Bakk Ian, Koch Terah, Stanek Joseph, O'Brien Sarah H, Reed Suzanne
The Ohio State University College of Medicine.
Divsion of Hematology/Oncology/Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, OH.
J Pediatr Hematol Oncol. 2018 Jan;40(1):27-30. doi: 10.1097/MPH.0000000000000997.
Childhood acute lymphoblastic leukemia achieves excellent cure rates in part due to induction chemotherapy including high dose corticosteroids. Hypertension (HTN) is a known complication of corticosteroids, but incidence and risk factors for steroid-induced HTN are poorly understood. We sought to describe these using a large pediatric health database. Of the 5578 unique patients receiving induction chemotherapy, 14.7% received anti-HTN medications during their initial hospital admission. We found that age below 1 year, obesity, secondary diabetes mellitus, and abnormal glucose were associated with developing steroid-induced HTN. We also found that ICD-9 codes had poor sensitivity for detecting treatment of HTN, suggesting underreporting by physicians.
儿童急性淋巴细胞白血病之所以能取得优异的治愈率，部分原因在于包括大剂量皮质类固醇在内的诱导化疗。高血压（HTN）是皮质类固醇已知的一种并发症，但对于类固醇诱导的高血压的发病率和危险因素，人们了解甚少。我们试图通过一个大型儿科健康数据库来描述这些情况。在5578名接受诱导化疗的独特患者中，14.7%在首次住院期间接受了抗高血压药物治疗。我们发现，1岁以下的年龄、肥胖、继发性糖尿病和血糖异常与发生类固醇诱导的高血压有关。我们还发现，国际疾病分类第九版（ICD - 9）编码在检测高血压治疗方面的敏感性较差，这表明医生报告不足。
