自体造血干细胞移植治疗1型糖尿病合并甲状腺功能减退2例*

背景：已有研究证实造血干细胞移植技术治疗1型糖尿病效果确切。 目的：观察自体造血干细胞移植治疗1型糖尿病合并甲状腺功能减退的安全性和有效性。 方法：免疫清除联合自体造血干细胞移植治疗1型糖尿病合并甲状腺功能减退患儿2例。经造血干细胞动员、采集、免疫抑制及造血干细胞回输治疗。治疗前后观察比较胰岛素、左旋甲状腺素钠用量、血清C肽质量浓度、糖化血红蛋白水平及甲状腺功能的差异。 结果与结论：1例患儿治疗后C肽质量浓度恢复正常，停用胰岛素，甲状腺素片减量，甲状腺功能正常；另1例患儿治疗后胰岛素减量64%，停用甲状腺素片，甲状腺功能正常。说明自体造血干细胞移植治疗1型糖尿病合并甲状腺功能减退的患儿是安全的，近期疗效明显。

Autologous hematopoietic stem cell transplantation for the treatment of type 1 diabetes mellitus combined with hypothyroidism in two cases

BACKGROUND: Previous studies have confirmed that the outcome of hematopoietic stem cell transplantation for treatment of type 1 diabetes mellitus is identified. OBJECTIVE: To observe the safety and efficacy of autologous hematopoietic stem cells transplantation in treatment of type 1 diabetes mellitus combined with hypothyroidism. METHODS: A total of two cases of type 1 diabetes mellitus and hypothyroidism were subjected to immune clearance and hematopoietic stem cell transplantation. The hematopoietic stem cell mobilization, collection, immune suppression and hematopoietic stem cell reinfusion all achieved satisfactory results. Insulin, levothyroxine sodium content, serum C peptide mass concentration, glycosylated hemoglobin level and thyroid gland function differences were compared prior to and following treatment. RESULTS AND CONCLUSION: C peptide mass concentration recovered to normal in 1 case following treatment. Insulin was withdrawn. Dose of thyroxine tablets was reduced and thyroid function resulted in the normal range. In another case, insulin dose reduced by 64%. Withdraw of thyroxine tablets resulted in normal thyroid function. These indicated that it is safe to treat type 1 diabetes mellitus combined with hypothyroidism, resulting in obvious short-term outcomes.