摘要
目的探讨小儿急性淋巴细胞白血病(ALL)化疗肝损伤的发生率、相关因素及预后,并观察保肝药物的临床疗效。方法回顾性分析61例ALL患儿,统计其化疗肝损伤总体发生率及肝损伤程度构成比,不同性别、年龄、危险度分型、化疗阶段化疗肝损伤发生率及肝损伤程度的异同,化疗时存在感染及输血的患儿化疗肝损伤发生率的差别,化疗肝损伤后应用保肝药与未用保肝药物对预后的影响有无差异,各组差异比较采用χ2检验。结果 61例患儿中发生化疗肝损伤49例,其发生率为80%。其中轻度肝损伤占23%,中度肝损伤占39%,重度肝损伤占18%。不同性别、年龄、危险度分型化疗肝损伤发生率比较,差异无统计学意义(Pa>0.05)。不同化疗阶段肝损伤发生率差异有统计学意义(P<0.05),巩固治疗期较其他化疗阶段化疗肝损伤发生率明显偏低(P<0.005)。化疗中发生感染、输血可增高化疗肝损伤发生率(Pa<0.05)。应用保肝药与未用保肝药对化疗肝损伤预后的影响差异有统计学意义(P<0.05)。结论小儿ALL化疗肝损伤发生率较高。化疗肝损伤的发生率与患儿年龄、性别、危险度分型等因素无显著相关。化疗并感染是化疗肝损伤的高危因素,化疗输血也与化疗肝损伤相关,应用保肝药可显著提高化疗肝损伤的治愈率。
Objective To explore the incidence rate, related factors and prognosis, and the therapeutic effect of the liver - protective drugs on chemotherapy- induced liver disease in children with acute lymphoblastic leukemia （ALL）. Methods Sixty - one children with ALL were retrospectively analyzed ,including the incidence rate and the constituent ratio of chemotherapy -induced liver disease ; and the incidence rate and degree of liver injury when they were in different circumstances, such as different genders, ages, risk classification, stages of chemotherapy, with infection and blood transfusion during chemotherapy process were observed ; and the therapeutic effect when they were taking liver - protective drugs or not was compared. The differences between groups were analyzed by Chi - square test. Results The incidence rate of chemotherapy - induced liver disease was 80% , including 23% mild, 39% moderate and 18% severe liver disease. The incidence rate of chemotherapy - induced liver disease was not significantly correlated with age, gender, risk classification （ Pa 〉 0.05 ）. There were significant differences among 5 stages of chemotherapy（ P 〈0.05 ）. Furthermore, there were less incidence rate of chemotherapy -induced liver disease during the consolidation therapy（ P 〈 0. 005 ）. Infections and blood transfusion could increase the incidence rate of chemotherapy - induced liver disease （ Pa 〈 0.05 ）. There was a significant difference between the 2 groups whether taking the liver - protective drugs or not （ P 〈 O. 05 ）. Conclusions There is a high incidence rate of chemotherapy - induced liver disease in children with ALL. The chemotherapy-induced liver disease is not significantly correlated with age, gender, risk classification. Its important risk factors are infections and blood transfusion during chemotherapy process. Taking the liver - protective drugs can enhance the cure rate of the chemotherapy - induced liver disease in children with ALL.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第15期1174-1176,共3页
Journal of Applied Clinical Pediatrics
关键词
化疗
肝损伤
白血病
急性
淋巴细胞
chemotherapy
liver disease
leukemia, acute
lymphocytic
