首页|1例结肠癌患者靶向联合化疗后血糖异常升高的病例分析

1例结肠癌患者靶向联合化疗后血糖异常升高的病例分析

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1例结肠癌患者使用贝伐珠单抗联合氟尿嘧啶2周期后出现腹痛伴恶心呕吐,完善检查发现血糖异常升高至40mmol·L-1,血气分析:酸碱度7。24,实际碳酸氢根4mmol·L-1,酮体+++,尿糖+++,判定为轻度糖尿病酮症酸中毒。经过大量补液和胰岛素、德谷门冬双胰岛素治疗后,血气分析和酮体、尿糖恢复正常,空腹血糖控制在8。6 mmol。L-1,病情稳定,但患者需要长期使用门冬胰岛素。对糖尿病酮症酸中毒与可疑药物进行关联性分析,评定糖尿病酮症酸中毒"可能"为贝伐珠单抗和氟尿嘧啶联合用药引起。查阅国内外文献,对肿瘤相关糖代谢异常进行了分析和总结,化疗药物或化疗辅助用药引起的血糖异常不容忽视,尤其是有糖尿病史或者糖尿病前期的肿瘤患者,以期为同类反应提供一定的参考。
Case analysis of abnormal increase in blood glucose after targeted combination chemotherapy in a patient with colon cancer
This article introduced a case of colon cancer patient who developed abdominal pain with nausea and vomiting after two cycles of using bevacizumab combined with fluorouracil.The perfect examination founded that the blood sugar rose abnormally to 40 mmol·L-1,the pH of blood gas was 7.24,the actual bicarbonate was 4 mmol·L-1,ketone body 3+,and urine sugar 3+.It was judged as mild diabetes ketoacidosis.After a large amount of fluid infusion,insulin treatment,and dual insulin treatment,The patient's blood gas analysis,ketone bodies,and urine sugar have all been normal,and their fasting blood sugar is controlled at 8.6 mmol·L1.The patient's condition was stable while long term use of insulin aspart was necessary.According to the association evaluation method of the National ADR Monitoring Center,the author evaluated the association of diabetes ketoacidosis,and assessed that diabetes ketoacidosis"may"be caused by the combined use of bevacizumab and fluorouracil.Through consulting domestic and foreign literature,the author analyzed and summarized tumor related glucose metabolism abnormalities,realized that abnormal blood glucose caused by chemotherapy drugs or chemotherapy adjuvant drugs can not be ignored,especially in tumor patients with diabetes history or pre diabetes.Hope the analysis can provide a certain reference for similar reactions.

Diabetic ketoacidosisHigh blood sugarFluorouracilBevacizumab

吴燕、王鑫

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苏州市中西医结合医院药剂科(江苏苏州 215101)

苏州市中西医结合医院肾病内分泌科(江苏苏州 215101)

糖尿病酮症酸中毒 高血糖 氟尿嘧啶 贝伐珠单抗

2024

药物流行病学杂志
中国药学会 武汉医药(集团)股份有限公司

药物流行病学杂志

CSTPCD
影响因子:0.746
ISSN:1005-0698
年,卷(期):2024.33(2)
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