糖代谢的影响  

Effect of Deferoxamine Combined with Deferiprone on Glucose Metabolism in Children Patients with Thalassemia Major

作　　者：周传恩[1] 熊寿贵[1] Zhou Chuan＇en(Xiong Shougu;Zhuhai Maternal and Child Health Care Hospital,Zhuhai,Guangdong,China 51900)

机构地区：[1]广东省珠海市妇幼保健院,广东珠海519000

出　　处：《中国药业》2018年第13期46-49,共4页China Pharmaceuticals

摘　　要：目的探讨去铁胺(DFO)联合去铁酮(DFP)对重型地中海贫血患儿血糖代谢的影响及其影响因素。方法选择医院2010年1月至2017年12月收治的重型地中海贫血患儿114例,随机分为DFO组(48例)和DFO+DFP联合组(66例),疗程均为12个月。结果治疗12个月后,联合组患儿治疗总有效率为92.42%,空腹血糖(FBG)正常患儿比例为74.24%,均高于DFO组的77.08%和47.92%(P<0.05);联合组患儿的平均血清铁蛋白(SF)为(967.94±387.42)ng/m L,明显低于DFO组的(2 304.79±248.35)ng/m L(P<0.05);两组患儿FBG、空腹胰岛素(FIns)、胰岛素抵抗指数(HOMA-IR)均较治疗前降低,且联合组患儿指标低于DFO组患儿(P<0.05)。经DFO+DFP治疗后,血糖正常患儿年龄、病程、体质量指数、血清SF水平均低于血糖受损患儿(P<0.05)。结论去铁胺联合去铁酮可有效改善重型地中海贫血患儿铁过载及血糖代谢紊乱,疗效优于去铁胺单药治疗。Objective To investigate the clinical effect of deferoxamine（ DFO） combined with deferiprone（ DFP） on glucose metabolism in children patients with thalassemia major and its related influence factors. Methods Totally 114 children patients with thalassemia major admitted to our hospital from January 2010 to December 2017 were selected and randomly divided into the DFO group（ n = 48） and the DFO ＋ DFP combined group（ n = 66）. The two groups were treated for 12 weeks. Results After 12 months of treatment,the total effective rate and proportion of children patients with normal fasting blood glucose（ FBG） in the combined group were 92. 42% and74. 24%,respectively,which were higher than 77. 08% and 47. 92% in the DFO group（ P 0. 05）. The levels of serum ferritin in the combined group was（ 967. 94 ± 387. 42） ng/m L, which were significantly lower than（ 2 304. 79 ± 248. 35） ng/m L in the DFO group（ P 0. 05）. The levels of fasting blood glucose（ FBG）, fasting insulin（ FIns） and homeostasis model assessment of insulin resistance（ HOMA-IR） in the two groups were lower than those before treatment,and those in the combined group were lower than those in the DFO group（ P 0. 05）. In the combined group,the age,course of disease,BMI and the level of serum ferritin of children patients with normal glucose were lower than those of children patients with abnormal glucose（ P 0. 05）. Conclusion Deferoxamine combined with deferiprone in the treatment of thalassemia major can effectively improve iron overload and blood glucose metabolism disorder,the curative effect is better than that of deferoxamine alone.

关 键 词：去铁胺 去铁酮 重型地中海贫血 血糖代谢 铁代谢 

分 类 号：R969.4[医药卫生—药理学] R973.3[医药卫生—药学]