| Objective:To observe the heavy thalassaemia patients blood glucose abnor mallities, after stem cells transplantation on patients with transplantation to poor glucose metabolic disorder of incidence and the influence factors of sugar meta-bolism and the mechanism, for transplantation of patients with poor provide meaningful monitoring indicators.Method:Collect the first affiliated hospital of guangxi medical university for a full year after stem cells transplantation of heavy thalassaemia patients as transplantation group (95 cases, of which the male 65, female 30,3-20 years old, the median age of 6.7±2.9 years old, the time 12-111 month after transplantation, the median time of 12 ±111 months), to collect the corresponding age group did not receive stem cell transplantation in patients with poor to lean as the control group (103 cases, of which the male 70, female 33,3-20 years old, the median age of 6.8±2.8 years old) and healthy children as normal control group (54 cases, of which 37 male, female 17,3-15 years old, the median age of 6.6±2.6 years old), respectively to detect the fasting plasma glucose (FPG), fasting insulin (FINS), serum ferritin (SF), bone morphogenetic protein-9 (BMP-9) plasma concentration, and according to the HOMA formula to calculate the indexes of insulin resistance (HOMA IR) and insulin sensitive index (ISI).Results:For each group compared the results of correlation analysis:In 95 patients with transplant to lean,21 patients (22.11%) of short stature,12 patients (12.63%) of low weight; In poverty in the control group,38 cases (36.89%) of short stature,30 patients (29.13%) of the underground in weight;Transplantation group of patients with abnormal glucose metabolism in patients with a total of 10 cases (10.53%), including 8 cases of impaired fasting glucose (8.42%),2 cases (2.11%) for patients with diabetes, elevated fasting insulin in 8 cases (8.42%), apparent insulin resistance for 10 cases (10.53%); In 14 patients with poor control group (13.59%) in sugar metabolism disorder, in which 12 cases (11.65%) for impaired fasting glucose, and 2 cases (1.95%) for patients with diabetes, transplantation group and to lean the incidence of abnormal blood sugar control group two groups of patients compared with chi-square test results there was no evident difference in two groups, there is no statistical significance (P> 0.05). Transplantation group fasting plasma glucose and fasting blood glucose in patients with poor control group to also have no obvious difference (P> 0.05), but the transplant patients FINS, BMP-9 and HOMA-IR values were significantly higher than those in poor control patients and healthy children, and we have significant statistical significance difference (P< 0.05), while SF, ISI value is significantly lower than the poor in the control group, the difference was statistically significant (P< 0.05). In transplant patients with mild-to-mo-derate iron overload in 36 cases (37.89%), severe iron overload is 32 cases (33.68%); While on the ground and poor control in patients with mild-to-mo-derate overload of 41 cases (39.81%), severe iron overload is 55 cases (53.40%). BMP-9 in the secretion in the serum of patients with transplant group is most at a lower level, BMP-9 plasma concentration in patients group were significantly higher than those in the poor control at the same time significantly lower than the normal control group, the difference was statistically significant (P< 0.05). Blood sugar and influence glycemic index of partial correlation analysis results indicate:the FPG and SF, age, blood transfusion volume and weight, there is a positive correlation relationship with BMP-9 there is a negative correlation relationship, the higher the SF, level, age, blood transfusion, the more patients with FPG will is higher, and reduced level of BMP-9 can also lead to a rise in blood sugar. Factors influencing the blood sugar level of patients with age, SF levels, blood transfusion amount and BMP-9 levels, but from the point of specific R value and P value, the levels of SF, and BMP-9 is the main influence factors affect blood sugar.Conclusion:1,The heavy to poor patients received fasting glucose abnor-malities after hematopoietic stem cell transplantation and the occurrence of diabetes to did not receive the transplant and the poor patients were compared with no significant difference; 2, The influencing factors of transplant patients blood sugar disorder with the age of the transplant, blood transfusion amount, serum ferritin and plasma concentration of bone morphogenetic protein-9, the main influencing factors are the levels of serum ferritin and bone morphogenetic protein-9. |
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