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[地中海贫血患者的β-胰腺功能。一项为期4年的随访]

[Beta-pancreatic function in subjects with thalassemia. A 4-year follow-up].

作者信息

Zanini R, Briante G, Cantone P, Sticca M, Grasso U

出版信息

Pediatr Med Chir. 1985 Sep-Oct;7(5):749-53.

PMID:3915549
Abstract

High Hb level transfusion scheme for treatment of thalassemia mayor has improved life prognosis but has increased also the incidence of Diabetes Mellitus. 10 patients with thalassemia major have been followed with OGTT for a period 4 years long (1979-1982). In 1979 we changed from low to high level transfusion regimen, and we began to use the pump for slow subcutaneous administration of desferrioxamine to treat iron overload. The results we obtained show a progressive increase of the average values in the insulinemic and glycemic plasma concentration from year to year. At the beginning of the follow-up period, insulinemic and glycemic values after OGTT showed a primitive pancreatic damage which evolved towards a better pancreatic function with the appearance of a peripheral insulin resistance. It is probable that both chronic hypoxia (low Hb level) and the iron overload (high Hb level) may cause, with different processes, an impairment of glucose metabolism.

摘要

高血红蛋白水平输血方案治疗重型地中海贫血虽改善了生存预后,但也增加了糖尿病的发病率。对10例重型地中海贫血患者进行了为期4年(1979 - 1982年)的口服葡萄糖耐量试验(OGTT)随访。1979年,我们从低水平输血方案改为高水平输血方案,并开始使用泵缓慢皮下注射去铁胺治疗铁过载。我们获得的结果显示,胰岛素血症和血糖血浆浓度的平均值逐年逐渐升高。在随访期开始时,OGTT后的胰岛素血症和血糖值显示出原发性胰腺损伤,随着外周胰岛素抵抗的出现,胰腺功能逐渐改善。慢性缺氧(低血红蛋白水平)和铁过载(高血红蛋白水平)都有可能通过不同的过程导致糖代谢受损。

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